ECZEMA

General Information

DEFINITION--A chronic allergic skin disorder.

BODY PARTS INVOLVED--Skin, especially of the hands, scalp, face, back of the neck or skin creases of elbows and knees. Types: atopic eczema, occurs in people who have a tendency toward allergy and is common in babies; nummular eczema occurs in adults and the cause is unknown; hand eczema usually results from irritation by a substance.

SEX OR AGE MOST AFFECTED--May begin between 1 month and 1 year. It usually subsides somewhat by age 3, but it may flare again at any age.

SIGNS & SYMPTOMS--

Skin affected by eczema has the following characteristics:

• Itching (sometimes severe).
• Small blisters with oozing.
• Thickening and scaling from chronic inflammation.

CAUSES

Often occurs for no known reason. An allergic reaction to a wide variety of things, including:

• Foods, such as eggs, wheat, milk or seafood.
• Wool clothing.
• Skin lotions and ointments.
• Soaps, detergents, cleansers.
• Plants, tanning agents used for shoe leather, dyes, topical medications.

RISK INCREASES WITH

• Stress.
• Medical history of other allergic conditions, such as hay fever, asthma or sensitivity to certain drugs.
• Clothing made of synthetic fabric, which traps perspiration.
• Weather extremes, including humidity, severe cold and severe heat (especially with increased sweating).

HOW TO PREVENT

• Avoiding risk factors.
• Wearing rubber gloves for household tasks.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as blood and skin tests to identify allergies.

APPROPRIATE HEALTH CARE

• Home care.
• Doctor's treatment.

POSSIBLE COMPLICATIONS--Bacterial infections caused by injury to the skin.

PROBABLE OUTCOME--Variable. Some children outgrow eczema. Others are resistant to treatment, and eczema may persist through puberty. However, symptoms can usually be controlled with treatment. Skin irritation from any other cause can trigger a flare-up or aggravate existing eczema.

How To Treat

GENERAL MEASURES--

• Wear loose, cotton clothing to help absorb perspiration.
• Minimize stress whenever possible.
• Keep fingernails short and put soft gloves on at night to minimize scratching. Scratching worsens eczema.
• Bathe less frequently to avoid excessive skin dryness. Soap and water may trigger flare-ups. When bathing, use special non-fat soaps and tepid water. Use no soap on inflamed areas.
• Lubricate the skin after bathing.
• Avoid extreme temperature changes.
• Avoid anything that has previously worsened the condition.

MEDICATION--Your doctor may prescribe:

• Ointments containing coal tar or cortisone drugs to decrease inflammation. These may help more if used at night under occlusive plastic wrap. Ask your doctor.
• Antihistamines to decrease itching.
• Antibiotics for complicating infections, if they occur.
• Sedatives or tranquilizers (rarely).

ACTIVITY--No restrictions. Sometimes being exposed to sunlight helps heal the rash. Take care not to get burned.

DIET--No special diet. Eliminate any foods known to cause flare-ups of eczema.

Call Your Doctor If

• You have symptoms of eczema that don't clear up with self-care.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.