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Eczema

Reviewed by: HU Medical Review Board | Last Reviewed: May 2016.

Eczema is an inflammatory skin condition that can be a sign of allergic disease.1 It is not a symptom of asthma. However, many people have both eczema and asthma. In fact, the two conditions overlap so often that health care providers look for signs of eczema when diagnosing asthma.2 Similarly, the history of asthma is a clue to the diagnosis of eczema.1 Eczema is also called “atopic dermatitis.”

When eczema flares up, it may look like blisters that weep or ooze.1 In less severe flare-ups, you may see bumpy patches of skin that are dry, scaly, and red. It is almost always itchy.3 Over time, frequent scratching can cause hardened patches of skin. In infants, eczema usually affects the cheeks, scalp, chest, back, arms, and legs.3 In children, the joint areas are typically affected. In adults, eczema often affects the back of the hands and feet.

Eczema usually starts in early childhood.1 It frequently overlaps with hay fever (“allergic rhinitis”), as well as asthma.

What causes eczema?

The outer layer of skin has two important jobs: prevent water from getting out and prevent irritants, allergens, and germs from getting in.3 In people with eczema, this layer is disrupted, which allows allergens to reach the second layer of skin and turn on immune cells.2 This leads to a cycle of itching, scratching, and additional damage to the skin.1

Eczema often runs in families. Certain triggers make cause eczema to flare-up or get worse. These triggers include:4

  • Irritants, such as soaps, detergents, or juices from fresh produce
  • Allergens, such as pets, pollen, and mold
  • Hot and cold temperatures
  • Food allergies
  • Stress
  • Hormones

How common is eczema in people with asthma?

The National Health Interview Survey showed that 10.2% of US adults have eczema.5 The same survey showed that 3.2% of US adults with eczema have a history of asthma, hay fever, or both. People with eczema were more likely to have asthma attacks and persistent asthma than people without eczema.5

Nearly 13% of US children have eczema.6 Sixty-five percent of children are diagnosed before age one year and 85% are diagnosed by age five.3 Thirty percent of children with eczema develop asthma.1

How is it evaluated?

Eczema is diagnosed based on history and physical exam.1 Your health care provider will look for the following:

  • Itchy skin, especially around joints
  • Dry skin all over the body
  • History of asthma or hay fever
  • Rash starting before age 2 years

How is eczema treated?

Dry skin makes eczema worse. Protecting your outer layer of skin can help keep eczema under control. Things that you can do at home to take care of your skin include:1

  • Take warm (not hot!) showers
  • Use a moisturizing, non-soap cleanser
  • Apply a thick moisturizer within minutes of showering

The main treatment for eczema flare-ups are topical corticosteroids.1 These medications come as ointments, creams, and lotions, based on your preference. Your health care provider may recommend taking these only when your eczema flares up. If you have recurring, moderate-to-severe flare-ups, you may be told to take these on a regular basis.

Other medications are available if topical corticosteroids are not enough.1 These include different topical medications, antibiotics, oral corticosteroids, or UV phototherapy.

Homeopathic remedies, hypnotherapy, biofeedback, or massage therapy have not been well studied for treating eczema.1 Studies have not shown that Chinese herbal medicine, fish oil, vitamin E, minerals, multivitamins, and probiotics can treat eczema.1,7

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Are you diagnosed with both asthma and atopic eczema? We want to hear from you!

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