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What is Eczema?

Posted Aug 24 2008 1:49pm
ANNOUNCER: Some problems, while not life-threatening, can be both unpleasant and uncomfortable. That's the case with atopic eczema, an inflammatory skin condition.

DORIS DAY, MD: We know eczema to be a hypersensitivity reaction. Your body is more reactive, more turned on, more in tune to anything, and so anything that touches your skin, affects it from inside or from outside, will make you itch. That itch will make you scratch. The scratch will bring out the eczema, and then you have a problem.

There are different sizes of patches that can be red. There can be some scale. They're typically very itchy and uncomfortable.

A. PAUL KELLY, MD: Others have little bumps that stick up and some have bumps with fluid in it. And those who do a lot of scratching, the skin markings are thicker and you can see the skin much easier than people who've had it on an acute basis. It's characteristically in the folds of the skin. That is, behind the knees and in front of the elbows. The neck is a common area also for eczema.

ANNOUNCER: Identifying eczema may be tricky .

DORIS DAY, MD: Other conditions that we can confuse with eczema are things like allergic contact dermatitis or an irritant dermatitis that's due to a specific product. Psoriasis sometimes can look like eczema, and that can be a little bit confusing, but usually the distribution will make it more clear; family history will help make it more clear; and sometimes a biopsy will be helpful.

ANNOUNCER: More than 15 million people in the United States suffer from this condition, which knows no age barrier. In fact 10% of all infants can have eczema and over half of those who get it as kids will have it all their lives.

A. PAUL KELLY, MD: Sixty percent of the patients with eczema have it before the age of one. And 90% manifest it by the age of five.

DORIS DAY, MD: Usually you wont see eczema for the first time in someone who is 40 or 50 years old and has never had it before. But eczema can be seen in any age group.

ANNOUNCER: What actually causes eczema is unknown, but experts have an idea what factors may contribute.

DORIS DAY, MD: There are many causes of eczema. People who have an underlying hypersensitivity, people who tend to be overly sensitive to different environmental stimuli. And it's a product of both your genes and the environment.

ANNOUNCER: What is known is that certain triggers do seem to cause flare-ups.

DORIS DAY, MD: And this includes lower humidity, lower temperature, certain clothing, like wool or clothing that irritates or causes itching of the skin. Stress can make anything worse, whether it's eczema, psoriasis, acne, anything. We're not sure about foods; whether or not foods cause eczema to become more pronounced or more of a problem.

A. PAUL KELLY, MD: Your eczema can get worse if you are allergic to a certain preparation. Something in skin cream that you're using, a perfume, for instance, that can make you break out.

DORIS DAY, MD: Some people have their eczema worse in the summer and some people are worse in the winter. So you can definitely see patterns.

ANNOUNCER: Eczema can range from mild to severe and can span a lifetime

DORIS DAY, MD: The amount of body surface area, the discomfort level, the amount of itching, and even if there's an infection or not associated with it. And that's a way that we have of grading the eczema within any given individual.

ANNOUNCER: Sometimes warding off a flare-up can be a simple procedure.

A. PAUL KELLY, MD: The first line of defense usually is something to keep the skin from being this dry. So we use what we call emollient creams or lubricating creams or ointments.

ANNOUNCER: Traditionally, steroid creams or ointments were used for flare-ups, but they had side effects when used long term.

DORIS DAY, MD: The concerns I have with topical steroids are that over time, if you use it without taking breaks, you can get thinning of the skin. You can actually have acne-like breakouts, get broken blood vessels, something called neo-vascularization, and stretch marks.

ANNOUNCER: But now non steroidal preparations offer a treatment that is not only effective but seems free of long term side effects.

DORIS DAY, MD: We have some very new, very exciting medications that are prescription-strength that actually are non-steroidals that help clear eczema and maintain clearance.

A. PAUL KELLY, MD: It often burns and itches a little bit. So sometimes you use it every other day to start with and maybe go to everyday after that.

ANNOUNCER: Eczema isn't always active and especially in the case of children, it may even disappear as they grow older.

A. PAUL KELLY, MD: Remission in eczema can last for a few weeks, it can last for a year sometimes. And some people "outgrow" it; that's what people say, "Well, I've outgrown my eczema."

ANNOUNCER: But for many, eczema remains a life long condition.

DORIS DAY, MD: Right now there is no cure for eczema. As we do more research and we understand it better, we're hoping to find a cure and work in that direction. But fortunately, with a lot of the treatments we have, we're able to control it, and that's where we're at right now.

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