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Eczema, or atopic dermatitis, is a chronic skin condition characterized by inflammation and irritation. It often manifests as red, itchy rashes and can affect individuals of all ages, with a higher prevalence in children.

Eczema, also known as atopic dermatitis, is a chronic, relapsing, and remitting inflammatory skin condition characterized by patches of dry, itchy, red, and sometimes cracked or oozing skin. Studies suggest that about 50% of cases begin in the first year of life, 85% begin within in five years and a majority resolve by adolescence. But there is adult-onset atopic dermatitis that is estimated to affect 3% and 7% of people in the US.

Eczema is caused by genetic vulnerability that compromises the skin barrier which allows toxic chemicals, bacteria, irritants, pollutants, and allergens to penetrate the skin. This triggers an immune response that shows as red, itchy skin. It is related to asthma, allergic rhinitis and food allergy, and many patients have all these conditions.

In children, symptoms include rashes in the bends of the elbows, behind the knees, on the neck, wrists, or ankles. In adults the rash typically appears on the face, behind the knees, wrists, hands, and feet.

Eczema symptoms can vary from mild to severe and can include:

  • Red, raw, inflamed, and itchy skin
  • Thickened, cracked skin
  • Dry itchy skin
  • Severe itching at night
  • Dark colored patches of skin
  • Rough, leathery, or scaly patches of skin
  • Patches of small, raised bumps that can ooze and crust over
  • Swollen skin
  • Skin infections caused by scratching

Understanding eczema triggers

Eczema flare-ups can be influenced by various factors, including:

  • Genetics: A family history of eczema, asthma, or hay fever may increase the likelihood of developing eczema.
  • Environmental Factors: Exposure to allergens, irritants, or changes in weather can trigger or worsen eczema symptoms.
  • Dry Skin: Individuals with dry skin are more susceptible to eczema flare-ups.
  • Stress: Emotional stress can contribute to the onset or exacerbation of eczema symptoms.
  • Infection
  • Hormonal changes

Types of eczema

  • Contact dermatitis (caused by skin contact with irritants or allergens)
  • Dyshidrotic eczema (blistering on the hands and feet)
  • Nummular eczema (circular patches of irritated skin)

Eczema management and treatment options

Topical treatments:

  • Emollients and Moisturizers: the cornerstone of treatment is protection of the skin barrier from water loss. This may include soaking baths in lukewarm water daily. Adding oatmeal preparations can soothe the skin. Soaps should be bland and contain no dyes or fragrances to avoid irritations.
  • Topical Steroid Creams and Ointments: effectively reduce inflammation, itching, and redness. These medications come in varying strengths to match the severity of symptoms.
  • Non-Steroidal Creams and Ointments: calcineurin inhibitors and topical JAK inhibitors modulate the immune response, effectively managing eczema symptoms without the use of topical steroids.

Phototherapy/Excimer Laser Therapy:

  • Narrowband UVB reduces the inflammatory response in the skin with regular treatments over time.
    • At Beacon Dermatology we offer the best in class, Daavlin Neolux Device, a full body treatment for moderate to severe eczema (atopic dermatitis).
    • At Beacon Dermatology we offer excimer laser therapy, a more targeted therapy for localized or recalcitrant eczema (atopic dermatitis).

Systemic treatments: 

  • Systemic Medications may be recommended in more severe cases of eczema. Oral or injectable systemic medications may be prescribed to address inflammation and modulate the immune system.
  • Biologics: Dupixent and Adbry specifically target certain parts of the immune system (IL-4 and/or IL-13) that is shown to contribute to eczema (atopic dermatitis) inflammation.
  • Oral JAK inhibitors: Rinvoq and Cibinqo selectively block a certain part of the immune system called the JAK pathway that has been shown to reduce inflammation related to eczema (atopic dermatitis).
  • Immunosuppressants

Partnering for healthy skin

Schedule a consultation with Dr. Rains or Lola Gifford PA-C to discuss your unique concerns and to develop a comprehensive and personalized treatment plan for your eczema.

At a Glance

Michael Rains, MD, FAAD

  • Board certified in dermatology
  • Specializing in medical, surgical and cosmetic dermatology
  • Author of multiple peer-reviewed publications and previous adjunct faculty at Dell Medical School at the University of Texas at Austin
  • Learn more

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