Dr. M.J. Bazos, MD
Patient Handout
ECZEMA
About Your
Diagnosis
Eczema is a chronic skin
condition characterized by reddened, dry, itchy, scaly skin. Several types of
eczema are known, the most common being atopic dermatitis, hand eczema, and
nummular eczema. These may result from hypersensitive skin or chronic
irritation; however, often no clear cause can be determined. Eczema is not
contagious, but some cases do “run in families.” It is not curable,
but careful treatment can minimize the itching and dryness of the skin, and
prevent complications such as infection. Various forms of eczema affect between
5% and 10% of all Americans each
year.
Living With Your
Diagnosis
Eczema may first appear in
infancy or childhood. Reddened, scaly patches appear on the face, forearms, and
lower legs. After school age, patches are more common behind the knees and in
the folds of the elbows. Eczema almost never affects the back. Hand eczema
usually involves the fingers and palms. Nummular eczema can occur on any body
surface but is most common on the chest, arms, and abdomen. Symptoms of eczema
include intense itching and irritability. Often no visible rash is noted until
after the patient has begun scratching. If untreated, the skin will be damaged
by the scratching and can become thickened with scars. Infection can also occur
because the scratching can decrease the skin’s ability to fight
bacteria.
Treatment
All
treatment is aimed at breaking the itch-scratch cycle. Avoid irritants such as
hot water, detergents, and other chemicals as much as possible. Keep
children’s fingernails short, and put mittens on young infants to prevent
scratching. Antihistamine medicines, taken by mouth, can decrease the itching.
However, these medicines are very sedating (sleep inducing), and you must be
careful to avoid driving, cooking, or working with machinery while using them.
Use antihistamines cautiously in children as well, because school performance
may suffer if the child is too sleepy in class. Other treatments include
lubricating and moisturizing the skin, which also helps minimize the itching.
Use mild, hypoallergenic, over-the-counter skin creams or ointments to prevent
excessive skin dryness. Use prescription steroid creams for more resistant cases
of irritation and scaling as directed by your doctor. (Do not use these creams
on your face unless specifically prescribed for facial rash. The facial skin is
fragile and can be thinned by overuse of steroid creams.) Occasionally your
doctor may prescribe oral steroids (tablets or syrup) for a severe episode of
inflammation. These are powerful anti-inflammatory drugs and can have serious
side effects if used frequently. These side effects include stomach irritation,
ulcers, and osteoporosis. Be sure to use these medicines carefully and exactly
as directed by your doctor. If infection is present, your doctor will prescribe
oral antibiotics to fight the bacteria. Over-thecounter antibiotic creams will
not fight the infection adequately, so be sure to complete your oral antibiotics
as prescribed.
The
DOs
• Do follow a daily skin
wellness regimen, even when your skin is free of
itching.
• Do lubricate your skin
after each exposure to water.
• Do
use the mildest soap and shampoo
available.
• Do keep fingernails
short, and bandage areas of severe itching if possible to keep the risk of
scratching minimal.
• Do use long
sleeves and long pants to help prevent the itch-scratch cycle, especially in
children.
• Do double-rinse clothing
to minimize irritation.
The
DON’Ts
• Don’t bathe
with hot water because it will dry the skin and increase
irritation.
• Don’t use steroid
products on the face or near the eyes unless specifically directed to do so by
your doctor.
When to Call Your
Doctor
• If you have fever or
chills.
• If you have nausea or
vomiting.
• If you have increased
redness, bleeding, or discharge around the
rash.
For More
Information
American Academy of
Dermatology
930 N. Meachum
Road
Schaumburg, IL
60173
847-330-0230
National
Eczema Association
1221 S.W.
Yamhill, #303
Portland, OR
97205
503-228-4430
Inflamed
hand eczema with early fissure. (From Goldstein
BG,
Goldstein AO: Practical
Dermatology, vol 1. St. Louis,
Mosby–Year
Book, 1992. Used
by permission.)