Eczema is a chronic problem for an estimated 35 million Americans. One to 3 percent affected are adults and 10-20 percent affected are children. Seventy percent of cases start in children younger than 5 years old, and about 60 percent of infants who have eczema continue to have one of more symptoms into adulthood. With proper treatment, the disease often can be controlled.
October is National Eczema Awareness Month and the National Eczema Association has launched a campaign to raise awareness of what eczema is and how those that have it suffer.
What is eczema?
Eczema is a general term for a set of chronic skin conditions caused by inflammation. Atopic dermatitis (AD) is the most common type and has been called “the itch that rashes.” The word “atopic” means an allergy that is usually hereditary, and “dermatitis” is defined as inflammation of the skin.
Symptoms of eczema
No matter which part of the skin is affected, eczema is almost always itchy. Sometimes the itching will start before the rash appears, but when it does, the rash most commonly appears on the face, back of the knees, wrists, hands or feet. It may also affect other areas as well.
Affected areas usually appear very dry, thickened, or scaly. In fair-skinned people, these areas may initially appear reddish and then turn brown. Among darker-skinned people, eczema can affect pigmentation, making the affected area lighter or darker.
In infants, the itchy rash can produce an oozing, crusting condition that happens mainly on the face and scalp, but patches may appear anywhere.
What Causes Eczema?
The exact cause of eczema is unknown, but it's thought to be linked to an overactive response by the body's immune system to an irritant.
In addition, eczema is commonly found in families with a history of other allergies or asthma. Also, defects in the skin barrier could allow moisture out and germs in.
Some people may have "flare-ups" of the itchy rash in response to certain substances or conditions. For some, coming into contact with rough or coarse materials may cause the skin to become itchy. For others, feeling too hot or too cold, exposure to certain household products like soap or detergent, or coming into contact with animal dander may cause an outbreak. Upper respiratory infections or colds may also be triggers. Stress may cause the condition to worsen.
Although there is no cure, most people can effectively manage their disease with medical treatment and by avoiding irritants. The condition is not contagious and can't be spread from person to person.
Treatment for eczema
The goal of treatment for eczema is to relieve and prevent itching, which can lead to infection. Since the disease makes skin dry and itchy, lotions and creams are recommended to keep the skin moist. These products are usually applied when the skin is damp, such as after bathing, to help the skin retain moisture. Cold compresses may also be used to relieve itching.
Over-the-counter products, such as hydrocortisone 1% cream, or prescription creams and ointments containing corticosteroids, are often prescribed to lessen inflammation. In addition, if the affected area becomes infected, antibiotics to kill the infection-causing bacteria may be prescribed by your doctor.
Other treatments include antihistamines to lessen severe itching, tar treatments (chemicals designed to reduce itching), phototherapy (therapy using ultraviolet light applied to the skin), and the drugcyclosporine for people whose condition doesn't respond to other treatments.
The FDA has approved two drugs known as topical immunomodulators (TIMs) for the treatment of mild-to-moderate eczema. The drugs, Elideland Protopic, are skin creams that work by altering the immune system response to prevent flare-ups. However, both drugs carry the FDA’s “black box” warning because there is a possible cancer risk associated with their use. The warning advises doctors to prescribe short-term use of Elidel and Protopic only after other available eczema treatments have failed in adults and children over the age of 2. It should not be used in kids under age 2.
Preventing eczema flare-ups
Eczema outbreaks can sometimes be avoided or the severity lessened by following these simple tips.
- Moisturize every day.
- Wear cotton or soft fabrics. Avoid rough, scratchy fibers and tight clothing.
- Take lukewarm baths and showers, using mild soap or non-soap cleanser
- Gently pat your skin dry with a soft towel – do not rub.
- Apply a moisturizer within three minutes after bathing to “lock in” moisture.
- When possible, avoid rapid changes of temperature and activities that make you sweat.
- Learn your eczema triggers and avoid them.
- Use a humidifier in dry or cold weather.
- Keep your fingernails short to help keep scratching from breaking the skin.
- Some people with allergies find it helps to remove carpets from their house, and give pets dander treatments.
- Use unscented, mild skincare and sunscreen productswith no additives or chemicals.
Written by Cristi Driver