Eczema/Atopic Dermatitis

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A common skin condition, atopic dermatitis is frequently described as “the itch that rashes.” Scratching often leads to redness, swelling, cracking, “weeping” of clear fluid, crusting, and scaling of the skin. Intensely itchy patches form, which can be widespread or limited to a few areas.

Between 10 and 20 percent of people worldwide develop atopic dermatitis, making it the most common type of eczema. For an estimated 65 percent‚ atopic dermatitis begins during their first year of life, and 90 percent have the condition before age 5. While rare, atopic dermatitis can first appear at puberty or later.


 

Infantile Eczema

When atopic dermatitis begins during infancy, it often is called infantile eczema. In infants, the itchy patches tend to develop on the scalp and face, especially on the cheeks. When atopic dermatitis develops in an infant or young child, the child tends to get better with time. For some children, the condition completely resolves by age two.

Infantile eczema/atopic dermatitis

Eczema in Later Life

Atopic dermatitis also can be a lifelong condition. Fortunately, it tends to become less severe with age. During the teenage and young-adult years, the itchy patches often develop on the elbows and knees. Other common sites for these patches are the hands, feet, ankles, wrists, face, neck, and upper chest. Patches are not limited to these areas; they can appear anywhere on the body, including around the eyes and on the eyelids.

In teens and adults, patches of atopic dermatitis are typically dry, red to brownish gray, and may be scaly or have thickened skin.

 

Hand Eczema

Having —or having once had—atopic dermatitis increases the risk of developing hand eczema. Some people who see their atopic dermatitis clear during adolescence develop hand eczema as adults. About 50 percent of those who develop atopic dermatitis continue to experience skin inflammation as adults, often in the form of hand eczema.

Hand eczema has many causes. Overexposure to an irritant, an allergic reaction, or a fungal infection can cause hand eczema. Since having — or having had— atopic dermatitis tends to leave one with a lifetime of dry, fragile skin, the skin is usually more susceptible to irritants, allergens, and fungal infections.

Without proper diagnosis and treatment, hand eczema can become chronic (long lasting), interfering with everyday activities and on-the-job tasks. Treatment involves using medication as directed and making lifestyle changes. Hand eczema can be stubborn. It may take months for the patches of red, scaly, and inflamed skin to heal. For hand eczema to resolve, patients must continue using the medication as directed, keep appointments with the dermatologist, and not get discouraged.

 

Eczema/Atopic Dermatitis

To lessen the risk of developing hand eczema, dermatologists recommend:

  • Protect hands against soaps, cleansers, and other chemicals by wearing gloves. If the gloves irritate your skin, see a dermatologist for recommendations.
  • Use an automatic dishwasher as much as possible.
  • Use lukewarm water and very little soap when washing the hands and always apply a dermatologist-recommended ointment or cream immediately after washing.
  • To keep hands soft and supple, apply the dermatologist-recommended product frequently throughout the day.
  • When outdoors in cool weather, wear gloves to prevent dry, chapped skin.

Eczema/Atopic Dermatitis

Questions and Answers About Atopic Dermatitis


Q. Since this condition is associated with allergies, can certain foods be the cause?
A. While foods do not directly cause eczema, several studies suggest that certain foods can worsen eczema. Some infants and young children with severe atopic dermatitis develop itchy hives and swelling after eating certain foods; these reactions can be dangerous. Studies show that eliminating the culprits from a child’s diet often leads to dramatic improvements within a short time.
Before eliminating foods from a child’s diet, be sure to discuss the plan with a dermatologist. Some elimination diets can cause children to suffer from severe protein and calorie deficiencies.
Q. Are environmental causes important, and should they be eliminated?
A. Many everyday objects can irritate the skin and cause atopic dermatitis to flare. Wool and other fabrics that feel rough to the touch, juices from meats and fruits, jewelry, and even some lotions can worsen atopic dermatitis. Learn what irritates the skin and limit contact with these things. Eliminating contact with airborne substances provides little relief for atopic dermatitis but can be important in controlling hay fever and asthma.
Q. Are skin tests such as those given to diagnose hay fever or asthma effective in finding the cause of atopic dermatitis?
A. Skin tests and blood tests can sometimes help to identify a food allergy, asthma, and hay fever. These tests are seldom helpful for identifying the cause of atopic dermatitis.

Q. Are “shots” such as those given for hay fever and other allergies useful?
A. No. Allergy shots have not proven reliable for relieving atopic dermatitis. They may even make the skin condition worse in some patients.
Q. What should be done to treat this condition?

A. See a dermatologist. Other skin conditions can resemble atopic dermatitis.  Without an accurate diagnosis, treatment can be ineffective.

If the diagnosis is atopic dermatitis, a dermatologist can prescribe an appropriate treatment plan. Medical research continues to show that the most effective treatment plan involves using a combination of therapies to treat the skin and making lifestyle changes to control flare–ups. Applying a corticosteroid or one of the newer immune–modifying medications to the skin can help reduce the inflammation and itch. Sometimes an antihistamine is beneficial. If the patient has an infection, which is common in patients with atopic dermatitis, an antibiotic will be prescribed. For severe cases, a dermatologist may recommend ultraviolet (UV) light therapy or another treatment.

Lifestyle changes include frequently applying an appropriate moisturizer,avoiding certain clothing, and using exzema–friendly bathing techniques. A dermatologist can offer many other tips that can help.

If a patient has another atopic disease such as hay fever or asthma, a dermatologist can refer the patient to an allergist for testing. Finding an allergy caused by food or something in the patient’s environment can be beneficial. Sometimes eliminating allergens brings great relief when combined with appropriate treatment and lifestyle changes.

A dermatologist is a physician who specializes in treating the medical, surgical and cosmetic conditions of the skin, hair and nails. To learn more about eczema/atopic dermatitis, log onto www.aad.org, www.skincarephysicians.com, or call toll-free (888) 462-DERM (3376) to find a dermatologist in your area.


To Learn More
Contact the American Academy of Dermatology (AAD), which represents almost all dermatologists in the U.S. and has more than 16,000 members worldwide. Most of the Academy’s members are board-certified in dermatology, which means they have completed a three-year residency and passed a rigorous two-part test administered by the American Board of Dermatology. Log on to the Academy’s Web site at www.aad.org, and you can:

  • Locate a dermatologist in your area;
  • Read information on skin conditions, including more than 65 brochures on individual dermatology topics;
  • Get advice about skin cancer prevention and detection, and other ways to care for your skin; and
  • Learn about the latest dermatologic procedures and how to make informed decisions about having those procedures.

 

For more information about Eczema/Atopic Dermatitis, please visit EczemaNet or call toll-free (888) 462-DERM (3376) to find a dermatologist in your area.


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Infantile eczema/atopic dermatitis
Eczema/atopic dermatitis
Eczema/atopic dermatitis
©2008 American Academy of Dermatology Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides American Academy of Dermatology P.O. Box 4014, Schaumburg, Illinois 60168-4014 AAD Public Information Center: (888) 462-DERM (3376) AAD Member Resource Center: (866) 503-SKIN (7546) Web:www.aad.org PAM 07

 

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