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All about eczema

Published in Skin Care, Pediatrics Author: Elizabeth Blixt,MD Author: Elizabeth Blixt, MD

A four-month-old has dry, scaly patches on his cheeks and scalp; a 2-year-old has a red, raised rash on her back, arms and legs which also presents on other parts of her body; a 40-year-old has red, dry patches in the creases of his elbows and knees which become very itchy and irritated.

All of these scenarios can describe eczema, also known as atopic dermatitis. Eczema affects the skin's ability to hold moisture. The skin becomes itchy, dry and easily irritated. The cause of eczema is usually unclear. The symptoms and triggers of eczema are different for everyone and can change over time. Many people who have eczema have a family history of allergies or asthma.

Eczema signs and symptoms

  • Itchy skin
  • Dry, sensitive skin
  • Red, inflamed skin
  • Dark colored patches of skin
  • Tiny, white bumps
  • Rough patches of skin that feel leathery or scaly
  • Oozing or crusting
  • Areas of swelling

If you or your child has experienced any of the above signs or symptoms, it may be eczema. A provider can diagnose eczema, evaluate if you should have allergy testing and advise you on a treatment plan to keep the eczema under control.

Eczema treatment

A health care provider will tailor treatment measures to your specific eczema triggers and symptoms. Treatment may include:

  1. Moisturizers. Keeping the skin moisturized is key to preventing eczema from worsening or spreading to other parts of the body, also known as a “flare-up.” Take a lukewarm shower or bath, but do not soak with soap or bubble bath. Use a plain, fragrance-free soap only to areas where soap is needed (under arms and undergarment areas), towel off gently and apply moisturizer such as Vanicream, Vaseline or Aquaphor as soon as possible to help lock in the moisture. Try to moisturize the skin two to four times a day.
  2. Topical steroid cortisone creams. When the eczema goes from mild to moderate or severe, topical steroid (cortisone) creams can help control the eczema and get it back to your baseline. The creams vary in strength from the extremely mild over-the-counter hydrocortisone cream, to mild, medium, strong and very strong prescription creams. The strength of the cream prescribed will depend on the location and severity of the eczema.
  3. Avoid skin irritants. Use a mild, fragrance-free and dye-free laundry detergent. Double rinse the wash to help get all the detergent out. Avoid fabric softener and dryer sheets. Wash all new clothes. Choose cotton clothing, sheets and blankets, which can be less irritating to the skin. Do not use scented lotions, soap or bubble bath. Try to keep the humidity of at 25 to 40 percent in your home. During the dry winter months, use a humidifier in your room and run air conditioning in the summer to help keep the humidity stable.