in New York City
If you suffer from the red, itchy, inflamed skin that is common with eczema you’re not alone. It is estimated that over 30 million Americans suffer from this chronic skin condition.
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 — you know it as “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
- Stasis dermatitis
What causes eczema?
Despite its prevalence, eczema is not fully understood. Normal, healthy skin works to retain moisture. This provides protection from bacteria, irritants, and allergens. It is thought that eczema develops due to a gene variation that affects the skin’s ability to retain moisture and then loses the corresponding protection from the moisture. This allows the skin to be affected by environmental factors, irritants, and allergens. Further proof of the possibility of a genetic link is that eczema seems to run in families.
Some research has shown that those with eczema have a skin defect that allows moisture to leave through the skin, opening the door for germs to make their way in. An overactive immune system, similar to how the body reacts when a person has an allergy, is thought to also play a role in eczema.
Regardless of how the process occurs, when an irritant or an allergen causes the immune system to react, this produces the skin inflammation common to all forms of eczema.
These are some potential triggers of an eczema breakout:
- Contact with irritating substances such as wool, synthetic fabrics, and soaps
- Heat and sweat
- Cold, dry climates
- Dry skin
What are the common signs and symptoms of eczema?
Atopic dermatitis is far and away from the most common form of eczema. Here are descriptions of what is typical with 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 contagious?
Just as allergies are not contagious, neither is eczema. Eczema is caused by a combination of genetic factors, immune system overreactions, and environmental triggers.
How is eczema diagnosed?
Lab work isn’t necessary when diagnosing eczema. Dr. Quintana and Dr. Boker are able to diagnose the skin condition simply by examining your skin and reviewing your medical history. They may use patch testing to rule out other skin diseases or identify conditions that accompany your eczema.
How is eczema treated?
As discussed above, the first step is to be sure we’re dealing with eczema, not a skin irritation from another cause. After checking your skin and discussing your symptoms, your health history, and your family history of eczema or allergies, Dr. Quintana or Dr. Boker will be able to tell if it’s eczema. From there, treatment options may depend on the severity of your inflammation, and what type of eczema you have.
Treatments can start with simple things, such as changing your skincare products and regimen. 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 our dry winter months in New York is helpful. Limiting stress is key, although that’s not always easy to do.
If your eczema is more severe and stubborn, the above probably won’t be enough. We will need to progress to various medications and treatments. These are some of our options:
- 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 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.
Is eczema curable?
There is no cure for eczema. Part of the annoyance of this skin condition is that it flares up and then goes into remission. It may go away for months at a time, but it will come back. Treatment is key to successfully manage your eczema, and that’s where we come in at Laser & Mohs Dermatology.
How can I prevent eczema flare-ups?
As mentioned above, there is no cure for eczema. The goal is to minimize your flare-ups and to manage them when they occur. There are various things you can do to help:
- Moisturize your skin often.
- Avoid sudden changes in temperature or humidity.
- Try not to sweat or get overly hot.
- Manage stresses in your life.
- Avoid scratchy clothing, such as wool.
- Get rid of harsh soaps, detergents, and solvents.
- Identify and avoid the foods that seem to trigger symptoms.
- Use a humidifier in your bedroom, particularly in the winter months.