Understanding Eczema (atopic dermatitis)

Eczema (EG-zih-mah) is a skin condition that usually comes and goes. The most common form of eczema is atopic dermatitis (ay-TOP-ick dur-ma-TIE-tiss), which is an inflammation of the skin. During a flare-up, the skin becomes extremely itchy, red, scaly, and irritated. Eczema can be widespread or limited to a few areas of the body depending on your age.

Atopic dermatitis affects about 35 million people in the United States. This disease can occur at any age, but atopic dermatitis first appears most often in infants and young children.

Most people with atopic dermatitis have family members with atopic dermatitis as well. However atopic dermatitis does not spread from person to person.

Eczema Causes

No one really knows what causes eczema (atopic dermatitis), however, we do know of certain things that can cause eczema to “flare-up”, or get worse. A flare-up occurs when the immune system in people’s skin overreacts to environmental or emotional triggers and causes symptoms such as an itchy rash to appear.

People with eczema may have a unique set of causes, or triggers, that produce a skin rash. Some of the more common causes of eczema flare-ups include:

  • Changes in temperature or humidity
  • Chemical irritants, such as pesticides, paint strippers, alcohol, astringents, perfumes, harsh soaps, detergents, and household cleaners
  • Physical irritants, such as clothes made of rough or scratchy fabrics, like wool
  • Allergies (to dust, pollen, mold, animal dander, etc.)
  • Intense emotion or stress
  • Infections of any kind

People with eczema should work closely with their healthcare providers to determine what triggers their eczema flare-ups. They can then take steps to avoid these triggers and minimize the onset of a skin rash.

How Common is Eczema

Many people have eczema (atopic dermatitis). It is a very common problem in the United States. In fact, eczema is the most common skin problem in children under the age of 12. Children with a parent, grandparent, brother, sister, aunt, or uncle who have or have had eczema, asthma, or hay fever often have eczema themselves. In fact, if both parents have eczema, there is an 80% chance that their children will too. However, even people who don’t have these conditions in their families can develop eczema too.

Eczema appears most often in early childhood. Nine out of 10 people who have eczema get it before they are 5 years old. People who have it as children may always have dry or extra-sensitive skin, even as adults.

About two thirds of eczema cases begin in babies under the age of 1 year. It starts usually in babies between the ages of 6 and 12 weeks. It may clear up but then may come back from time to time.

It is not common for someone to have eczema for the first time as an adult, but it can happen.

Many people with eczema also have asthma or hay fever as children or adults. Children with eczema often have allergies to such things as food or pollen.

In older children and adults, eczema appears less often on the face and more commonly on the hands, neck, inner elbows, backs of the knees, and ankles.

In infants and toddler, eczema usually appears on the face, elbows, knees, and possibly on other areas.

How To Learn More About Eczema

Your healthcare provider can give you the best advice about eczema (atopic dermatitis) flare-ups and how to treat them. To learn more, you may find the following Web sites helpful:

National Eczema Association for Science and Education
http://www.nationaleczema.org
The National Eczema Association for Science and Education works to improve the health and the quality of life of persons living with atopic dermatitis/eczema, including those who have the disease as well as their loved ones.

Inflammatory Skin Disease Institute
http://www.isdionline.org The goal of the Inflammatory Skin Disease Institute (ISDI) is to promote public awareness and enhanced treatment of inflammatory skin diseases through education, research, and patient advocacy.

What To Ask Your Doctor

If your healthcare provider prescribes medicine for eczema (atopic dermatitis), you may want to ask the following questions:

  • Are there any side effects to watch for?
  • Does my product contain steroids?
  • If it’s a cream or ointment, how much should I apply?
  • If it’s a pill or liquid (syrup), how much should I take?
  • How often should I apply the medicine or take the pill or liquid?
  • Are there any parts of my body where I should not apply the medicine?
  • How soon can I expect to start feeling better after using this medicine?
  • Is it OK to go out in the sun when using the medicine?
  • Should I apply a bandage over the medicine?
  • Should I reapply the medicine after washing?
  • What are the advantages and disadvantages of creams versus ointments?

Provided by ArmMed Media
Revision date: July 9, 2011
Last revised: by Janet A. Staessen, MD, PhD