Eczema: What to Do About This Common But Complex Skin Condition

The exact cause of eczema is unknown, but there are plenty of contributing factors.

eczema

The most common places for eczema to appear are the cheeks, wrists, hands, behind the knees, in the creases of elbows, and on the buttocks.

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Eczema is common and complicated. It’s not one condition; it’s at least seven. In one form or another, eczema affects more than 30 percent of the U.S. population.

Up to 18 million Americans have symptoms of atopic dermatitis (AD), the most common type of eczema. Ninety percent of those who get AD do so before the age of 5, and half of them continue to have symptoms for a lifetime. It’s manageable but not curable. Atopic dermatitis is not contagious, but it runs in families. The symptoms are different in adults than they are in children. Its cause is a mystery.

The list of quirky facts about eczema/atopic dermatitis (the two terms will be used synonymously in this report) goes on and on, but here are some important ones to remember.

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Eczema Symptoms

Common symptoms of eczema can include:

  • Dry, scaly skin
  • Itchy skin
  • Thickened or cracked skin
  • Rash that is red, swollen, and sore
  • Rash that gets worse with scratching
  • Rash or bumps that may leak clear fluid
  • Rash that becomes infected

The most common places for the rash to appear are the cheeks, wrists, hands, behind the knees, in the creases of elbows, and on the buttocks. Flares (or flare-ups) among those who have had AD as children tend to be milder in adulthood.

Causes and Triggers

The exact cause of eczema is unknown, but there are plenty of contributing factors. You’re more likely to have atopic dermatitis if a family member has it, or if you have allergies, hay fever, or asthma.

The connection has to do with a genetic variation that alters the skin’s ability to protect itself. The crossed signals also cause the body to overreact to outside forces—triggers—including:

  • Scratchy clothes
  • Cleaning products
  • Soaps
  • Dust
  • Animal dander and saliva
  • Feeling too hot or too cold
  • Perspiration
  • Stress

Foods (nuts, dairy products, eggs, fruit juices, soy products, wheat) do not cause AD, according to the American Academy of Dermatology, but food allergies may make it worse.

Studies have also shown that those who have been diagnosed with irritable bowel syndrome and also suffer from eczema, hay fever, and/or asthma are more likely to develop leaky gut syndrome. For more information, check out “5 Top Reasons You Might Have Leaky Gut Syndrome and Feel Tired All the Time.”

The list of triggers is long, but not every person’s body responds to every trigger. Part of prevention is knowing which substances or events cause your particular symptoms and avoiding them.

Eczema Diagnosis and Treatment

Diagnosis by a family doctor or dermatologist is relatively straightforward. It consists of a person’s medical history, observation of symptoms, and perhaps a blood or patch test.

Treatments for eczema can include:

  • Corticosteroids
  • Antibiotic, antiviral, and antifungal drugs if AD is accompanied by a skin infection.
  • Antihistamines, which can reduce the itching and scratching associated with AD, but should be taken at bedtime because they can cause drowsiness.
  • Light therapy (phototherapy), which uses ultraviolet rays to treat moderate cases of dermatitis.

Corticosteroids are still the treatment of choice, but the FDA has approved newer and effective gels, foams, and oils. In March 2017, the FDA approved dupilumab (Duprixent) in injection form to treat adults with moderate to severe AD. The medication is intended for patients whose eczema is not controlled by topical drugs or for whom topical therapies are not advisable.

For information on how you can treat eczema naturally, check out “What is Eczema and How Can You Treat It Naturally?”

Prevention of Eczema

Among the home measures you can take is to apply an over-the-counter moisturizer/body lotion every day, doing so within three minutes of bathing or showering to capture moisture.

“One of the biggest mistakes people can make in terms of skin care in general is not using moisturizers,” says UCLA dermatologist, Lorraine Young, MD.

Here are others preventive measures:

  • Take lukewarm baths (so that hot water doesn’t trigger a flare-up).
  • Wear soft fabrics, not scratchy ones.
  • Use mild or non-soap products when washing.
  • Use a humidifier in dry or cold weather.

The Big Picture

The atopic dermatitis variety of eczema comes with lots of baggage. Knowing what to look for and what to do about it won’t cure the skin disorder, but it can make living with AD less painful and less stressful.

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