What is Eczema?

Jennifer E. Wolford, DO, MPH, FAAP
Children's Hospital of Pittsburgh,
Division of Child Advocacy

What is Eczema?

  • Eczema is a chronic disease that causes dry, red, itchy, flaky skin.
  • Another name for eczema is atopic dermatitis(atopic = allergic; derm = skin; itis = inflammation.)
  • People with eczema have periods when the eczema is very severe and periods when the eczema is mild and well-controlled.
  • When eczema is severe, the skin is very itchy. When a person itches, the skin breaks down and the eczema gets worse and worse, making it more painful and difficult to treat.

What are the symptoms of eczema?

  • Intense itching
  • Red, dry, flaky skin
  • Skin that flakes off and becomes scale-like. (diagram 1)
  • Young infants' faces, arms, legs, and torsos are often affected by eczema. (diagram 2)
  • In older children, the creases in elbows, wrists, and knees are common sites. (diagram 3).

Is eczema dangerous?

  • In rare extremely severely affected children, eczema can lead to infections in the skin that can be serious and require hospitalization and special treatment.
  • More importantly, eczema is very difficult for a person. It is extremely itchy and uncomfortable. It is very difficult, or impossible, for a child to resist the urge to scratch their skin.
  • It can be difficult to concentrate in school when your skin is so itchy from eczema.
  • Severe eczema can lead to scarring of the skin. This can be stressful for children.
  • Over one-half of the children with eczema will outgrow this condition by adulthood.

What causes an eczema?

  • Doctors do not know what causes eczema.
  • Eczema runs in families. Eczema is more common in people that have a blood-related family member with eczema, but anyone can have it.
  • People with asthma or allergies are more likely to have eczema.

What makes eczema worse?

  • Different times of the year (winter) may be worse for some people with eczema
  • Hot dry environments
  • Tight clothing and too much sweating
  • Lack of moisturizer for skin
  • Exposure to cigarette smoke, certain chemicals or cleaning solutions, or wool or synthetic fibers
  • Using harsh soaps, perfumes or detergents

How is eczema treated?

  • Avoid long baths or showers more than 10 minutes. Long bathing dries out the skin. Try to avoid very hot baths and showers.
  • Moisturizing creams or ointments - to keep skin hydrated and moist. These should be applied right to skin after a short bath or shower.
  • Steroid creams and ointments - these medicines are applied to the skin and tame down the inflammation. Some steroid creams are used on faces and others are not.
  • Anti-itch (antihistamine) pills - This pill (or liquid) medicine is taken by mouth. For some people, these medicines help relieve the itching. The medicines do not work for everyone. Some of these medications can make you sleepy and are best for nighttime.
  • Immune system medications - These medicines are prescribed by doctors for a few people with very severe cases when all other treatments have failed. These medicines tame down the immune system which plays a role in eczema.

How does a person get diagnosed with eczema?

  • There is no single test for eczema.
  • A doctor will complete a close examination of the skin and ask many questions.

When should I see a doctor for eczema?

  • A person with eczema should see their doctor for regular check-ups and medication refills.
  • If you are having a severe flare up of eczema, you should see your doctor.
  • In some severe cases, the primary care doctor may want a dermatologist (a skin doctor) to evaluate your skin and give recommendations.

Diagram 1:

Diagram 2:

Diagram 3:

Content Sources:
American Academy of Pediatrics: www.healthychildren.org
American College of Allergy, Asthma and Immunology: www.acaai.org
Cincinnati Children's Hospital: www.cincinnatichildrens.org/health/e/eczema
National Center for Environmental Health: www.cdc.gov/nceh
Up To Date: www.uptodate.com

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