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Eczema
is term for a group of medical conditions that cause
the skin to become inflamed or irritated.
The
most common type of eczema is known as atopic dermatitis,
or atopic eczema. Atopic dermatitis is the form of eczema
caused by allergies. It affects about 10% to 20% of
infants and about 3% of adults and children in the U.S.
Most infants who develop the condition outgrow it by
their second birthday, while some people continue to
experience symptoms on and off throughout life. But,
with proper treatment, the disease can be controlled
in the majority of sufferers.
What
Are the Symptoms?
No
matter which part of the skin is affected, eczema is
almost always itchy. Sometimes the itching will start
before the rash appears, but when it does the rash most
commonly occurs on the face, knees, hands, or feet,
but may also affect other areas.
Affected
areas usually appear very dry, thickened, or scaly.
In fair-skinned people, these areas may initially appear
reddish and then turn brown. Among darker-skinned people,
eczema can affect pigmentation, making the affected
area lighter or darker.
In
infants, the itchy rash can produce an oozing, crusting
condition that occurs mainly on the face and scalp,
but patches may appear anywhere.
What
Causes It?
The
exact cause of eczema is unknown, but it's thought to
be linked to an overactive response by the body's immune
system to an irritant. It is this response that causes
the symptoms of the disease.
In
addition, eczema is commonly found in families with
a history of other allergies or asthma.
Some
people may suffer "flare-ups" of the itchy
rash in response to certain substances or conditions.
For some, coming into contact with rough or coarse materials
may cause the skin to become itchy. For others, feeling
too hot or too cold, exposure to certain household products
like soap or detergent, or coming into contact with
animal dander may cause an outbreak. Upper respiratory
infections or colds may also be triggers. Stress may
cause the condition to worsen.
Although
there is no cure, most people can effectively manage
their disease with medical treatment and by avoiding
irritants. The condition is not contagious and can't
be spread from person to person.
How
Is It Diagnosed?
A
pediatrician, dermatologist, or your primary care provider
can make a diagnosis of eczema. Since many people with
eczema also suffer from allergies, your doctor may perform
allergy tests to determine possible irritants or triggers,
especially among children.
How
Is It Treated?
The
goal of treatment is to relieve and prevent itching,
which can lead to infection. Since the disease makes
skin dry and itchy, lotions and creams are recommended
to keep the skin moist. These solutions are usually
applied when the skin is damp, such as after bathing,
to help the skin retain moisture. Cold compresses may
also be used to relieve itching.
Over-the-counter
or prescription creams and ointments containing corticosteroids,
such as hydrocortisone, are often prescribed to reduce
inflammation. For severe cases, your doctor may prescribe
oral corticosteroids. In addition, if the affected area
becomes infected, your doctor may prescribe antibiotics
to kill the infection-causing bacteria.
Other
treatments include antihistamines to reduce severe itching,
tar treatments (chemicals designed to reduce itching),
phototherapy (therapy using ultraviolet light applied
to the skin), and the drug cyclosporine A for people
whose condition doesn't respond to other treatments.
In
addition, the FDA recently approved the first of a new
class of drugs known as topical immunomodulators (TIMs)
for the treatment of moderate-to-severe eczema. The
drugs work by altering the immune system response to
prevent flare-ups.
How
Can Flare-ups Be Prevented?
Eczema
outbreaks can usually be avoided or the severity lessened
by following these simple tips.
Moisturize
frequently
Avoid sudden changes in temperature or humidity
Avoid sweating or overheating
Reduce stress
Avoid scratchy materials, such as wool
Avoid harsh soaps, detergents, and solvents
Avoid environmental factors that trigger allergies (for
example, pollen, mold, dust mites, and animal dander)
Be aware of any foods that may cause an outbreak and
avoid those foods
Reviewed
by the doctors at The Cleveland Clinic Department of
Pulmonary, Allergy and Critical Care Medicine.
Edited
by Charlotte E. Grayson, MD, Feb. 2004, WebMD.
Portions
of this page © The Cleveland Clinic 2000-2004
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