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Eczema

Eczema refers to an inflammation of the skin that causes itching and redness in the affected area. Often you will hear doctors use the term Dermatitis to explain this condition as well. Both words describe the same condition

The term eczema is broadly applied to a range of persistent skin conditions. Eczema may affect anyone of any age, including infants. Symptoms include dryness and recurring skin rashes which are characterized by one or more of these symptoms: redness, skin edema (swelling), itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding.

What Causes Eczema?


Causes of Eczema vary. Here’s a quick review of the main types of Eczema and causes:

  • Atopic Eczema appears to have some hereditary basis and seems to run in families with histories of asthma and hay fever.
  • Contact Eczema (often called dermatitis) is caused by
  •  A delayed allergic response to exposure to an allergen. This allergen may be almost anything from the fragrance or color in detergent to the dander from a family pet. The top metal allergen is nickel, found in many fashion earrings. Plants can cause eczema, as is the case of poison ivy.
  •  A near-immediate response from skin contact with a substance that provokes irritation.
  • Xerotic eczema (also known as winter itch) is a form of eczema that is characterized by changes that occur when skin becomes abnormally dry, itchy, and cracked. Lower legs tend to be especially affected, although it can appear in the underarm area as well. Xerotic eczema is common in elderly people, though it is not uncommon for people in their 20s. It can appear in red, bumpy, pimple-like irritations.
  • Seborrhoeic eczema (also known simply as seborrhea) is a skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the sebum-gland rich areas of skin.

Where Does Eczema Occur?


Eczema can occur anywhere on the body. It’s most common in the creases of the elbows and wrists, and behind the knees but some have eczema on large areas of the body. It also affects babies’ faces, in particular the cheeks and may show up in infancy.

Children can’t manage eczema on their own and will scratch an itch no matter what! Scratching can cause infection so alleviating the itch is important both for your child’s comfort and for health. Our Board-Certified physicians and medical staff can provide effective solutions to help your child be as comfortable and untroubled as possible.

torrance childhood eczema

Eczema Flare Avoidance


tarzana eczema children

An Eczema ‘flare’ can be triggered by any number of things. Each person’s ‘flare’ triggers are different, but there are many common triggers to watch out for. Materials that irritate the skin, like wool, can cause flares. Extreme temperatures (high or low), infection, and stress can also lead to flares. People with eczema are often sensitive to soaps, perfumes, smoke, and paints, as well as allergens, which often include pollen, pets, and certain food allergies.

Suggestion? Keeping a diary of flare-ups will help you to identify your own personal triggers.

Avoidance techniques to try:

  • Avoid foods that cause eczema flares
  • Avoid soaps that contain fragrances or deodorants
  • Avoid contact with scratchy or synthetic fabrics
  • Avoid irritating cosmetics and personal hygiene products
  • Reduce stress
  • Avoid extreme temperatures and temperature changes, which can result in excessively dry or sweaty skin (Avoidance Techniques Source – Healthology)

Treatments for Eczema


Corticosteroids

Corticosteroids block certain substances made by the body that result in inflammation. Topical corticosteroids, which are rubbed on the skin, reduce inflammation of the skin, and are the most common treatments used for eczema. There are low-strength corticosteroids, like some hydrocortisones, but often doctors will prescribe stronger topical corticosteroids, depending on the severity of symptoms.

Phototherapy

Phototherapy uses ultraviolet A or B light waves, and is reserved for children over 12 and adults. It is very much like a tanning bed, and, like tanning beds, can cause skin cancer if used too much, for too long. Doctors use the minimum exposure necessary to ease itching and reduce inflammation.

Antibiotics

Antibiotics can be prescribed to treat secondary infections associated with eczema. Medications used to fight infection can come in ointment or pill form and are taken for a set period of time.

Antihistamines

Sedating antihistamines, which are best to take at bedtime, can help ease severe itching associated with eczema, and help restless sleepers and “scratchers” to sleep. The sedating antihistamines are more effective at relieving itching than the newer, non-sedating antihistamines, but these drugs cause drowsiness, and can affect an adult’s ability to work and think, and children’s ability to learn if taken during the day.

Immunomodulators

Topical immunomodulators (TIMs) are a new class of steroid-free drugs that have proven effective in the treatment of mild to moderately severe eczema. These drugs work by altering the reactivity of the immune cells in the skin. Elidel (pimecrolimus), which comes in a cream-based formula, and Protopic (tacrolimus), an ointment-based drug, belong to this class of medications. Side effects are usually limited to a mild burning upon application.

Non-steroidal, topical immunomodulators control acute inflammation without the side effects associated with long-term steroidal treatments. They can also be used on sensitive skin where corticosteroid use is restricted and in people who experience relapsing flares after discontinuing a course of steroidal treatments.

Immunosupressants

In severe cases of eczema that do not respond to any other treatment, an immunosuppressive drug, like cyclosporine, may be used for a short time although the safety and effectiveness of cyclosporine in children has not been clearly established by clinical trials. These drugs block the production of some of the body’s immune cells and curb the effect of others. They can provide relief from very serious eczema flares, but this improvement while on the drug often does not continue after the drug course is over. Side effects include hypertension and kidney problems, nausea, tingling or numbness, headaches, and a possible increase in cancer risk.

Practical Recommendations


Key to the effective prevention of eczema flares is moisturizer for the skin. Bland, non-fragranced ointments and creams will help prevent dryness. As dry skin is more prone to eczema flare-up, keeping the skin moisturized is especially important.

Soap can be the enemy when you have eczema. A main ingredient in many household cleansers is sodium lauryl sulfate, a surfactant. This and sodium laureth sulfate – common component of soaps – can be mildly to severely irritating to eczematic skin.

Choosing a soap

  • Avoid harsh detergents, drying soaps and scented soaps
  • Choose a soap that has an oil or fat base; a “super fatted” goat milk soap is best
  • Patch test your soap choice, by using it only on a small area until you are sure of its results
  • Use a non-soap based cleanser . Cetaphil and Aveeno Moisturizing Bar are examples
  • Use a cleanser recommended by your dermatologist

Resources


*For any procedure and service described on this website, individual results may vary and may not be applicable in all cases.