Eczema: Symptoms and Treatment
Up to 15 million Americans are afflicted with the chronic skin disorder eczema, the vast majority of them infants and children who have a strong chance of eventually outgrowing the condition.
Characterized by dryness, inflammation and itching that can occur anywhere on the body, eczema is typically triggered by an allergy-like response to certain substances or situations, according to the Cleveland Clinic.
Symptoms & Causes
Eczema often strikes people with a history of asthma, hay fever and other allergies, according to the National Institutes of Health (NIH). In adults, rashes are usually found on the insides of knees and elbows, along with the neck, hands and feet.
About 90 percent of eczema patients develop the condition before age 5, according to the National Eczema Association. In infants and small children, rashes usually begin on the face, scalp, hands and feet.
For all patients, symptoms include:
- Skin redness or inflammation
- Itchy patches
- Scaly or crusted lesions that thicken when repeatedly scratched
- Small, fluid-filled blisters that ooze
- Ear discharge or bleeding
- Skin pigment changes
While it appears to run in families, eczema's exact cause is unknown. However, symptoms flare or worsen when exposed to specific triggers, such as:
- Allergens, including pollen, pet hair, dander, mold and foods such as eggs, wheat, nuts and dairy products
- Skin irritants, including perfumes, harsh soaps, chemicals, alcohol-containing skin products, wool or tight clothing
- Water, especially hot baths
- Colds or flu
- Climate conditions such as heat and low or high humidity
Diagnosis & Tests
Eczema is remarkably simple to diagnose by looking at a patient's skin and their personal and family history. However, other conditions should first be ruled out and sometimes a skin biopsy will be taken to analyze its cells under a microscope, according to the NIH.
Treatments & Medications
Eczema treatment depends largely on the severity of symptoms. For minor cases, some over-the-counter (OTC) products can reduce itching and skin redness. These include oral antihistamines, topical antibacterial and antifungal creams, and topical creams or ointments containing the steroid cortisone, which reduces inflammation.
More severe cases warrant prescription-strength cortisone products, including pills and topical creams. Additionally, the U.S. Food and Drug Administration approved a new class of drugs called topical immunomodulators (TIMs), which alter the body's response to allergens. Non-steroidal TIMs include tacrolimus (known as the brand name Protopic) and pimecrolimus, according to the National Eczema Association.
Phototherapy, which uses special lamps to bathe skin lesions in ultraviolet light, may also improve acute eczema, according to the Cleveland Clinic.
Avoiding triggers and minimizing scratching go a long way toward coping with eczema. According to the NIH and the Cleveland Clinic, effective home care can include:
- Applying cold compresses to reduce severe itching
- Cutting children's fingernails short to curtail scratching
- Keeping skin moist with multiple applications of lotions and ointments each day, especially after bathing
- Using less soap than usual
- Taking shorter baths or showers
- Avoiding sudden temperature and humidity changes
- Wearing clothes made with cotton (not wool)
- Wearing gloves for jobs that require putting hands in water
- Drinking eight glasses of water a day to keep skin moist
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