October is Eczema Awareness Month. And, since this itchy skin condition impacts more than 30 million people in the U.S., it’s important to spread the facts about the condition to help people improve the health of their skin. At U.S. Dermatology Partners in Fairfax, Virginia, Dr. Kathleen Ellison works on a regular basis with children and adults who suffer from this condition. In this blog, Dr. Ellison discusses some of the common symptoms, causes of this skin condition, and what you can do to prevent and treat flareups.
What is Eczema?
According to Dr. Ellison, “Eczema is a dry, itchy skin condition that occurs due to inflammation and sensitivity to allergens and irritants. The skin is unable to retain moisture and becomes dry, inflamed, and itchy.” There are several different varieties of eczema. The main types are:
- Atopic dermatitis – This is the most common form of this condition. It causes redness, irritation, and itching usually on the face, arms, and legs. It often develops for the first time in childhood and can be triggered in adults typically in conjunction with allergies.
- Contact dermatitis – This form occurs when the skin is exposed to an environmental irritant or a substance they’re allergic to.
- Dyshidrotic eczema – More common in women than in men, this form is typically concentrated at the edges of the fingers, toes, palms, and soles of feet. It is most common during the spring allergy season.
- Nummular eczema – This is a complicated skin condition that is hard to diagnose and treat because it affects people so differently. The name comes from the Latin word for coin because the flareups tend to be coin-shaped. Unlike other forms, nummular eczema is not genetic.
- Seborrheic dermatitis – This is a chronic form of the condition that impacts people of all ages, but it is most common in infants (often called cradle cap) and adults between the ages of 30 and 60. It is most concentrated near the oil-producing (sebaceous) glands that it takes its name from, including the upper back, nose, and scalp.
- Stasis dermatitis – This form develops due to circulation problems, usually in the lower legs. Pressure builds up in the veins causing fluid to leak out under the skin. This causes discoloration, swelling, scaling, and itching.
Approximately 10-20% of the population develops eczema, with most developing it during infancy or childhood. Dr. Ellison says, “Eczema appears differently in infants, children, and adults. The condition can occur anywhere on the body of infants. In children, eczema commonly appears on the folds of the elbows, knees, and ankles. And in adults, eczema is commonly located on the neck, elbows, and knees.” About half of people with childhood eczema will grow out of it as an adult. However, for those who continue to have the condition into adulthood, their symptoms are generally milder than in childhood.
What Causes Eczema?
Eczema is complex, and researchers are hard at work to discover the exact causes. The different types may have more specific underlying causes, but in general, researchers have indicated that eczema is due to a combination of genetic predisposition, external triggers, and one’s immune system. If you have family members who struggle with the eczema, you are much more likely to struggle with this condition. Eczema can also be linked to allergies and asthma, though it is possible for patients to have one condition without the other.
Eating certain foods does not cause this condition. However, since those with eczema are more prone to allergies, it can be common for the two conditions to coexist. Before making dietary changes, be sure to talk to your pediatrician and dermatologist.
In order to control this condition, you should become aware of your triggers. Some of the common triggers that lead to flareups for sufferers include:
- Dry skin
- External irritants (chemicals, smoke, metals, medications, perfumes)
- Stress
- Sweating
- Extreme heat and cold
- Infections
- Allergies
- Hormonal fluctuation
How Do I Know I Have Eczema?
Because specific forms of eczema can have differing symptoms, it’s always best to talk to a dermatologist and receive an official diagnosis and treatment plan. Some of the common warning signs you should be aware of include:
- Skin that is sensitive to perfumes, dyes, and chemicals in common products like laundry detergent, body wash, and dish soap
- Generally dry skin and/or patches of dry or flaky skin
- Red, discolored, or inflamed skin
- Itching and irritation of the skin
- Darker-colored and/or rough patches of skin
- Oozing or seeping sores
- Swelling near sites of irritated skin
What Treatments are Available for Eczema?
Unfortunately, there is no cure for eczema. However, there are numerous medications, at-home skincare routines, biologic prescriptions, and laser and phototherapies that can help when you experience a flare-up. When you work with a dermatologist like the skilled specialists at U.S. Dermatology partners, you can create a plan personalized to your unique experience that helps you reduce the number and severity of flareups. Some of the most common treatment recommendations include:
- Over-the-counter (OTC) ointments – moisturizing and healing ointments are readily available in your local pharmacy. If you try one that doesn’t seem to help you, try another product. Each person experiences different symptoms, and they may respond to different OTC treatment options.
- Prescription topical treatments – if OTC ointments aren’t effective, you may also want to consider prescription-strength topical treatments. Depending on your condition, these ointments may include corticosteroids, PDE4 inhibitors, calcineurin inhibitors (sometimes called TCIs), and skin barrier creams.
- Phototherapy – this treatment utilizes a machine that emits a narrowband UVB ray. When applied to skin affected by eczema, phototherapy can reduce itching, decrease inflammation, improve vitamin D production, and encourage healthy immune function.
- Oral medications – while there’s not one specific cause of eczema, it is likely that the immune system plays a role in eczema flareups. An overreaction in the immune system can lead to itching, irritated, and inflamed skin. For this reason, we may prescribe an immunosuppressant to treat eczema.
- Intravenous biologics – injected as an infusion, biologics are created to target specific immune functions that may be likely to trigger flareups.
Can I Prevent Eczema Flareups at Home?
According to Dr. Ellison, “Prevention is an essential aspect of every eczema treatment plan. We highly recommend making a plan to help prevent flareups, improve moisture levels and heal the skin.” Everyone is different, but some of the steps we recommend include:
- Partner with a dermatologist to create a personalized care plan
- Learn your triggers (a dermatologist can help you track and pinpoint external and internal factors that cause flareups)
- Implement a bathing and moisturizing routine to keep skin free of bacteria and prevent dryness and infection
- Use medications (OTC and prescriptions) as directed by your dermatologist
- Reduce stress and develop healthy coping techniques when stress arises
- Avoid itching or scratching at the areas of skin impacted by eczema
Dr. Ellison gives the following tips for at-home care, “Use thick creams and ointments to moisturize and repair the skin. Since fragrances and wools can be irritating, avoid these products. Instead, use fragrance-free products and wear gentle fabrics. Avoid contact with air pollutants such as cigarette smoke and try to optimize temperature and humidity in your home.”
When Should I Contact U.S. Dermatology Partners?
If it’s your first eczema flareup or 400th, U.S. Dermatology Partners can help. We offer guidance to determine your triggers, advanced treatment for severe or chronic eczema, and work with patients to achieve healthy skin and reduce uncomfortable symptoms. To get started, simply fill out our online request form. One of our knowledgeable team members will be in touch soon to discuss your treatment options and schedule your visit.
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