Eczema, also known as Atopic Dermatitis, is a common rash treated by dermatologists. Eczema can start in early childhood but can affect any age group. Eczema is seen on the skin as red, flaky patches of dry skin. It can be extremely itchy and can have a strong negative impact of quality of life.
Many treatments exist for eczema. Use of a mild soap and a good moisturizing cream after every shower or bath is helpful. Prescription topical therapies include topical steroids and calcineurin inhibitors. Occasionally, patches of eczema may become infected, requiring antibiotics. For moderate-severe eczema which does not respond to topical treatment, there are oral and injectable options as well.
What is causing my eczema?
Eczema is caused by a combination of environmental and genetic factors. Eczema is more common in dry climates (including Colorado) and in the winter. It can be aggravated by harsh soap, hot water, and even certain types of clothing. Genetic factors involve a disruption of the barrier function of the skin, allowing more water to escape and more irritants to enter the skin. People with eczema also have an imbalance in some immune system functions particular to the skin.
What are the symptoms of eczema?
Eczema most commonly appears as a red, flaky, itchy rash. It can affect skin anywhere on the body, but has a predilection for the creases of the elbows and knees, the wrists and ankles, and the hands. Sometimes, patches of eczema can become infected. When this happens, the skin become more red, painful, warm, and weeping. Chronic eczema can lead to thickening of the skin in the affected area.
What can I do for my eczema prior to seeing the dermatologist?
We recommend short, luke warm showers. It is important to use a mild soap, such as Dove. After showering, towel dry lightly and apply a thick moisturizing cream, such as Cetaphil or Cerave, to damp skin.
If you have slightly red and itchy patches of skin, you can try over the counter hydrocortisone cream twice daily. If the patch has not resolved after two weeks of use, it may be time to see the dermatologist.
Dermatitis is a broad term referring to inflammation in the skin. The most common types of dermatitis are allergic and irritant contact dermatitis. Allergic contact dermatitis occurs when your skin comes into contact with something you're allergic to. Examples of allergens include perfume, nickel, and certain preservatives. Irritant contact dermatitis occurs after exposure to irritating chemicals such as harsh soaps and detergents. Prolonged exposure to water is also a cause of irritant dermatitis.
Other types of dermatitis include seborrheic dermatitis (dandruff), stasis dermatitis, and nummular dermatitis.
Your dermatologist will determine which type of dermatitis you have and will prescribe the appropriate treatment.
How can I tell which type of dermatitis I have?
The differences between the various types of dermatitis can be subtle. Your dermatologist will take a thorough history to aid in the diagnosis. It is important to note what products you have used recently, and if you have had any environmental exposures (such as to poison ivy).
Is it possible I could be reacting to a product I've used for years?
Yes. While it is more common to develop a reaction to a products you've used several times, many people develop sensitivities to products they have used to years.
Is there a way to determine what I'm reacting to?
Apart from taking a careful history, noting any new products or exposures, your dermatologist may recommend a patch test. A patch test is performed by taping a panel of allergens to your back. A reading is taken several days after the test is applied, and it can be helpful in determining the specific allergen you're reacting to.
How long will my rash last?
Once you eliminate the allergen or irritant from your environment, allergic contact dermatitis and irritant contact dermatitis should improve. It may be necessary to use a topical steroid to speed resolution of the rash.
If you have allergic contact dermatitis, your allergy is life long, and you will need to avoid that allergen in the future to prevent recurrence of your rash.