Eczema/Dermatitis

With over 30 million Americans struggling with symptoms of eczema, this is a common medical problem that dermatologists often treat. Eczema is not a single condition; rather it is a collection of various skin diseases that cause patches of skin to become rough, inflamed, itchy and sometimes secondarily infected. Those affected may have difficulty staying focused at school or work as well as difficulty sleeping. While it’s prevalent in babies and young children, persons of all ages can develop eczema.

Some forms of eczema cannot be cured and require chronic maintenance to help relieve and prevent flares. Treatment for eczema largely depends on the type of eczema. Some general eczema treatments are listed below, however, depending on your type of eczema Dr. Kittridge may recommend other specific home and in-office treatment modalities.

There are many different forms of eczema, each of which are managed differently. Many individuals may have more than one form of eczema. Listed below are some common forms of eczema.

  • Atopic dermatitis: itchy patches of skin often accentuated on the cheeks in infants and skin folds in children which may persist into adult years or improve with age. Often these patients also have contact allergies, seasonal allergies and asthma.
  • Allergic contact dermatitis: an extremely itchy allergic reaction to things such as poison ivy, nickel, neomycin (Neosporin), fragrances, etc. The itchy rash usually appears within 48 hours after contact with a substance to which the skin is sensitive.
  • Irritant contact dermatitis: pink, irritated skin caused by direct chemical damage to an external irritant. The hands are the most common site of irritant contact dermatitis due to repeated exposure to soaps, cleansers, and solvents at home and at the workplace.
  • Dyshidrotic eczema: a particularly itchy form of eczema found on the palms, soles, or sides of the fingers that can present as flakey patches or vesicles.
  • Nummular dermatitis- round shaped patches or plaques on the body with symptoms of itch. Often confused for fungal infections.
  • Stasis dermatitis: inflamed, pink skin on the lower legs due to the presence of swelling and congestion and inflammation of the veins of the lower legs. In severe cases, the skin can break down to form small ulcers. Patients with stasis dermatitis need to wear compression stockings to improve their condition.
  • Seborrheic dermatitis: also known as dandruff, presents as a scaly, pink rash that shows up on the scalp and on the T-zone of the face.

A treatment plan for eczema/dermatitis often includes topical or oral anti-inflammatory and anti-itch medications, a skin care regimen, and lifestyle changes. The treatment plan is meant to not only treat the current course of eczema but to also prevent flare-ups. Each treatment protocol is geared toward the individual patient and depends on the type of eczema, the severity of disease, the age of the patient, the resources available etc. The goal of the care plan is to control itch, reduce redness and irritation of the skin, treat and prevent any secondary infections, remove scale from thickened areas of eczema and prevent eczema from spreading. Listed below are some general skin care recommendations.

  • Take lukewarm showers or baths for no more than 5-10 minutes.
  • Use a mild soap or cleanser that is free of fragrance.
  • Dry your skin very gently by patting dry with a towel. Do not aggressively rub.
  • Use a mild, fragrance-free cream or emollient immediately after bathing. Dr. Kittridge often recommends combing a moisturizing cream with equal parts petroleum jelly and applying to the skin immediately after bathing.
  • Try to decrease scratching.

ECZEMA MEDICATION & THERAPY

Topical, oral or injected medications may be prescribed. These medications help to keep symptoms under control by decreasing inflammation, repairing the skin barrier, fighting skin infection and relieving itch. In some cases vinegar soaks or bleach baths may be recommended to decrease bacterial colonization and prevent secondary infection of inflamed eczematous skin.

When an at-home treatment plan does not work to control symptoms, other in-office or inpatient treatments may be recommended.

  • Ultraviolet B light therapy is effective in treating chronic or persistent cases, but does carry an increased risk of sunburn and skin cancer if used for too long.
  • Wet dressing application in a controlled hospital setting. Wrapping the affected areas of skin with topical medication and wet dressings is effective in treating certain forms of eczema.
  • Oral systemic therapy is used in chronic, moderate to severe, persistent eczema. Dr. Kittridge has years of experience prescribing these medications safely in individuals.
  • Newer biologic medications have been approved for chronic, moderate to severe atopic dermatitis and have been very effective in controlling eczema and the associated itch.
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