Eczema (Atopic Dermatitis)

Symptoms include: Dry, itchy skinCracks behind the ears or in other skin creasesRashes on the cheeks, arms, and legsRed, scaly skinThick, leathery skinSmall, raised bumps on the skinCrusting, oozing, cracking, or scaling of the skinWorsening in the winter, when inside air is dry due to central heating DiagnosisYour doctor will ask about your symptoms and medical history, and perform a physical exam. You may be referred to a doctor who specializes in skin disorders (a dermatologist) and/or allergies (an allergist). Treatment The main goals of eczema treatment are to: Heal the skin and keep it healthyStop scratching or rubbingAvoid skin infectionPrevent flare-upsLearn to avoid scratchingTreatment options may vary and your doctor may recommend more than one depending on your condition. They include: Skin CareAvoid hot or long (15 minutes or more) baths or showers.Use mild, unscented bar soap or nonsoap cleanser sparingly.Air-dry or gently pat dry after bathing and apply gentle moisturizer immediately.Treat skin infections immediately. MedicationsPrescription creams and ointments containing cortisone, tacrolimus, or pimecrolimusIn the most severe cases, oral medications such as prednisone or cyclosporineAntibiotics applied directly to the skin or taken by mouth (only for treating infections)Prescription or over-the-counter antihistamines to help prevent itching PhototherapyTreatment with ultraviolet light (by a doctor) PreventionIt can be difficult to prevent eczema, particularly when there is a strong family history. Some studies suggest that breastfeeding reduces a childs risk of developing eczema. But if you already have eczema, there are several things you can do to try to control it:

Follow guidelines for limiting house dust mites in bedding.Avoid direct contact with wool to the skin.Seek advice from your doctor about any use of natural or herbal remedies. Some of these may worsen eczema.Avoid scratching or rubbing whenever possible.Follow your doctors recommendations for treatment. Improvement may take several weeks or even months after a new medication is started.Maintain a cool stable environment and consistent humidity levels.Recognize and limit emotional stress. RESOURCES: American Academy of Allergy, Asthma, and Immunologyhttp://www.aaaai.org The American Academy of Dermatologyhttp://www.aad.org The National Eczema Societyhttp://www.eczema.org CANADIAN RESOURCES: Canadian Dermatology Associationhttp://www.dermatology.ca/english/ Dermatologists.cahttp://www.dermatologists.ca/index.html References: American Academy of Allergy, Asthma, and Immunology website. Available at: http://www.aaaai.org . American Academy of Dermatology website. Available at: http://www.aad.org . Barnetson RS, Rogers M. Childhood atopic eczema. BMJ . 2002;324:1376-1379. Brehler R, Hildebrand A, Luger T. Recent developments in treatment of atopic eczema. J Am Acad Dermatol . 1997;36:983-994.

Holscher B, Frye C, Wichmann HE, Heinrich J. Exposure to pets and allergies in children. Pediatr Allergy Immunol . 2002;13:334-341. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ . Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet . 1995;346:1065-1069. Wahn U, Bos JD, Goodfield M, et al. Efficacy and safety of pimecrolimus cream in the long-term management of atopic dermatitis in children. Pediatrics . 2002;110(1 Pt 1):e2. Last reviewed November 2007 by Ross Zeltser, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.