What is eczema (atopic dermatitis)?

Eczema (say "EGG-zuh-muh") is also called atopic dermatitis. It's a skin problem that causes intense itching and a raised rash. Sometimes the rash develops blisters and crusts. It is often scaly. The rash is not contagious. You can't catch it from others.

In lighter skin, the rash may look pink or red. In darker skin, the rash may be hard to see or it may look dark brown, gray, or purple. Or there may be patches of lighter skin.

Eczema often runs in families. People with eczema may also have allergies and asthma.

There is no cure for eczema. But you may be able to control it with care at home.

Eczema is most common in babies and children. It tends to come and go over months to years. It is common for the rash to get infected at times. Most children outgrow it. But some teens and adults continue to have problems with it, though usually not as bad as when they were children.

Eczema starts with dry skin that is often very itchy. Scratching causes the dry skin to become irritated. Tiny bumps that look like little blisters may appear and ooze fluid or crust over. This can happen when the skin is rubbed or scratched or if a skin infection is present.

These symptoms may come and go. Over time, a recurring rash can become tough and thick from constant scratching.

Eczema may be mild, moderate, or severe. How much your symptoms affect you will depend on how much of your skin has a rash and how itchy it is. It also depends on how much the eczema affects your daily activities, sleep, and well-being.

The areas most often affected are the face, scalp, neck, arms, and legs. The rash is also common in areas that bend, such as the back of the knees and the inside of the elbows.

Treatment for eczema depends on how severe your rash is. It's usually treated with medicines that you put on your skin (topical medicines) and with moisturizers. Some mild cases can be treated at home with moisturizers—including skin barrier repair moisturizers—and gentle skin care. Most of the time, rash and itching can be controlled within 3 weeks.

Getting medical treatment early may keep your symptoms from getting worse.

• Topical medicines are usually creams, gels, or ointments. These may include:
  • Corticosteroids.
  • Calcineurin inhibitors (tacrolimus ointment and pimecrolimus cream).
  • Crisaborole.
• Moisturizers are a key part of treating the condition. Use plenty of moisturizer and use it several times a day. This will reduce the itching. It will also keep your rash from getting worse and help your rash heal.

For rashes that don't get better with topical medicines and moisturizers, treatment may include:

• High-strength corticosteroids. When the rash has a severe flare, oral corticosteroids may be used for a short period of time.
• Phototherapy, which includes various types of exposure to ultraviolet (UV) light. This may be given with or without other medicine.
• Medicines that affect the immune system. Examples include cyclosporine, dupilumab, and methotrexate. They're used for adults, and sometimes children.

Your doctor may talk to you about bleach baths and wet wraps. You'll get directions on how to use these treatments.

For itching, treatment may include antihistamines. Taking baths with colloidal oatmeal (such as Aveeno) may help.

If the rash gets infected, you may get antibiotic, antiviral, or antifungal medicines.

Phototherapy is the supervised use of ultraviolet (UV) light to treat skin conditions, including eczema. Ultraviolet B (UVB) or ultraviolet A (UVA) may be used during therapy. The most common type of phototherapy to treat eczema is narrowband UVB.

During phototherapy, you may stand in a booth that contains light tubes that give off UV light. Or you may have treatment with a smaller device if you have eczema in a limited area. Treatment is usually several times a week at first. Once your eczema is doing better, you may have treatment less often. Sometimes people are able to do the treatment at home.

To keep yourself safe, carefully follow all of your doctor's instructions. This may include protecting your eyes by wearing UV-blocking goggles during treatments.

There is no known way to prevent eczema. If you have family members with eczema, you have a higher risk of getting it. Although you may not be able to prevent eczema, taking care of your skin can help to keep it as healthy as possible.

A doctor can usually tell if you have eczema by doing an exam and asking questions about your health. You may also be asked about your family health history. Sometimes a skin biopsy or allergy testing is recommended.

For the diagnosis and treatment of atopic dermatitis, consult with a:

• Family medicine physician.
• Nurse practitioner (NP).
• Physician assistant (PA).
• Pediatrician.
• Dermatologist.

Use moisturizers at least twice a day. If your doctor prescribes a medicine, use it exactly as directed. Wash with warm water only. Use a moisturizer right after bathing. For itching, you can use antihistamines or apply a cold, wet cloth to the area. Avoid scratching. And avoid things that trigger your rash.

The major risk factor for eczema is having a family history of the condition. You are also at risk if family members have asthma, allergic rhinitis, or other allergies.

The itching and rash of eczema can be triggered by:

• Allergens, such as dust mites, pollen, molds, or animal dander. Rarely, certain foods trigger a rash and itching.
• Harsh soaps or detergents, rubbing the skin, and wearing wool.
• Workplace irritants, such as fumes and chemicals.
• Weather changes, especially dry and cold.
• Temperature changes, such as a suddenly higher temperature. This may bring on sweating, which can cause itching.
• Stress. Stress may lead to more itching and scratching.
• Washing without moisturizing afterward. This can lead to drier skin and more itching.

There are some other health problems that can happen when you have eczema.

Eczema can cause problems with sleep. The itching caused by it, especially during flares, can make it hard to fall asleep or to get good sleep.

Skin infections can happen more often in people who have it. The skin may become reddish and warm, and a fever may develop. Most skin infections are treated with antibiotics.

People with eczema often have allergies and asthma. Depression and anxiety have also been linked with eczema.

The cause of eczema isn't clear, but it involves a problem with the skin's ability to hold in moisture. Most people who have it have a personal or family history of allergies and asthma. It can be triggered by harsh soaps, temperature changes, and stress.

Eczema, sometimes called atopic dermatitis, is a skin problem. It causes dry skin, intense itching, and a raised, reddish rash. Sometimes the rash develops clear fluid-filled blisters. It can also be scaly. The rash is not contagious. You can't catch it from others. Moisturizers and prescription creams often help.