Eczema is a dermatitis which presents as a red, itchy rash. It can occur on almost any skin surface. Itch is often very severe with this condition and can cause extreme distress of the affected patient. Eczema can affect young infants, children, and adults. The cause is often unknown, but in some cases may be inherited or result from skin contact with an irritant and allergen, for example poison ivy. Eczema may be acute, lasting only a few days to weeks or can become chronic, being recurrent over many years.
Eczema can take the form of elevated red bumps or papules as well as flat red areas called patches. Affected areas can become scaly. Because of the intense sensation of itch, patients with eczema frequently scratch the affected skin, sometimes to the point of bleeding. Not only can open skin be a route to infection of the skin, continuous scratching can cause permanent changes to the skin such as discoloration and thickening.
Patients with eczema often suffer from a disrupted skin barrier and thus are more susceptible to bacterial and viral skin infections, skin irritation and dryness, and development of allergy to topical commercial products. The restoration of skin barrier function is a critical component in the treatment of eczema.
The main component of any treatment regimen is topical therapy, though oral medications may be indicated. The latter requires blood testing both prior to and during therapy. Diagnosis and treatment regimens are best made by a skin specialist or dermatologist. Simple allergy tests (no needle sticks!) can be performed by a dermatologist for patients with eczema that may be caused by an irritant or allergen (see Skin Allergy Testing on our website for more information). Early intervention is important to relieve itch, restore skin barrier function, and decrease the risk of permanent skin changes. Consultation of a dermatologist may improve quality of life, both now and for years to come.