As we head into the colder months of the year, when the air may be drier, a common problem will likely start popping up more and more: eczema.
According to the National Eczema Association, eczema is an inflammatory skin condition and a chronic skin condition that causes the skin to become itchy, inflamed, or have a rash-like appearance. Over 31 million Americans have some form of eczema. The condition can begin during childhood, adolescence, or adulthood, ranging from mild to severe. Eczema can appear anywhere on the body and can affect anyone at any age. Atopic eczema is the most common form of eczema linked to hereditary factors.
While we do not know the exact cause of eczema, we do know that people develop the condition due to a combination of genes and environmental triggers. Common triggers include allergens, irritants, weather changes, and stress, and these can vary from person to person. When an irritant or allergen from outside or inside the body “switches on” the immune system, it produces inflammation. The skin’s barrier function also plays a crucial role; when this barrier is compromised, it increases susceptibility to irritants, allergens, and bacteria, leading to inflammation and other symptoms. This inflammation causes symptoms that are common to most types of eczema. Eczema is not contagious; genetic and environmental factors cause it. To address concerns about eczema being contagious, it is important to note that eczema cannot be spread through contact and is not an infectious disease. Additionally, eczema is not classified as an autoimmune disease, but rather involves immune dysregulation without the immune system attacking the body’s own tissues.
Atopic Eczema
Eczema often starts in childhood, with 80% of cases occurring before age 6, but it can also begin in adulthood. Black children in the U.S. are reported to be twice as likely to develop eczema compared to white children.
Atopic eczema, or atopic dermatitis, is the most common form of eczema and often runs in families. It is associated with other atopic conditions like hay fever, asthma, and food allergies. Atopic eczema usually begins in childhood and may persist into adulthood. Adult eczema is a chronic, inflammatory skin condition that can persist or even begin in adulthood, often resulting in persistent symptoms such as red, itchy, and inflamed patches, and requires proper management and diagnosis by specialists.
Eczema is also associated with the development of food allergies, hay fever (allergic rhinitis), and asthma, a progression known as the ‘atopic march.’ It often appears as dehydrated skin, scaly, intensely itchy patches on the skin. In severe cases, the skin can crack, weep, and become more prone to infection. Understanding the genetic and environmental factors contributing to atopic eczema is crucial for managing the condition effectively.
Atopic Dermatitis Symptoms: What to Look For?
The most important thing to remember is that eczema and its symptoms differ for everyone, but the most common complaint is itchy skin. The itch can range from mild to moderate. Eczema can also cause changes in skin color, such as redness or discoloration, and these changes may look different depending on your skin tone. For example, on lighter skin tones, eczema may appear pink or red, while on medium or darker skin tones, it can look brown, purple, or gray. Eczema can vary in appearance depending on skin tone.
But in some cases, it can become much worse, and you might develop extremely inflamed skin. Sometimes, the itch gets so bad that people scratch until it bleeds, making eczema worse. This is called the “itch-scratch cycle.” Eczema can also cause a burning sensation, especially in cases like contact dermatitis.
Common symptoms:
- Itch
- Dry, sensitive skin
- Inflamed, discolored skin
- Rough, leathery, or scaly patches of skin
- Oozing or crusting
- Areas of swelling
- Burning sensation
Other types of dermatitis, such as seborrheic dermatitis, can also cause similar symptoms, particularly in oil-rich areas of the body, like the scalp.
Dehydrated skin is a significant symptom of eczema and can greatly impact the severity of itching and flare-ups. You might have all of these symptoms of eczema, or just a few. You might have flare-ups regularly, or your symptoms could go away entirely for an extended period. It’s standard for eczema to go away as a child ages, but some will continue to experience it into adulthood. Adults can develop eczema even if they never had it as a child.
The best way to determine if you have eczema is to consult with a dermatologist, such as Dr. Timothy G. Rodgers. The dermatologist can examine your skin, ask about your symptoms, and provide a definitive diagnosis.
