Eczema

Eczema develops due to a combination of genetic and environmental factors. Eczema is common in families with a history of allergies or asthma and affects approximately 10% to 20% of infants and 3% of adults and children in the United States. Most infants who develop the condition tend to outgrow it by their 10th birthday, while some people continue to have symptoms on and off throughout their lives. Flare-ups can be triggered by mold, pollen, detergent, and other environmental factors.

Eczema may be a common problem, but it is not contagious. While there is no cure for the condition, an experienced dermatologist from our team at Bryn Mawr Skin & Cancer can provide a customized and effective treatment protocol to manage symptoms.

Atopic Dermatitis

Atopic dermatitis or atopic eczema is a hereditary form of eczema, and the most common type. The condition typically manifests during infancy or early childhood, and is marked by inflamed, itchy areas of skin behind the knees, inside the elbows, and on the face, neck, hands, and scalp.

Children who suffer from atopic dermatitis often have asthma and/or hay fever, and have family members with similar issues.

Contact Dermatitis: Allergic & Irritant

Allergic contact dermatitis occurs due to a delayed reaction from the immune system after exposing the skin to an allergen. Skin inflammation occurs about 48 hours after contact with the allergy-inducing substance. Common causes of this type of dermatitis include poison ivy, metals, perfumes, preservatives, and dyes.

Irritant contact dermatitis is more common than allergic contact dermatitis. It occurs due to repeated exposure to chemicals that damage the outer skin layers, such as strong soaps and cleaning products, as they strip the skin of its oils and moisture, which triggers inflammation.

Exposure to such allergens and irritants is quite common in the workplace. According to recent statistics, skin disorders make up more than 45% of all occupationally related diseases. Among all occupational skin disorders, irritant contact dermatitis comprises about 80%, and allergic contact dermatitis about 30% (some patients have both).

Treatments for Eczema

A combination of treatments and medications are best for most types of eczema. Your dermatologist can help you plan a treatment regimen to effectively control your symptoms and to help prevent future flares. Your dermatologist may also recommend allergy testing to determine if there are any predictable and avoidable triggers of your eczema flares.

Non-Prescription Medications & Treatments

• Moisturizers containing emollients can relieve scaling and dryness of the skin to increase comfort. Some barrier-repairing moisturizers contain essentials oils, such as ceramides, that are missing from eczematous skin.
• Cool compresses with tap water or “Domeboro’s solution” can relieve itching and inflammation.
• Coal tar can soothe inflamed skin by reducing itching, flaking, and redness, and it is available in bath oils, gels, creams, shampoos, ointments, and in combination with corticosteroids.
• Antihistamines can relieve itching and facilitate sound sleep.

Prescription Medications

Topical corticosteroids, ranging from mild to very potent, are the most effective anti-inflammatory agents. They should be applied as your doctor has prescribed until the inflammation has been resolved. Other non-corticosteroid topical options include Elidel, Protopic, and Eucrisa, which suppress the immune system in the skin. In 2017, Dupixent was approved. It is an injectable prescription medicine used to treat adult patients with moderate to severe eczema, whose disease is not well-controlled with prescription topical therapies, or who cannot use topical therapies. Dupixent can be used with or without topical corticosteroids.

Both topical and oral antibiotics are used when skin infections occur as a complication from the skin barrier being broken due to inflammation and scratching, allowing bacteria to enter the skin.