Eczema is a common condition that affects about 15-20% of children and 1-3% of adults. It is a chronic, itchy rash that can affect any part of the body. Eczema can be a genetic condition, known as atopic dermatitis, which will present during early childhood or it can be an acquired condition that starts during adulthood mainly caused by dryness of the skin.
Regardless of the type of eczema, the primary way to prevent flare ups as much as possible is to moisturize the skin well and avoid things that dry out the skin more. I recommend using as thick of a moisturizer that is tolerable for the patient to use daily. Any brand is fine and the moisturizer does not need to be expensive but it should not be able to pour out of the bottle easily. The best time to apply moisturizer is right after a bath or shower while the skin is still damp. Showering habits can also affect dryness of the skin. Showers should be short, about 5-10 minutes; lukewarm water should be used, not hot; and a non-soap cleanser is recommended or at the very least a body wash that has moisturizer mixed into it. If the weather is very dry, a humidifier can help.
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Treatment is also the same for whether eczema is genetic or acquired. The mainstay therapy is topical steroids. Topical steroids of the appropriate strength can help quickly calm down flares of eczema. It is important to use the appropriate strength in different areas as long-term topical steroid use can cause thinning of the skin and other problems if used inappropriately. The length of time a topical steroid should be used will depend on the severity of the flare and area of the body so if something does not calm down within 1-2 weeks, see your dermatologist for more guidance.
Patients who have more frequent flares, who have areas affecting the scalp, face, hands and groin and/or who have large body surface areas that are affected may be eligible for systemic medications such as methotrexate, cyclosporine or Dupixent. Methotrexate and cyclosporine are older systemic medications that work well but can have potential significant side effects so need to be monitored closely by a dermatologist. Dupixent is a newer medication that is a biologic injectable with very minimal potential severe side effects.
Eczema is a common skin condition that can affect all ages. Fortunately, there are many effective and safe treatments that can be used to control eczema. If you think you may be affected by eczema or are having trouble controlling your skin, visit your dermatologist as there are many good treatments available to make anyone with eczema feel comfortable.