Diagnosing Eczema
Getting an accurate diagnosis is a crucial first step in managing eczema and preventing complications like skin infections or worsening symptoms. If you’re experiencing eczema symptoms—such as itchy, dry, or inflamed skin—a primary care provider or dermatologist will typically start with a thorough physical exam. They’ll look for classic signs of eczema, including patches of very dry skin, scaly or leathery patches, and areas of skin irritation or inflamed skin. Your doctor will also ask about your medical history, including any family history of eczema, allergies, hay fever, or asthma, since these factors can increase your risk of developing eczema.
To help diagnose eczema and identify potential eczema triggers, your healthcare provider may recommend additional tests. A patch test can be used to check for allergic contact dermatitis by applying small amounts of common allergens to your skin and monitoring for a reaction. In some cases, a skin scraping or biopsy may be performed to rule out other skin diseases or infections that can mimic symptoms of eczema. If food allergies or environmental triggers like dust mites are suspected, you might be referred to an allergist for further testing, such as a skin prick test, to pinpoint specific allergens that could be making your eczema worse.
Accurate diagnosis is essential, as untreated eczema can lead to chronic skin inflammation, increased risk of skin infections, and even scarring. The National Eczema Association recommends working closely with your healthcare provider to develop a personalized treatment plan. This plan may include avoiding common eczema triggers—such as harsh soaps, certain foods, and environmental factors—and using topical therapies like moisturizers and topical corticosteroids to relieve itching and reduce inflammation.
In addition to medical treatments, self-care plays a big role in managing this chronic condition. Keeping your skin well-moisturized, avoiding scratching, and choosing breathable clothing can help prevent eczema flares and reduce skin irritation. By understanding your unique triggers and following your provider’s recommendations, you can take control of your eczema symptoms and improve your quality of life.
If you notice persistent itchy patches, very dry skin, or other symptoms of eczema, don’t hesitate to consult your primary care provider or dermatologist. Early diagnosis and a tailored treatment plan can help relieve itching, prevent complications, and keep your skin healthy.
Skin Infections
People with eczema are more susceptible to skin infections because eczema is a type of skin disease that increases vulnerability to infections due to the compromised skin barrier, which makes it easier for bacteria, viruses, and fungi to enter the skin. Scratching can also introduce bacteria like Staphylococcus aureus into the skin, leading to infections that may require antibiotic treatment. It’s crucial to keep the skin clean and hydrated and to seek medical advice if you notice signs of infection, such as increased redness, warmth, swelling, or pus-filled bumps.
Eczema Triggers
Knowing what may be causing your eczema is a significant factor and common eczema triggers include:
- Soaps and detergents
- Certain fabrics
- Environmental factors like cold and dry weather
- Stress
- Pet dander
Common triggers for eczema include exposure to allergens such as pet dander and dust mites. Flare-ups can also be caused by foods, cosmetics, soaps, and dust mites. Keeping a symptom journal can assist in tracking eczema flare-ups alongside daily activities and food intake. Living in urban areas with higher air pollution or in cold, dry climates can increase the risk of developing eczema. Emotional stress and anxiety release cortisol, which can worsen inflammation and barrier function in eczema.
Contact dermatitis is a form of eczema triggered by specific irritants or allergens. Food allergies can also exacerbate eczema symptoms, with common allergens like milk, eggs, and peanuts contributing to the severity of the condition. Stress is another significant factor that can lead to eczema flare-ups. Also, hay fever, asthma, or food allergies increase the risk of developing eczema.
Food Allergies
Food allergies can play a critical role in exacerbating eczema, particularly in children. Up to 63 percent of young children with moderate to severe eczema also have food allergies. Common food allergens such as dairy, eggs, soy, wheat, nuts, and shellfish can trigger or worsen eczema symptoms. If you suspect that food allergies might be contributing to your or your child’s eczema, it’s essential to undergo an allergist’s evaluation. An allergist can perform tests to identify specific food triggers that elicit an allergic response and help you develop an effective dietary plan to manage eczema and minimize flare-ups. Children and adults diagnosed with eczema can manage the condition with the guidance of an allergist, especially if food allergies are suspected.
