Eczema or dermatitis are broad terms used to describe inflammation of the skin. Inflammation of the skin results in red, itchy and often scaly patches. There are a wide variety of causes for eczema.
One type of eczema is contact dermatitis, which is usually the result of an allergy to or irritation from something that has repeatedly touched the skin. This ‘something’, that contacts the skin causing an allergic response, we refer to as an allergen or irritant. Contact dermatitis is often quickly improved and prevented by strictly avoiding the offending allergen or irritant. Common allergens include nickel in jewelry, fragrances in soaps and detergents, and antibiotic creams. It can be difficult to find the exact cause but avoidance of the offending allergen is key. If necessary, we can prescribe a steroid ointment to decrease inflammation and thus improve the signs and symptoms of eczema.
Another type of eczema is atopic dermatitis. The term atopic dermatitis is used to describe an itchy, scaly, skin rash that often starts in infancy or early childhood. Atopic dermatitis usually follows a prolonged course and goes along with a personal or family history of seasonal or environmental allergies and asthma. Patches of eczema can occur anywhere on the body but are especially common on the face, hands, and behind the elbows and knees. Atopic dermatitis can be difficult to treat. The best form of treatment is the use of a thick moisturizing cream twice daily for maintenance and avoidance of known trigger factors. Flares can be treated with a topical steroid cream.
Nummular eczema is another form of dermatitis. Nummular eczema is characterized by dry, red, scaly patches on the skin in the shape of a coin. This condition most commonly occurs on the arms, legs, and trunk in a random, spotty pattern. Nummular eczema is most common between the ages of 15 and 25 and 55 and 65. The patches are often itchy and do not have a known cause. There are overlapping features between nummular eczema and other forms of eczema. The treatment of nummular eczema is similar to that of other forms of eczema. Frequent use of moisturizers and topical prescription steroid creams are most effective.
As the name suggests, hand eczema is a form of dermatitis commonly found on the hands. It can occur in anyone but is more common in adults with occupations that require repeated contact with water or irritants or require frequent hand washing. Adults with a history of atopic dermatitis often have a problem with hand dermatitis. Hand dermatitis often starts as dry, chapped hands that can progress to cracking and bleeding. Another common form of hand dermatitis is called dyshidrotic eczema. Dyshidrotic eczema is characterized by small, intensely itchy, fluid-filled blisters on the sides of the fingers. Hand dermatitis is often worse in the cold winter months when the air is dry. It is best managed with frequent use of thick moisturizing creams and ointments and by eliminating trigger factors. Topical prescription steroid creams and ointments are used for flareups.