Eczema is a chronic inflammation of the outer layers of the skin. Eczema is most common in infants and children, but it can also occur in adults. Eczema is not contagious.

Causes

The exact cause of eczema is unknown. Factors that may contribute to eczema include:

• Genetics

• Environment

• Allergies (May be allergies to things that touch the skin such as wool or perfumes in soaps, allergies to dust mites, or allergies to foods. Dust mite allergy is very common in children with eczema. Food allergies are quite rare but do occur.)

• Stress, especially if it leads to scratching

• Frequent washing of affected areas

• Use of rubber gloves in persons sensitive to latex

• Scratching or rubbing of skin

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Age: five years old or younger (eczema becomes less common after the ages of 5-10)

• Living in urban areas or places with low humidity

• Having family members who have eczema or allergic disorders

Symptoms

The symptoms of eczema vary from person to person. Scratching and rubbing can cause or worsen some of the symptoms.

Symptoms include:

• Dry, itchy skin

• Cracks behind the ears or in other skin creases

• Rashes on the cheeks, arms, and legs

• Red, scaly skin

• Thick, leathery skin

• Small, raised bumps on the skin

• Crusting, oozing, cracking, or scaling of the skin

• Worsening in the winter, when inside air is dry due to central heating

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. You may be referred to a doctor who specializes in skin disorders (a dermatologist) and/or allergies (an allergist).

Treatment

The main goals of eczema treatment are to:

• Heal the skin and keep it healthy

• Stop scratching or rubbing

• Avoid skin infection

• Prevent flare-ups

• Learn to avoid scratching

Treatment options may vary and your doctor may recommend more than one depending on your condition. They include:

Prevention

It can be difficult to prevent eczema, particularly when there is a strong family history. Some studies suggest that breastfeeding reduces a child’s risk of developing eczema. But if you already have eczema, there are several things you can do to try to control it:

• Follow guidelines for limiting house dust mites in bedding.

• Avoid direct contact with wool to the skin.

• Seek advice from your doctor about any use of “natural” or herbal remedies. Some of these may worsen eczema.

• Avoid scratching or rubbing whenever possible.

• Follow your doctor’s recommendations for treatment. Improvement may take several weeks or even months after a new medication is started.

• Maintain a cool stable environment and consistent humidity levels.

• Recognize and limit emotional stress.

RESOURCES:

American Academy of Allergy, Asthma, and Immunology
http://www.aaaai.org

The American Academy of Dermatology
http://www.aad.org

The National Eczema Society
http://www.eczema.org

References:

American Academy of Allergy, Asthma, and Immunology website. Available at: http://www.aaaai.org.

American Academy of Dermatology website. Available at: http://www.aad.org.

Barnetson RS, Rogers M. Childhood atopic eczema. BMJ. 2002;324(7350):1376-1379.

Brehler R, Hildebrand A, Luger T. Recent developments in treatment of atopic eczema. J Am Acad Dermatol. 1997;36:983-994.

Holscher B, Frye C, Wichmann HE, Heinrich J. Exposure to pets and allergies in children. Pediatr Allergy Immunol. 2002;13(5):334-341.

National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/.

Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet. 1995;346(8982):1065-1069.

Wahn U, Bos JD, Goodfield M, et al. Efficacy and safety of pimecrolimus cream in the long-term management of atopic dermatitis in children. Pediatrics. 2002;110(1 Pt 1):e2.