Dry Skin
When skin becomes too dry, it can quickly become brittle, scaly, rough, or tight, leading to an eczema flare-up. Applying fragrance-free moisturizers immediately after lukewarm baths helps lock in moisture and supports eczema management. Petroleum jelly is an effective, safe moisturizer for maintaining skin hydration and barrier function, and is suitable for use in infants and children. Using unscented products can also help reduce the risk of eczema flare-ups. An allergist’s evaluation is crucial for children with severe eczema to identify potential food allergies and develop an effective treatment plan.
Irritants
Everyday products and even natural substances can cause your skin to burn, itch, or dry and red. These can include products you use on your body or home and natural liquids, such as juice from fresh fruit, vegetables, or meats. Maintaining a healthy skin barrier is essential to prevent moisture loss and protect against allergens and irritants.
Common irritants include:
- Metals (especially nickel)
- Cigarette smoke
- Soaps, household cleaners, and disinfectants
- Bubble baths, body wash, and shampoos
- Fragrances
- Certain fabrics like wool and polyester
- Antibacterial ointments like neomycin and bacitracin
- Formaldehyde, which is found in household disinfectants, some vaccines, glues, and adhesives
- Isothiazolinone, an antibacterial that is found in personal care products like baby wipes
- Paraphenylenediamine, which is used in leather dyes and temporary tattoos
Stress
Emotional stress can trigger eczema, but we don’t know exactly why. Some people’s eczema symptoms get worse when they’re feeling stressed, and others may become stressed due to a flare-up, which can make eczema worse.
Eczema Prevention: Can We Cure It?
Unfortunately, we do not yet have a cure for eczema. But we do have many effective treatment options. Depending on age and eczema severity, these treatments include over-the-counter (OTC) remedies such as hydrocortisone cream, which can help relieve itching, as well as prescription treatments recommended for more severe cases. Prescription topical medications include topical steroids, which are commonly prescribed for moderate to severe eczema, and newer options like crisaborole, an FDA-approved topical treatment for mild to moderate eczema. For moderate to severe cases, dupilumab is a prescription medication that has been approved for use. If topical treatments are insufficient to control flare-ups and reduce inflammation, oral medications may be considered. Other options include phototherapy, immunosuppressants, and biologic drugs. Many people with eczema also find success with natural and alternative treatments. Wearing gloves in cold weather can help protect the skin and prevent eczema flare-ups.
For most types of eczema, managing flares comes down to these basics:
- Know your triggers so that you can avoid exposure. Identifying and avoiding triggers can help manage eczema flare-ups.
- Implement a daily bathing and moisturizing routine. A compromised skin barrier can lead to skin infections.
- Use OTC and prescription medication consistently and as prescribed.
Here are a few more specific tips that may help prevent flare-ups and associated symptoms:
- Moisturize skin at least twice a day. Creams, ointments, and lotions seal in moisture. Choose a product that works well for you.
- Try to identify and avoid triggers that worsen the condition. Things that can worsen the skin reaction include sweat, stress, obesity, soaps, detergents, dust, and pollen. Reduce your exposure to your triggers.
- Take shorter baths or showers. Limit your baths and showers to 10 to 15 minutes, and use warm, rather than hot, water.
- Use gentle soaps. Deodorant and antibacterial soaps can remove natural oils and dry out your skin.
- Dry off carefully. After bathing, gently pat your skin dry with a soft towel and apply moisturizer while your skin is still damp.
You may have noticed that we mentioned using products and gentle cleansers to help with eczema. It is often challenging for patients to find the right products, and this is where Dr. Rodgers at Rodgers Dermatology can help. He can examine your eczema and recommend what you should use.
Schedule An Appointment To Treat Your Eczema
If you or someone in your family may have eczema, schedule an appointment with us today! Schedule a consultation by calling 972-704-2400 or booking your appointment online.