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Overview

Eczema, also known as “atopic dermatitis,” is a non-contagious, inflammatory skin condition that is characterized by itching, redness, and scaly rashes. These symptoms can be painful, and can cause skin coloring changes and blisters. Symptoms of eczema often appear on the arms, legs, hands, and face. The itch associated with eczema can be severe and can often interrupt sleep. When kids scratch their skin, they can get an infection. Infants who have eczema may rub against bedding or other things in an attempt to relieve the itch.

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Eczema most commonly shows up before the age of 5, but adolescents and adults can also develop the condition. About 60 percent of patients will experience eczema symptoms by age 1, and another 30 percent will experience symptoms by age 5. Children born into families that have a history of allergic diseases such as asthma or hay fever are at an increased risk for eczema. Eczema is not caused by any type of allergy, but is associated with the development of food and environmental allergies. Eczema develops due to a defective skin barrier. Eczema is often inherited and infants with parents who have allergies or asthma are at highest risk for development.

Eczema is considered to be part of the “atopic march.” The atopic march involves the diagnosis of eczema during infancy, followed by food allergy, allergic rhinitis (also known as hay fever) and asthma, typically in that order.

Some young children with severe eczema benefit from food allergy testing and potential removal of certain specific foods from their diet. Peanut, egg, and milk are the most common food allergies identified in these children. It is not recommended to test all children with eczema for food allergies due to the high rate of false positive results. This leads to misdiagnosis and unnecessary food avoidance. Scientists have found that people who have a protein deficiency known as Filaggrin deficiency are at risk for developing eczema.

Children and adults diagnosed with eczema can manage the condition with the guidance of an allergist. In cases of moderate or severe eczema, an allergist may recommend prescription medication, including topical steroids and/or antihistamine. Milder cases may be treated with ointments and moisturizers. Flare-ups of eczema can be caused by any fragranced product including cosmetics, soaps, and detergents. Other triggers include harsh clothing such as dry climates, cold air, illnesses such as the common cold and stress.

FAQs

Will my eczema symptoms improve?

Eczema is a chronic condition, and the symptoms can come and go over time. Symptoms often improve as children age. The symptoms are treatable. Talk to your allergist about topical ointments or creams that can be applied to the skin. You can also help manage your eczema with regular moisturizing after baths and showers, avoiding things may that trigger a flare up (fragranced products, for example), and wearing loose-fitting, soft cotton clothing.

Is all eczema the same?

No. We have mainly discussed atopic dermatitis, also known as atopic eczema. Many other types of inflammatory skin conditions are also part of the eczema family. One such example is contact dermatitis, which is caused by direct contact with substances such as cosmetics, detergents, perfumes, and a host of other allergens and substances to which an individual has developed sensitivities.

What about the new eczema medications? Are they safe for children?

There are newly-approved treatment options for severe eczema, as well as exciting new treatments under development. Many of these are biologic therapies, which target specific immune pathways. Most are being studied for use in adults or older children, but this is a rapidly changing area. Board certified allergists will have the most up to date information available, to see if it applies to your situation.

Updated 12/28/17