Shielding Your Skin From Eczema

By Derek K. Johnson, MD

What Is Eczema?

We all know or have heard the word eczema. Some may have eczema or have loved ones who suffer from this disorder. Eczema, or atopic dermatitis, is a relatively common skin condition that usually leads to very itchy rashes, dry skin, and leathery, discolored patches of skin that can cause significant discomfort.

Eczema usually starts in early infancy. Initially, the face, neck and creases of the elbows and knees are the most affected areas, although the diaper area is commonly spared. In older children and adults, the skin rashes are commonly localized to areas behind the knees and inner arm surfaces.

What Causes Eczema?

Eczema is associated with abnormalities in skin barrier function. The most important job the skin has is to prevent water from escaping the body, and to prevent bacteria from entering. Both of these are reduced when eczema is present. Also, there is an increased amount of certain enzymes that break down the skin, and a decreased amount of a special type of fat, called ceramide, that normally helps reinforce the barrier function of skin.

Eczema is often the first manifestation of the “allergic march,” and many patients with eczema will later develop allergic rhinitis and/or asthma. Because of this, it is important for a child with eczema to be evaluated by an allergist, who can fully assess allergic status.

What Makes Eczema Worse?

Many factors can worsen eczema. Exposure to allergens such as dust mites and pet dander can increase allergic inflammationa major player in eczema.

Food allergens are a common trigger in young children and infants, but are much less problematic in older children and adults. Bacteria such as Staphylococcus and Streptococcus can complicate eczema as well. Extreme temperatures and some fabrics may also provoke symptoms.

How Is Eczema Treated?

Because the main problem in eczema is that the skin cannot retain water as well as it should, both replacing moisture, and sealing it into the skin are the mainstays of treatment.

Soaking in a bath for 20-30 minutes daily, followed by immediate application of petroleum jelly, is actually the ideal treatment. Use of soaps can cause eczema to worsen.

If you think you or your child may have eczema, consultation with an allergist can be very beneficial.

Allergists are not only well trained in the current treatment of eczema, but they are also able to help identify allergic triggers that can cause symptoms to persist.