UNIVERSITY STUDENT HEALTH SERVICES • Fact Sheet ECZEMA (Atopic Dermatitis) WHAT IS IT? Eczema is a common skin condition that is often itchy and can be chronic or intermittent in nature. It is also known as atopic dermatitis. “Atopic” refers to someone who is likely to develop allergies, and “dermatitis” refers to skin that is inflamed and irritated. HOW COMMON IS IT? Eczema affects both adults and children but is more common in babies. Up to 10% of infants and 3% of all people in the United States have this condition. Eczema frequently improves as children age, but about 50% of individuals are affected throughout their lifetimes. WHAT CAUSES IT? While the exact cause of eczema is unknown, it appears to occur when the immune system responds abnormally, resulting in an overactive inflammatory response. Eczema tends to run in families and is associated with allergic conditions such as asthma and hay fever. Dryness of the skin aggravates the condition. Soaps, detergents, household cleaners, and aftershave lotions may be irritating to the skin. Symptoms may also be triggered by wool, lanolin (wool fat), temperature changes, certain foods, viruses, animal dander, dust mites, and stress. WHAT ARE THE SYMPTOMS? The skin is frequently itchy and may become red, dry, crusted, or oozing. The rash often occurs at the elbow folds, behind the knees, behind the neck, on the backs of the hands and/or feet, or on the face and eyelids. The rash may cover most of the body in some people or may occur in round coin-shaped patches (called nummular eczema). Eczema is not contagious. WHAT IS THE TREATMENT? Eczema can’t be cured, but it can be controlled by developing your own skin care and moisturizing plan. It is important to keep the skin well-moisturized, as dry skin often triggers symptoms. The following recommendations will help guide you with your skin care. Preventive Measures Avoid excessive bathing. Reduce bathing time to 10-15 minutes. Use lukewarm water while bathing – avoid hot or cold water. Do not vigorously scrub with a washcloth, sponge, or brush, as this can irritate the skin. Use very little soap and only in areas where needed. Avoid soaps that are lye-based. A mild soap such as unscented Dove, Oil of Olay, Basis, or Cetaphil is recommended. Do not use bubblebath. After bathing, dry your skin by patting gently with a towel. Avoid rubbing the skin. Apply a moisturizer immediately after bathing, while the skin is still warm and moist, in order to “trap” water in the skin. Use moisturizer several times daily to the whole body. Avoid lotions that contain alcohol. Lotions such as Lubriderm, Eucerin, Cetaphil, Lacticare, and Vaseline Intensive Care are helpful. Ointment-based moisturizers are thicker and can be more helpful in the winter; these include Aquaphor ointment, Eucerin or Cetaphil cream, and Vaseline petroleum jelly. Medicated creams and ointments should be applied to affected areas only. Moisturizers are applied to the whole body. If both are used at the same time, apply the medicated cream or ointment first. Do not use perfumes, colognes, sprays, powders, etc. on your skin. Avoid fabric softeners and harsh laundry detergents. If you must use them, use the liquid unscented variety in a quantity smaller than what the package recommends. If your symptoms persist despite good skin care and the use of prescription medication, double rinse your clothes after washing. Wear absorbent and non-irritating clothing. Cotton or a cotton blend is a good choice, while wool and silk may be more irritating. Avoid restrictive clothing and waterproof fabrics. Wear rubber gloves while washing dishes. Wear cotton gloves under the plastic gloves to soak up sweat from your hands. Attempt not to scratch itchy areas of skin. Instead pat, firmly press, or grasp the skin, and apply soothing lubricants. Cool wet compresses can also help. Control the environment. Maintain cool temperatures and avoid sweating. Do not overdress, and limit the number of blankets on your bed. Avoid saunas and steambaths. For extreme dryness, a humidifier or vaporizer may help. It’s important to keep it clean to prevent the growth of mold. Avoid food triggers. Keeping a food diary to identify triggers can be helpful. Eczema can flare up when you are under stress. It is important to learn how to recognize and cope with stress. Stress reduction techniques and changing your activities to reduce daily stress can be beneficial. Medications Antihistamine tablets (eg, Benadryl, Zyrtec, Claritin, Allegra) are often used to control itching. Topical corticosteroid preparations are the mainstay of eczema therapy. They are used during flare-ups to control inflammation, as well as itching. o Steroid creams, lotions, and gels are available in different strengths. It is best to use the lowest effective dose for as short a time as possible. o Generally nothing stronger than a low-dose steroid cream should be used on the face and neck. o Only a thin layer of steroid medication is needed to be effective. Excessive or long-term use can cause thinning and whitening of the skin. A short course of corticosteroid pills taken by mouth is sometimes used to treat severe eczema flares in individuals with chronic disease. “Immunomodulator” medications (eg, Elidel and Protopic creams) are effective for moderately severe cases of eczema. The FDA has issued warnings about a possible link between these medications and lymphoma and skin cancer; however, no definite causal relationship has been found. While research is still ongoing, the FDA recommends the use of these medications only in patients who fail or cannot tolerate the other treatment options described above. Dermatologists may recommend other oral medications and ultraviolet light treatments for people with severe cases of eczema. RECOMMENDED WEBSITES: www.aad.org www.nationaleczema.org ____________________________________________________________________________ Published by VCU Division of Student Affairs and Enrollment Services University Student Health Services (804) 828-8828 - Monroe Park Campus clinic (804) 828-9220 - MCV Campus clinic Wellness Resource Center (804) 828-9355 - 815 S. Cathedral Place Reviewed 7/11