Am Fam Physician. 1999;60(4):1209-1210
See related article on atopic dermatitis.
Eczema (also called “atopic dermatitis”) is a skin disease. (Say the word this way: ex-em-ah.) Eczema causes dry skin that can itch, get red and crack. Part of the skin might break out in a rash, or the rash might be on the whole body.
In adults, eczema usually develops on the insides of the elbows, the backs of the knees, the hands and the backs of the elbows. In young children, the rash is most often on the face.
Eczema is most common in people whose relatives have allergic conditions like asthma or hay fever. Up to 10 percent of children get eczema.
What causes eczema?
The exact cause of eczema isn't known. It may be caused or made worse by these things:
Soaps, laundry detergents and perfumes. Scratchy clothes (like wool) can also irritate the skin.
Allergens like pollens, pet hair or dander (dried bits of skin), food, feathers and dust mites. (Dust mites are very tiny, spider-like creatures. They make their homes in mattresses, pillows and rugs. They can only be seen under a microscope.)
Low humidity. During cold weather, the heated air inside homes and other buildings can make skin dry and itchy.
Heat, high humidity and sweating. These can make the itching worse.
Some foods cause eczema.
Emotional stress. Feeling upset can cause the face and body to get itchy, red and hot.
How is eczema treated?
Your doctor can help you find out what makes your eczema worse so you can avoid those things. No one treatment is best for all people with eczema.
Skin care is very important!
Shower in warm water instead of hot water only once a day for less than 10 minutes. A baby or small child may have a short bath.
Wash with a mild soap like Dove, Tone, Kiss My Face or Neutrogena. If you're not too dirty or sweaty, use soap only on the genital area, the armpits, hands and feet.
Pat your skin dry with a soft towel.
Use a moisturizer like Eucerin, Aquaphor or Lubriderm. You may need to use it several times a day.
Be sure to drink lots of water. Water helps keep the skin moist.
Because laundry soaps can irritate your skin, you might try running your clothes through two rinse cycles. You may also want to try using a milder laundry soap.
Wear gloves when you work with cleaning products that might irritate your skin.
Wash your sheets in hot water (and often) to get rid of dust mites. Use dust-proof covers on pillows, box springs and mattresses.
Soak in the bathtub with oatmeal soaking products, like Aveeno, to help make your skin less itchy.
Wear loose clothes made of cotton and other natural materials that “breathe.” This includes underwear. Wash new clothing before wearing it.
What can I do if food causes my eczema?
Your doctor may ask you to drop a certain food from your diet for a while. This way you can find out if this food makes your eczema worse.
What can I do about emotional stress?
First, learn what causes you (or your child) to feel stressed. Then use exercise, hobbies and meditation to control your stress reactions.
Can medicine help eczema?
There are medicines you can put on your skin, called topical steroids. They help keep down the itching, swelling and redness.
Topical steroids come in creams, ointments, lotions and sprays. Sprays and lotions are best on the scalp and other hairy areas.
If your eczema gets infected, you may also need an antibiotic.
Medicines called antihistamines can help make the rash go away.
Itching is a problem. What can I do about it?
It's a good idea to try not to scratch your itchy rash, because scratching might give you an infection. Here are some things that help:
Cut your fingernails short, and wear cotton gloves during the night. For children, knee-high socks work better than gloves because they're harder to pull off during sleep.
During the day, keep your hands busy. Many people scratch more when they have nothing else to do with their hands.
An antihistamine may help with the itching. Ask your doctor about this.
Where can I get more information about eczema?
For information and support, call the National Eczema Association for Science and Education at 1-800-818-7546. The Web address is: www.eczema-assn.org.