Eczema (Atopic Dermatitis)
Atopic dermatitis, commonly referred to as eczema, is a skin disorder that results in dry, scaly, red, and itchy skin. People of any age can develop it, and it may be more prevalent in some families than others. Approximately 10–20% of children and 1-3% of adults struggle from eczema. Although there is no known origin for atopic dermatitis, genetics is a strong factor.
This condition occurs when the epidermis (the skin’s outermost layer) does not function like it should. Normally, a functioning epidermis works to keep out irritants, allergens, and bacteria from the environment. When the epidermis malfunctions, these compounds enter the body and causes inflammation and triggers itching. This itching often triggers an ‘itch-scratch cycle’ that lead to more inflammation and in turn more itching and scratching. Allergies can act as important triggers to eczema. In children with moderate to severe atopic dermatitis, two out of three may have some underlying food allergy.
Eczema is often the first symptom of allergies in children. In the so called ‘allergic march’ children with allergic eczema are at risk of developing allergic rhinitis (hay fever) and allergic asthma as they get older.
Eczema symptoms typically start before the age of five. Clinically, eczema is identified by the characteristic appearance of skin lesions - dry, scaling patches of redness, small bumps, and flaking – and intense itching. While the condition may cause itching and irritation, you should try your best to avoid scratching or touching the affected area. Scratching can generate more inflammation, which in turn can cause more itchiness, thus perpetuating the situation and making it worse. In severe cases, skin may even begin oozing, which may indicate an infection.
Eczema rash typically appears on children’s faces, necks, wrists, hands, ankles, and feet. In older children and adults, symptoms typically develop in the flexural folds (back of the knees, bends of the arms) of the extremities and may develop very thick, rough skin (lichenification) or darkening of the skin (hyperpigmentation.)
There is no specific singular test designed to diagnose atopic dermatitis. The diagnosis is based on clinical history and physical examination. Testing done by a well-qualified allergist can identify potential triggers like environmental or food allergens.
Your allergist may also recommend skin tests or blood tests to identify allergic triggers of eczema. These types of tests will help our team determine the cause of your symptoms and design a treatment plan, accordingly, based on your specific needs.
Four Steps to Relief
Planning Your First Visit
Schedule an appointment at your local office and fill out our pre-registration and medical history forms to help minimize any wait time when you arrive.
Your First Visit
Your initial visit will last between two and three hours and consist of an initial consultation, evaluation, and comprehensive exam. We’ll create a treatment plan tailored to your unique needs.
Diagnostics and Testing
We may complete one or more tests to better understand the cause of your symptoms. Common tests include skin testing, pulmonary testing, and blood testing.
Following the evaluation and testing, we’ll provide a comprehensive diagnosis and implement a personalized treatment plan that will deliver relief.
Appropriate skin care is crucial for relieving eczema symptoms. Restoring a healthy skin barrier and reducing inflammation are the main facets of atopic dermatitis treatment. The best method for preventing skin dryness and enhancing the skin barrier is daily hydration (soaking in lukewarm water for 10–20 minutes) and moisturizing with a high-quality, hypoallergenic cream or ointment.
Additional treatments your allergist may recommend aiding in eczema relief include:
- Moisturizing cream applied at least twice a day and within three minutes after bathing can help temporarily relieve an eczema outbreak. Both intermittent and daily bathing are appropriate, but it is vital to use fragrance-free soap and pat dry.
- Avoiding known triggers can reduce the intensity of atopic dermatitis. Irritants, stress, heat/sweating, infections, and allergens can all cause exacerbations.
- Topical steroids or anti-inflammatory creams should be used as needed on red, inflamed skin. Only low-potency steroid or non-steroid creams should be used on the face because facial skin is thin.
- Medications like oral antihistamines can be prescribed to help control itching.
- Bleach baths and wet wraps can be used in select cases, as determined by your physician.
- Immunotherapy can be effective in improving eczema when allergies are a trigger. In young children, immunotherapy may prevent the ‘allergic march’ progression to hay fever and asthma.
- Dietary changes may be helpful if food allergies are driving eczema flares. Your allergist can help determine which foods, if any, should be avoided.
The Allergy Partners Difference
At Allergy Partners, our board-certified specialists can assist in identifying food or environmental triggers and collaborate with you and other medical professionals to develop a personalized treatment plan to fit your unique needs. Even though atopic dermatitis is a chronic condition, you can successfully manage it and significantly lessen the negative effects it has on your life by following a multi-tiered treatment plan under the guidance of your Allergy Partners allergist.