Callender Dermatology and Cosmetic Center | Glenn Dale MD

Eczema

Eczema Tratment Glenn Dale, MD
If you have the red, itchy, inflamed skin that is common to the various forms of eczema, you’re not alone — over 30 million Americans have eczema. This skin condition behaves differently in different people, but itchy outbreaks are common to all types of eczema.

Dr. Callender helps her patients deal with the irritation of eczema with various treatment options, depending on the patient’s unique situation.

What is eczema?

Eczema is the common name for a group of conditions that cause the skin to become red, itchy, and inflamed. The term “eczema” comes from a Greek word meaning “to boil over.” Patients dealing with an eczema flare-up can certainly relate to that description of their inflamed patches of skin. Eczema can range from mild to moderate to severe. In severe cases, the skin can become leathery and develop cracks.
 
Eczema is common in babies and is the basis of cradle cap. It usually resolves later in childhood. For adults with eczema, it can be a chronic condition that can appear on any part of the body. These are the different types of eczema, with atopic dermatitis being the most common:
 
  • Atopic dermatitis
  • Contact dermatitis
  • Dyshidrotic eczema
  • Nummular eczema
  • Seborrheic dermatitis
  • Statis dermatitis

What causes eczema?

Although eczema is quite common, it isn’t fully understood. Without eczema, your skin works to retain moisture. This protects the skin from bacteria, irritants, and allergens. In people with eczema, it appears there is a gene variation that affects the skin’s ability to retain moisture. Without the moisture, it is open to irritation due to environmental factors and allergens. Eczema seems to run in families, adding some weight to this genetic possibility.

Beyond the possible genetic link, there is research that points to a skin defect that allows moisture to leave through the skin, allowing germs in. An overactive immune system seems to also play a part.

Despite there being different types of eczema, when an irritant or allergen causes the patient’s immune system to kick in, the skin inflammation and redness is common to all types.


Are there triggers for eczema?

Certain things trigger eczema flare-ups in those with the condition:

  • Stress
  • Contact with irritating substances such as wool, synthetic fabrics, and soaps
  • Heat and sweat
  • Cold, dry climates
  • Dry skin

What are the most common symptoms of eczema?

Atopic dermatitis is far and away the most common form of eczema. Here are the symptoms of atopic dermatitis, although there are fairly wide variations between people:

  • Dry skin
  • Itching, which can be severe
  • Red to brownish-grey patches that occur on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and on the face and scalp of infants
  • Thickened, cracked, scaly skin
  • Raw, sensitive, swollen skin, usually from scratching
  • Possibly blistering or sore formation on dry patches

Is eczema painful?

Eczema is a chronic case of dry, irritated, red skin, wherever it occurs on the body. Acute pain isn’t a part of it, but chronic itching and scaly skin are which main be considered painful to some.

Is eczema contagious?

Eczema cannot be “caught” from another person. It is not contagious. Eczema is caused by a combination of genetic factors, immune system overreactions, and environmental triggers.

How is eczema treated?

When you come to Dr. Calender for treatment, her first job is to decide if you have some temporary skin irritation or if you one of the types of eczema. She’ll check your skin, discuss your symptoms, and ask about your health history and your family health history. She’ll look for a pattern of eczema or allergies. Once she diagnoses eczema, your treatment options may depend on the severity of your inflammation, and what type of eczema you have.

She’ll consider your skin care regimen as a first step. It’s important to use mild soaps that don’t dry your skin; moisturizing your skin is also important. Avoiding hot showers or hot baths is a good idea, as they can dry out your skin. Using a humidifier in the dry air of our Maryland winters is helpful. Limiting stress is key, but we could probably all use some of that.

While the above steps can handle mild eczema, they probably won’t calm severe or stubborn eczema. Dr. Callender may move to possible prescription medications and light therapy:

  • Hydrocortisone — These creams or ointments calm the skin inflammation.
  • Antihistamines — These help calm your immune reaction.
  • Corticosteroids — These anti-inflammatory drugs target serious outbreaks.
  • Immune system drugs — There are a number of drugs and prescription creams and ointments that control the inflammation and reduce immune system reactions. These usually can only be taken for short durations, however.
  • Injectables — Dupilumab (brand name Dupixent) is an injectable medicine for severe atopic dermatitis. Typically given every two weeks as an injection, it controls the body’s inflammatory response.
  • Prescription-strength moisturizers — These support the skin’s barrier against irritants and allergens.
  • Ultraviolet light therapy — This can help to calm the inflammation on the skin.
  • Intense pulsed light — These short duration pulses of wavelengths of high-intensity light can also calm inflammation.

Can children receive treatment for eczema?

In children, eczema is usually is in the form of seborrheic dermatitis. It occurs on the scalp and is commonly referred to as “cradle cap.” In older children, this type of eczema becomes dandruff. If the child isn’t uncomfortable or overly bothered by seborrheic dermatitis, it can be left untreated. Otherwise, mild seborrheic dermatitis can be treated with over-the-counter topical antifungal creams or medicated shampoos with ketoconazole, selenium sulfide, coal tar, or zinc pyrithione.

If you would rather avoid medications, you can try this home remedy for cradle cap:

  • Apply plain mineral oil or petroleum jelly to your baby’s scalp about one hour before bathing to loosen scales.
  • Gently massage shampoo into the scalp for a few minutes to remove the scales. A dandruff shampoo is best for this, but keep it out of the eyes.
  • Rinse well and gently pat the scalp dry.

Will eczema return even after treatment?

There is no cure for eczema. The condition is a constant flow of flare-ups and then remission. It may go away for months at a time, but it will usually return. Treatments help patients manage their eczema.

Are there at-home alternative treatments for eczema?

Keys to treating eczema involve knowing your triggers, bathing and moisturizing the right way with the right products, and using over-the-counter or prescription medication consistently. There are other “alternative” treatments that could be helpful.

  • Coconut oil — Studies show that coconut oil reduces the amount of staph bacteria on the skin, which reduces the chances of infection.
  • Sunflower oil — Sunflower oil boosts the skin’s barrier function, helping it retain moisture.
  • Cardiosperum — This extract from a tropical vine helps reduce inflammation, itching, and bacteria on the skin.
  • Topical vitamin B12 — Dr. Callender can give you instructions on mixing this B12 compound, as there isn’t a commercial product.
  • Lowering stress — Stress is a known trigger for atopic dermatitis. There are various options for lowering stress, from meditation to acupressure to massage.


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