Eczema

A common skin condition, atopic dermatitis is frequently described as “the itch that rashes”. Intensely itchy patches form. These patches can be widespread or limited to a few areas. Scratching often leads to redness, swelling, cracking, “weeping” of clear fluid, crusting, and scaling of the skin. Constant scratching can cause skin damage, infection, and sleep loss. This is a common skin disease in children. It is so common that people have given it a few names:

Eczema (name most people use)
Dermatitis
Atopic (a-top-ic) eczema
Atopic dermatitis

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To avoid confusion, we’ll use the medical term atopic dermatitis. Ten to 20 percent of children and 1 to 3 percent of adults develop atopic dermatitis, making it the most common type of eczema. For 60 percent or more, atopic dermatitis begins during the first year of life, and at least 80 percent have the condition before age 5. While rare, atopic dermatitis can first appear at puberty or later.

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Diagnosis

Effective treatment requires a correct diagnosis; however, it is not always easy to distinguish one type of eczema from another or from similar skin conditions. Your doctor has the medical training and experience needed to determine if eczema is present, and if present, which type. To diagnose eczema, your doctor examines the skin and asks about:

When the skin condition first appeared
Signs and symptoms, such as long-term pruritus (itching) or recurring dermatitis (inflammation of the skin)
Certain circumstances that may aggravate the condition, such as excessively dry air or emotional stress
Family medical history, including questions about close blood relatives who have asthma, hay fever, or eczema
Personal medical history

In some cases, a skin biopsy may be performed to rule out other causes

Treatment

Once eczema is diagnosed, a treatment plan will be made based on:

Type and severity of the eczema present
Age, health, and medical history

The primary goal of treatment is to relieve discomfort by controlling the signs and symptoms. Since eczema is usually dry and itchy, most treatment plans involve applying creams or ointments to keep the skin as moist as possible. The treatment plan also may require lifestyle modifications and using medication as directed. A topical (applied to the skin) medication may be prescribed to help relieve itching and inflammation. In extreme or refractory cases, systemic medications may be indicated such as Dupixent.

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