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Eczema

What is Eczema?

Eczema is a skin condition that affects more than 31 million Americans and can appear anywhere on the body. It is normally first noticed as itchy, uncomfortable red patches, although symptoms and severity can vary. The term, “eczema,” encompasses a group of common, and in most cases very manageable, conditions that cause inflamed skin. There are several types of eczema, and with proper treatment and care, many people with eczema can manage flares and symptoms with the help of their dermatologist. 

What are the types of Eczema? 

There are several types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema and nummular eczema.  Each type of eczema has its own triggers and treatment requirements, and some people experience more than one form of eczema. When you first notice symptoms of eczema, it is important to talk with your dermatologist to understand the best treatment options, as well as how to learn how to prevent or minimize flare-ups.

Atopic dermatitis

A chronic and inflammatory form of eczema that leads to dry, scaly skin, redness or purplish patches, itching, rashes or open sores during flare-ups. While the exact cause is unknown, it occurs as an immune system response to allergens or irritants.

Contact dermatitis

A form of eczema that occurs when an irritating substance or allergen touches the skin. Common irritants include detergents, fumes, astringents, certain soaps or artificial fragrances. It most commonly appears on the hands or parts of the body that encounter the allergen.

Dyshidrotic eczema

Leads to small, fluid-filled blisters on the feet and hands, frequently on the edges of fingers, toes or soles of the feet. It can be triggered by stress, moisture, exposure to nickel in jewelry or allergies. It also leads to itching and scaly or cracked skin.

Nummular eczema

Can occur at any age and appears as coin-shaped spots that are extremely itchy. Triggers are thought to be insect bites, dry skin or skin inflammation.

What are some Eczema symptoms? 

  • Itchy patches of skin
  • Changes in skin tone (commonly appearing as redness in lighter skin tones and purple or ashy patches in darker skin tones)
  • Raised patches
  • Open or “weeping” sores
  • Dry, sensitive skin
  • Areas of swelling

What are some Eczema treatment options? 

Topical corticosteroids: These are anti-inflammatory creams or ointments that can help reduce itching and inflammation. They work by suppressing the immune system and reducing inflammation in the skin. They are available in different strengths, and your doctor will prescribe the appropriate strength based on the severity of your eczema. It is important to follow your doctor's instructions carefully when using these medications, as overuse or prolonged use can lead to side effects such as thinning of the skin.

Emollients: These are moisturizing creams or ointments that can help keep the skin hydrated and prevent dryness. They work by forming a protective barrier over the skin, which helps to lock in moisture. This can be particularly helpful for people with eczema, as dry skin can exacerbate symptoms such as itching and inflammation.

Topical calcineurin inhibitors: These are non-steroidal creams or ointments that can help reduce inflammation and itching. They work by blocking certain immune system cells from producing inflammatory substances. They are generally considered safe for long-term use, but may cause side effects such as burning or stinging at the application site.

Phototherapy: This involves exposing the skin to controlled amounts of natural or artificial light to help reduce inflammation and itching. It is typically done in a doctor's office or clinic, and involves several sessions over a period of weeks or months. It can be an effective treatment option for people with moderate to severe eczema who have not responded well to other treatments.

Systemic medications: These are prescription medications that are taken orally or by injection to help reduce inflammation throughout the body. They are typically reserved for people with severe eczema who have not responded well to other treatments. Examples of systemic medications include corticosteroids, immunosuppressants, and biologic drugs.

It is important to talk to Dr. Greenberg about which treatment options may be best for you based on the severity of your eczema and your overall health. Dr. Greenberg may recommend a combination of treatments to help manage your symptoms and improve your quality of life.

What are some over-the-counter treatments for Eczema? 

Anyone with eczema should adhere to a skincare routine that includes products with gentle ingredients. Gentle soaps and cleansers such as Cetaphil, CeraVe and Dove white bar soap should be used, while harsh, fragranced soaps such as Dial, Irish Spring and Lever should be avoided. Stringents with ingredients like alcohol or salicylic acid and harsh washing tools like loofahs and scrub brushes should also be avoided. Patients with eczema should keep in mind that long, hot showers can exacerbate symptoms, and a cream-based emollient should be applied twice daily--especially after showering.

At Sunshine State Dermatology and Skin Cancer Center, Dr. Greenberg will work with you to understand your lifestyle, symptoms and concerns to develop the best treatment plant to manage your eczema and flare-ups.