What is eczema?

Eczema is the common name for the medical condition called atopic dermatitis (AD). AD is a chronic, relapsing inflammatory skin condition that ranges from mild to severe. It is not contagious. AD affects people of all ages, but the location of the eczema rash differs depending on your age. It affects about 30 million Americans.

AD frequently begins in infancy with dry scaly patches on the face, scalp and forehead. About 90% of children develop AD before their fifth birthday, and it often disappears as the child grows. However, some children with AD never outgrow it. Many people with AD also have asthma and hay fever.

Some adults with AD never had it as a child. This is called adult-onset AD and usually appears around age 50.  Some adults had AD as a child, and it went away, only to return years later.

Eczema begins as a sudden, intensely itchy rash and inflammation that evolves into weeping and oozing pimples. Itching is so intense that victims often scratch until the skin bleeds and becomes infected. The more they scratch the worse the itch. Eventually the skin becomes thick, discolored and leathery, and continues to itch.

What are the symptoms of eczema?

• Dry, scaly skin
• Red inflamed skin
• Intense itching that can interfere with sleep
• A rash on the cheeks, arms and legs
• Weeping sores
• Infected skin from itching

As an adult the rash is often located in the creases of the elbows, behind the knees, in nape of the neck, and on face, including around the eyes. Some types can affect your hands, fingers, toes, palms, soles of the feet and cause blisters.

Contact dermatitis is a type of eczema caused by an irritant that touches the skin. The contact may not cause an immediate reaction, but pain, swelling and blistering can follow a single exposure or an ongoing exposure to a mild irritant can cause the dryness, itching and skin cracking.

Dr. Farhang will conduct a complete evaluation of your condition to determine the cause of your rash.

What causes eczema?

The exact cause is not known but is believed to be a combination of genetics ( it runs in families) and environmental triggers. AD has been linked to a genetic variation that weakens the skin barrier which is designed to protect us from bacteria, irritants and allergens. Eczema affects people with a hyperactive immune system that is easily triggered by an environmental or internal substance that incites inflammation. Inflammation leads to the red, itchy and painful symptoms. Often the time between the trigger and the flare is not direct which makes it difficult to identify what caused eczema to flare up.

What are eczema triggers?

• Dry skin
• Dry, cold climates and humid conditions
• Food allergies
• Irritants like dust, mold, pollen, smoke, detergents and soaps, shampoo, cleaners, metals, fragrances, fabrics, pet dander
• Respiratory allergies like asthma and hay fever
• Stress
• Sweating
• Changes in women’s hormones

How is eczema diagnosed?

Dr. Farhang will conduct a thorough examination of your skin, evaluate your rash, and ask questions about your symptoms, and health history including allergies, and family history. Eczema is diagnosed by its appearance and symptoms. Every person’s symptoms and combinations of symptoms are individual to that person. Allergy testing may be recommended.

How is eczema treated?

The goals of treatment are to identify your triggers to reduce and prevent flareups; prevent worsening of the condition; relieve pain and itching; and prevent infections and thickening of the skin.

Dr. Farhang will provide general recommendations such as a good skin care regiment to help manage symptoms and reduce flareups. She will also develop a treatment plan tailored to address your symptoms. Your plan may include topical medications, over the counter medications phototherapy, immunosuppressant drugs, targeted therapies and complementary and alternative natural therapies.

Dr. Sheila Farhang is a board-certified dual fellowship trained Mohs surgeon, skin cancer surgeon, cosmetic surgeon, and dermatologist who provides medical and cosmetic dermatological services. She appreciates that eczema has a significant impact on your quality of life, and you will always be treated with sensitivity, compassion and respect. Dr. Farhang is a key opinion leader who integrates the most innovative, state of the art treatments with an integrative medicine approach. Call today to schedule a consultation with Dr. Farhang.