Reviewer: S. Randhawa, M.D., Allergist/Immunologist and Assistant Professor at NSU
What is atopic dermatitis (eczema)?
Atopic dermatitis (eczema) is a common skin rash that often affects the face, elbows and knees, especially in younger children. This red, scaly, itchy rash is more common in young infants and those who have a personal or family history of allergy.
What triggers atopic dermatitis flare-ups?
Common triggers include aeroallergens like cat dander or house dust, overheating or sweating, and contact with irritants like wool or soaps. Dust mite, more than foods, is the major cause of allergic atopic dermatitis.
For some patients, usually children, certain foods can also trigger eczema. Skin staphyloccus ("staph") infections or carrier status can cause a flare-up in children as well. Eczema patients usually have very dry skin and allergic shiners (an extra crease, called a Dennie's line) across their lower eyelids. They are also more at risk for other skin infections.
In older individuals, emotional stress can cause a flare-up.
Prevention of atopic dermatitis (eczema)
Preventing the eczema itch is the main goal of treatment. Do not scratch or rub your rash. Applying cold compresses and creams or ointments is helpful. Also remove all irritants that aggravate your condition from your environment.
If a food is identified as the cause, it must be eliminated from your diet.
Treatment of atopic dermatitis (eczema)
The maintenance daily treatment consist of bathing daily for 10 minutes in lukewarm water until the skin is "pruny".
Avoid soap. It is best to use non-soap cleansers. They usually do not contain sodium lauryl sulfate (SLS), a chemical that creates soap’s foaming action and can dry and irritate skin. Non-soap cleansers include Dove Sensitive Skin Unscented Beauty Bar, Aquaphor Gentle Wash, Aveeno Advanced Care Wash, Basis Sensitive Skin Bar, CeraVe Hydrating Cleanser, and Cetaphil Gentle Cleansing Bar.
Follow the bath immediately with liberal use of moisturizers. A simple regimen is to use Eucerin in the morning (less greasy) and Aquaphor in the evening.
Topical steroid cream medications and topical calcineurin inhibitors are most effective in treating any rash that you can feel with your hand. Hydrocortisone 1% is the first topical steroid to try (available over the counter). For more severe flare-ups, your doctor will prescribe a stronger topical steroid such as triamcinolone 0.1%.
Antihistamines are recommended to help relieve the itching. In severe cases, oral corticosteroids are also prescribed.
If a skin staph infection or colonization is suspected to be a trigger for your eczema flare-up, antibiotics are recommended for 2 weeks, followed by diluted bleach baths once or twice a week.
Atopic Dermatitis Treatment - Illustrated (click to enlarge the image):
References
Atopic dermatitis (eczema)
Allergic Skin Conditions. AAAAI.
Skin Care Tips for Individuals with Atopic Dermatitis (Eczema). AAAAI.
Published: 11/28/2011
Updated: 03/08/2014
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