Infantile eczema; Atopic dermatitis; Dermatitis - atopic; Eczema - atopic
Eczema is a chronic skin disorder that involves scaly and itchy rashes. Atopic eczema is the most common type.
Eczema is most common in infants. Many people outgrow it by early adulthood. The condition tends to run in families.
The following can make eczema symptoms worse:
Typical skin changes may include:
Both the type of rash and where the rash appears can depend on the age of the patient:
Itching, which is sometimes intense, almost always occurs. Itching may start even before the rash appears.
Diagnosis is primarily based on:
The health care provider should examine the lesions to rule out other possible causes. A skin lesion biopsy may be performed, but is not always needed to make the diagnosis.
Allergy skin testing may be helpful for people with:
SKIN CARE AT HOME
Taking care of your skin at home may reduce the need for medications.
Avoid scratching the rash or skin if you can:
Keep the skin moist (called lubricating or moisturizing the skin). Use ointments (such as petroleum jelly), creams, or lotions 2 - 3 times a day. Moisturizers should be free of alcohol, scents, dyes, fragrances, or other chemicals. A humidifier in the home will also help.
Avoid anything that makes your symptoms worse. This may include:
When washing or bathing:
Antihistamines taken by mouth may help with itching or if you have allergies. Often you can buy them without a prescription.
Most causes of atopic eczema are treated with medications that are placed directly on the skin or scalp (called topical medicines):
Other medicines that may be used include:
Eczema is a chronic condition, but you can control it with treatment, by avoiding irritants, and by keeping the skin well-moisturized.
In children, it often clears beginning around age 5 - 6, but flareups will often occur. In adults, it is generally a long-term or recurring condition.
People with eczema tend to have dry skin that flares up more in the winter, when the air is cold and dry.
Call for an appointment with your health care provider if:
Studies have shown that children who are breast-fed until age 4 months are less likely to get eczema.
If the child is not breast-fed, using a formula that contains processed cow milk protein (called partially hydrolyzed formula) may decrease the chances of developing eczema.
Eczema tends to run in families.
Keeping the skin well-moisturized and avoiding irritants is important.
Excema and hand dermatitis. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 3.
Atopic dermatitis. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 5.
Greer FR, Sicherer SH, Burks, W and the Committee on Nutrition and Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121:183-191.
Lewis-Jones S, Mugglestone MA; Guideline Development Group. Management of atopic eczema in children aged up to 12 years: summary of NICE guidance. BMJ. 2007;335:1263-1264.
Ascroft DM, Chen LC, Garside R, Stein K, Williams HC. Topical pimecrolimus for eczema. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005500.
Bath-Hextall FJ, Delamere FM, Williams HC. Dietary exclusions for established atopic eczema. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD005203.
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