by Scholten A
(Atopic Dermatitis)

Definition

Eczema is an inflammation of the skin. It makes parts of the skin red, itchy, and scaly. It may last for a long time or come and go.

Eczema
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Causes

Eczema is caused by the immune system overreacting. It is not known exactly why this happens. It may be due to genes, diet, and things in the environment.

Risk Factors

Eczema is more common in children.

Things that may raise the risk are:

  • Having a family history of eczema or allergies
  • Having asthma or allergies
  • Changes to certain genes
  • Eating a diet high in sugar and certain fats
  • Coming from a small family
  • Living in urban areas or places with low humidity

Many things can trigger flare ups of eczema. Some common ones are:

  • Very hot and very cold climates
  • Exposure to allergens or irritants such as:
    • Certain fabrics
    • Perfumes in soaps
    • Dust mites (common)
    • Foods
    • Nickel in jewelry
    • Certain plants
    • Latex, such as in rubber gloves
    • Cigarette smoke
  • Frequent washing, scratching or rubbing of the skin

Symptoms

Eczema usually begins at 3 to 6 months of age. It may improve by ages 5 to 7 years. For some, it continues into adolescence and early adulthood.

Symptoms can appear anywhere on the body. They may include:

  • Dry, itchy skin
  • Cracks behind the ears or in skin creases
  • Red patches on the cheeks, arms, and legs
  • A red, scaly rash
  • Thick, leathery skin
  • Crusting, oozing, or cracking of the skin

Diagnosis

The doctor will ask about your child’s symptoms and health history. A physical exam will be done. The diagnosis is based on symptoms and how the skin looks. The child may need to see an allergy or skin doctor for testing.

Treatment

There is no cure for eczema. The goals of treatment are to heal the skin and prevent flare-ups.

Options may be:

  • Skin care to reduce irritation and dry skin, such as:
    • Using moisturizing creams
    • Limiting baths and showers
    • Avoiding irritating soaps and gels
  • Medicines such as:
    • Steroid ointments to reduce inflammation
    • Antihistamines to prevent itching
    • Antibiotic pills or creams to treat infections

If skin care and medicines do not help, light therapy may be used on the skin.

Prevention

Eczema is difficult to prevent. Things that may help lower the risk in children are:

  • Breastfeeding
  • Using formula with hydrolyzed casein or 100% whey protein
  • Exposing children to pets at an early age

RESOURCES

Healthy Children—American Academy of Pediatrics  https://www.healthychildren.org 

National Eczema Association  https://nationaleczema.org 

CANADIAN RESOURCES

Canadian Dermatology Association  https://www.dermatology.ca 

Caring For Kids—Canadian Paediatric Society  https://www.caringforkids.cps.ca 

References

Atopic dermatitis. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/eczema/atopic-dermatitis. Accessed February 11, 2021.

Atopic dermatitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/atopic-dermatitis. Accessed February 11, 2021.

Avena-Woods C. Overview of atopic dermatitis. Am J Manag Care. 2017;23(8 Suppl):S115-S123.

Eczema. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/eczema-atopic-dermatitis.html. Accessed February 11, 2021.

Eczema and atopic dermatitis. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/eczema-and-atopic-dermatitis. Accessed February 11, 2021.

What is eczema? National Eczema Association website. Available at: https://nationaleczema.org/eczema. Accessed February 11, 2021.

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