Eczema

Eczema, also known as dermatitis, refers to a group of skin conditions that cause the skin to become irritated or inflamed. It is a common skin problem that affects about one in every five people at some point in their lives.

Eczema rashes vary in appearance and location, usually occurring as dry, cracked skin that becomes red and inflamed. The skin can also become swollen or blistered, and with frequent scratching over time may result in thickened areas of skin (lichenification). In the palms, fingers and soles, eczema can also appear as tiny “bubble”-like blisters (pompholyx eczema). In more severe cases of eczema, swelling and blistering can occur, and infection can complicate eczema.

Types of eczema include:

  • Atopic eczema
  • Allergic contact dermatitis
  • Irritant contact dermatitis
  • Seborrheic dermatitis
  • Discoid eczema
  • Pompholyx eczema
  • Varicose eczema
Treatment of eczema

Your dermatologist will try to identify and tackle the contributing factors that may be causing you eczema. Patch testing may be performed to identify a causative agent if your dermatologist suspects a contact allergy (allergic contact dermatitis).

Maintaining a good general skin care routine is important, especially as dermatitis can be a long-term affliction:

  • Keep your skin well moisturized by applying an emollient liberally and often, especially after bathing and when feeling itchy; avoid perfumed products where possible.
  • Take brief baths and showers, bathing between five and ten minutes to reduce evaporation.
  • Avoid hot water, use warm water instead.
  • Use a non soap-based cleanser as soaps tend to dry the skin out.
  • Always moisturize immediately after bathing.
Medications your dermatologist may prescribe include:
  • Topical steroids – These are used to control the inflammation of red and itchy areas. Different potencies are used on different sites.
  • Topical calcineurin inhibitors – Such as pimecrolimus and tacrolimus. These are newer anti-inflammatory creams with fewer side effects than topical steroids.
  • Topical PDE-4 Inhibitor – Crisaborole is the newest non-steroidal cream to eczema, can be used in children as young as 3 months old
  • Oral antibiotics – may be required if an infection is complicating or causing the eczema.
  • Antihistamine tablets – These may be prescribed to help reduce irritation and itching. They are particularly useful at night.
  • Other treatments – may include systemic steroids, or immunosuppressants in severe refractory cases.
  • Biologics – Dupilumab is FDA approved for moderate to severe eczema