We know: 1-Minute Lesson on Eczema

What is eczema?

Eczema is a term used for various inflamed skin conditions. Atopic dermatitis is one of the most common forms of eczema, and the one many people mean when they say eczema.

Tell me more about the form of eczema called atopic dermatitis?

In atopic dermatitis, the skin becomes extremely itchy. Scratching leads to redness, swelling, cracking, "weeping" clear fluid, and finally, crusting and scaling. It's chronic, but not contagious. The word atopic means an inherited tendency to develop other allergic conditions, such as asthma and hay fever.

Who gets eczema or atopic dermatitis?

It often begins in infancy and childhood. Scientists estimate that 65 percent of patients develop symptoms in the first year of life, and 90 percent develop symptoms before the age of 5. Onset after age 30 is less common and is often due to exposure of the skin to harsh or wet conditions.

What are the symptoms?

The most common symptoms of atopic dermatitis are dry, itchy skin and rashes on the face, inside the elbows and behind the knees, and on the hands and feet.

What causes this type of eczema?

The cause of atopic dermatitis is not known, but the disease seems to result from a combination of genetic (hereditary) and environmental factors.

Atopic dermatitis is also associated with malfunction of the body's immune system. Scientists have found that people with atopic dermatitis have a low level of a cytokine (a protein) that is essential to the healthy function of the body's immune system and a high level of other cytokines that lead to allergic reactions.

What are the treatments for this kind of eczema?

Because eczema is chronic, it's often best to work with your doctor to treat eczema. Many things such as fabrics, soaps, perfumes and smoke can irritate the problem. So life style changes can be helpful in avoiding allergens and managing the disease.

The two main goals in treating atopic dermatitis are healing the skin and preventing flares. These may be assisted by developing skin care routines and avoiding substances that lead to skin irritation and trigger the immune system and the itch-scratch cycle.

What about medications?

Medications that are used to treat eczema include:

Immuno-modulators that help control inflammation and reduce immune system reactions when applied to the skin. Examples of these medications are tacrolimus ointment (Protopic*) and pimecrolimus cream (Elidel).
Topical corticosteroid creams and ointments, which come in both over-the-counter and prescription varieties.
Corticosteroid taken by mouth or injection, such as prednisone. Typically, these medications are used only in resistant cases and only given for short periods of time.
Antibiotics to treat skin infections may be applied directly to the skin in an ointment, but are usually more effective when taken by mouth.
Antihistamines that cause drowsiness can reduce nighttime scratching and allow more restful sleep when taken at bedtime. This effect can be particularly helpful for patients who scratch in the nighttime.
Cyclosporine, methotrexate, or azathioprine, may be prescribed for adults to treat severe cases of atopic dermatitis that have failed to respond to other forms of therapy.

Any other treatments?

Phototherapy, or the use of ultraviolet A or B light waves, alone or combined, can be an effective treatment for mild to moderate dermatitis in older children (over 12 years old) and adults.