In atopic dermatitis, the skin is often dry with elevated hair follicles.
In atopic dermatitis, the skin is often dry with elevated hair follicles.
This image displays a close-up of brown, scaly, elevated follicles typical of atopic dermatitis (eczema).
This image displays a close-up of brown, scaly, elevated follicles typical of atopic dermatitis (eczema).
This image displays atopic dermatitis (eczema) in the body folds of the back of the legs coupled with staph bacteria.
This image displays atopic dermatitis (eczema) in the body folds of the back of the legs coupled with staph bacteria.
In atopic dermatitis (eczema), chronic itch and associated rubbing of the skin leads to skin thickening and the increased prominence of normal skin markings, as displayed in this image.
In atopic dermatitis (eczema), chronic itch and associated rubbing of the skin leads to skin thickening and the increased prominence of normal skin markings, as displayed in this image.
In atopic dermatitis (eczema), the rash often is seen as scaly bumps over each hair follicle.
In atopic dermatitis (eczema), the rash often is seen as scaly bumps over each hair follicle.
Inflammation around the hair follicles, giving a dotted appearance, is typical to follicular eczema.
Inflammation around the hair follicles, giving a dotted appearance, is typical to follicular eczema.
Atopic dermatitis (eczema) that has been present for an extended period of time begins to looks thickened and darker.
Atopic dermatitis (eczema) that has been present for an extended period of time begins to looks thickened and darker.
This image displays atopic dermatitis (eczema) on the back of the legs with erosions from scratching.
This image displays atopic dermatitis (eczema) on the back of the legs with erosions from scratching.
This image displays severe atopic dermatitis (eczema) on a child's eyelids.
This image displays severe atopic dermatitis (eczema) on a child's eyelids.
This image displays the typical scaly and slightly pink lesions of atopic dermatitis (eczema) in a teenager.
This image displays the typical scaly and slightly pink lesions of atopic dermatitis (eczema) in a teenager.
Atopic dermatitis (eczema) typically involves the folds of the elbows and knees. When longstanding, the skin can be very thickened (lichenified) from chronic scratching.
Atopic dermatitis (eczema) typically involves the folds of the elbows and knees. When longstanding, the skin can be very thickened (lichenified) from chronic scratching.

Images of Eczema (Atopic Dermatitis) (11)

In atopic dermatitis, the skin is often dry with elevated hair follicles.
This image displays a close-up of brown, scaly, elevated follicles typical of atopic dermatitis (eczema).
This image displays atopic dermatitis (eczema) in the body folds of the back of the legs coupled with staph bacteria.
In atopic dermatitis (eczema), chronic itch and associated rubbing of the skin leads to skin thickening and the increased prominence of normal skin markings, as displayed in this image.
In atopic dermatitis (eczema), the rash often is seen as scaly bumps over each hair follicle.
Inflammation around the hair follicles, giving a dotted appearance, is typical to follicular eczema.
Atopic dermatitis (eczema) that has been present for an extended period of time begins to looks thickened and darker.
This image displays atopic dermatitis (eczema) on the back of the legs with erosions from scratching.
This image displays severe atopic dermatitis (eczema) on a child's eyelids.
This image displays the typical scaly and slightly pink lesions of atopic dermatitis (eczema) in a teenager.
Atopic dermatitis (eczema) typically involves the folds of the elbows and knees. When longstanding, the skin can be very thickened (lichenified) from chronic scratching.

Eczema (Atopic Dermatitis)

Eczema, formally known as atopic dermatitis, is a very common allergic skin condition. Eczema looks different in people of different ages. In teens, it tends to look like red, dry, irritated skin on the hands, wrists, and legs, though it can appear anywhere.

Eczema is very itchy, and scratching tends to worsen the condition and can lead to infection of the skin caused by bacteria on the hands and nails. The key to controlling eczema is to avoid the triggers that bother it (eg, soaps, lotions, detergents, weather, and stress) and keep the skin well moisturized.

Who's At Risk?

Anyone may have eczema, but it is more common in people with other allergies or with asthma. It is more commonly seen in infants and children, who usually grow out of it, but it is sometimes seen in teens and adults who may or may not have had eczema as children.

Signs & Symptoms

The most common locations for eczema include the face, neck, in front of the elbows, behind the knees, and the arms and legs (extremities). Adults with eczema may notice the most irritation on the arms and legs, particularly in front of the elbows and behind the knees.

  • Thickened, scaly, pink to red bumps and patches of skin are seen in these areas.
    • Mild – few, scattered areas of involvement, which are easily treated with self-care measures
    • Moderate – more extensive involvement, which are more difficult to control with self-care measures and may require prescription therapy
    • Severe – diffuse involvement, which is difficult to treat even with prescription therapy
  • Some adults may have primarily chronic hand involvement.
  • Areas of involvement that become infected can develop thick crusts.
  • Dark-skinned individuals with eczema frequently have extensive accentuation of the hair follicles and shininess without obvious thickened, raised areas.

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Self-Care Guidelines

Maintaining healthy skin is very important for sufferers of eczema.

  • Moisturizing skin care routines are essential.
  • Non-soap cleansers, such as Cetaphil®, or moisturizing soaps, such as Dove®, are recommended.
  • Thick moisturizers such as petroleum jelly, Aquaphor® ointment, Eucerin® cream, CeraVe® cream, and Cetaphil cream should be applied to damp skin after daily bathing.
  • Attempt to minimize exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress.
  • Fragrance-free laundry detergent may be beneficial.
  • Keep the home air from getting too dry by using a humidifier or by setting out bowls of water, especially in the bedroom.
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Treatments

Topical or oral (systemic) medications can include:

  • Topical steroid creams or ointments may be prescribed to treat active areas of localized eczema. Lower strength steroids may be used on the face and medium to high strength steroids may be used on the torso and arms and legs.
  • Care should be taken when using topical steroids in skin folds because of the risk of thinning of the skin.
  • Steroid-sparing agents such as topical tacrolimus or pimecrolimus may be prescribed for milder cases of eczema or for certain areas of involvement, such as the face.
  • Oral antihistamines may be prescribed to decrease itching.
  • If an infection is suspected, topical or oral antibiotics may be prescribed.
  • In patients who have multiple areas of broken skin or a history of bacterial skin infections, dilute bleach baths may be prescribed.

Procedures:

  • For more extensive eczema, forms of light therapy may be recommended.
  • Those with resistant disease may be treated with oral medications used to suppress the immune system, such as cyclosporine or tacrolimus.

Visit Urgency

You should seek medical care if there is a lack of response to self-care measures or the eczema worsens or flares.

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References

Bolognia, Jean L., ed. Dermatology, pp.1999-2414. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed, pp.1180, 1188-1189. New York: McGraw-Hill, 2003.