What is eczema?
Eczema is a general term for a group of conditions
that cause the skin to become inflamed, red, dry, and itchy. In some cases, a
rash might develop in one area or over the entire body. One of the most common
forms of eczema is atopic eczema, also called atopic dermatitis. Skin barrier
function (the "glue" of the skin) is impaired; therefore, the skin is more
susceptible to infections.
What are the symptoms of eczema?
Eczema might look different from person to person,
and it might appear on different parts of the body. In adults, eczema most often
develops on the hands and elbows, and in "bending" areas such as the inside of
the elbows and back of the knees. In young children, eczema most often develops
on the face, neck, scalp, elbows, or knee folds.
Common symptoms of eczema include:
- Skin redness
- Dry, scaly, or crusted skin that might become thick and leathery from
- Formation of small, fluid-filled blisters that might ooze when scratched
- Infection of the areas where the skin has been broken
What causes eczema?
The exact cause of eczema is not known. However,
it appears to run in families and occurs more often in people who have a
personal or family history of asthma, hay fever, and other allergies, suggesting
a genetic (hereditary) factor in the development of eczema. In addition, eczema
symptoms tend to flare up or worsen when the person is exposed to certain
substances and situations, called triggers. Eczema triggers might include:
- Skin irritants — Irritants are substances that cause burning,
itching, or redness. They include harsh soaps, chemicals, perfumes, and skin
care products that contain alcohol. Some fabrics, such as wool, and tight
clothing can also irritate the skin.
- Allergens — Allergens are substances that trigger an allergic
reaction, which may include sneezing, itching, watery eyes, and a stuffed or
runny nose. Some allergens, such as pollens, pet hair or dander (dried bits
of saliva and skin), and even certain foods — such as eggs, wheat, nuts, and
milk products — can also trigger or worsen eczema symptoms.
- Climate and environment — Low humidity (dry air) can cause the skin
to become dry and itchy. Heat and high humidity cause sweating, which can
make itching worse.
- Stress — Stress has been shown to trigger flare-ups in some people
with eczema. In addition, it may be more difficult to control scratching
irritated skin when under stress.
How common is eczema?
Eczema is a common skin condition, affecting as
many as 15 million Americans. It can occur in both children and adults, but it
most often occurs in very young children. Ten percent to 20 percent of all
infants are affected by eczema (National Institutes of Health); although
nearly half outgrow the condition. It affects males and females equally, and is
more common in people who have a personal or family history of asthma and allergies.
How is eczema diagnosed?
In most cases, eczema is diagnosed from the
person’s history of symptoms and by examining the skin. The doctor might test an
area of scaly or crusted skin to rule out other skin diseases or infections.
How is eczema treated?
Treatment varies depending on the symptoms (for
example, dry skin is treated differently than oozing blisters), as well as the
factors that trigger or worsen symptoms. No one treatment is best for all
people. The goal of treatment is to reduce itching and discomfort, and to
prevent infection and further flare-ups.
Treatment options include:
Preventing flare-ups is the best way to manage eczema. For that reason, it is
important to try to identify and avoid symptom triggers, such as particular
detergents or food allergens.
Keeping your skin moist is important, because itching increases when the skin is
dry. Use a moisturizing cream or ointment. Lotions, although lighter and more
appropriate for summer, tend to evaporate quickly.. It is important to keep skin
moisturized by applying creams or ointments several times a day — including
after bathing/showering — to keep your skin moist. Use mild soaps and products
that are free of perfumes. Look for products that are "fragrance free" as
opposed to "unscented." Avoid skin care products with alcohol, because alcohol
can dry your skin. Avoid colored soaps as dyes can also be irritating. New
products that contain ceramide help replace some of the glue which is impaired
in the skin of eczema patients.
Over-the-counter creams and ointments containing the steroid cortisone — such as
hydrocortisone (Cortisone 10®) and hydrocortisone acetate (Cort-Aid®)
— may be used to help control the itching, swelling, and redness associated with
eczema. Prescription-strength cortisone creams, as well as cortisone pills and
shots, are also available for more severe cases of eczema, although long-term
use of cortisone is not recommended because of the possible side effects, which
include high blood pressure, weight gain, and thinning of the skin.
Newer medications, called topical immunomodulators (TIMs),
are showing progress in treating patients with moderate to severe eczema,
particularly those patients who do not respond to traditional treatment. TIMS —
such as tacrolimus (Protopic®) and pimecrolimus — work by modulating
(altering) the body’s immune response to allergens. TIMs also have fewer side
effects than steroids. The most common side effect reported with tacrolimus is a
temporary stinging or burning sensation that generally improves after a few days of use.
Other medications that might be used for patients with eczema include antibiotics if the skin
becomes infected and antihistamines to help control itching.
The ultraviolet light waves found in sunlight have been shown to benefit certain
skin disorders, including eczema. Phototherapy uses ultraviolet light, either
ultraviolet A (UVA) or ultraviolet B (UVB), from special lamps to treat people
with severe eczema. In some cases, medications called psoralens are prescribed
before phototherapy to make the skin more sensitive to the effects of the
ultraviolet light. This treatment is called PUVA (psoralens plus ultraviolet A).
Are there any complications associated with eczema?
Scratching or rubbing the rash or itchy areas can
break the skin, which can then become infected. Permanent scars can form when
the skin is damaged from prolonged scratching. Very itchy eczema can also
disturb sleep. Some people with eczema avoid social activities because they are
uncomfortable and/or self-conscious. In persons with darker skin, the eczema
patches may appear darker than the rest of the skin and may leave dark marks
which linger for longer than desired periods.
What is the outlook for people with eczema?
Nearly half of children with eczema will outgrow
the condition or experience great improvement by the time they reach puberty.
Others will continue to have some form of the disease. For adults with eczema,
the disease can generally be well managed with good skin care and treatment,
although flare-ups of symptoms can occur throughout life.
Can eczema be prevented?
There are steps you can take to prevent eczema outbreaks, including:
- Establish a skin care routine, and follow your doctor’s recommendations
for keeping your skin healthy,
- Wear gloves for jobs that require putting your hands in water. Wear
cotton gloves under plastic gloves to absorb sweat, and wear gloves outside,
especially during the winter months.
- Use mild soap for your bath or shower, and pat your skin dry instead of
rubbing. Apply a moisturizing cream or ointment immediately after drying
your skin to help seal in the moisture. Reapply cream or ointment 2 to 3 times a day.
- Take baths or showers with tepid as opposed to hot water temperature.
- Drink at lease 8 glasses of water each day. Water helps to keep your skin moist.
- Try to avoid getting too hot and sweaty.
- Wear loose clothes made of cotton and other natural materials. Wash new
clothing before wearing. Avoid wool.
- Avoid sudden changes in temperature and humidity.
- Learn to recognize stress in your life and how to manage it. Regular
aerobic exercise, hobbies, and stress-management techniques — such as
meditation or yoga — might help.
- Limit your exposure to known irritants and allergens.
- Avoid scratching or rubbing itchy areas of skin.
Can eczema be cured?
Currently, there is no cure for eczema. However, proper treatment and good skin care can often
control or minimize symptoms.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/6/2009…#9998