Atopic dermatitis (eczema) is a chronic, itchy inflammatory condition of the skin that is often associated with asthma or hay fever. It can be exacerbated by irritating clothes or chemicals, change in climate, emotions, skin infections and food allergies. Atopic dermatitis is predominately a childhood disease beginning before age one. However, most children outgrow their disease by adolescence. Adults may continue to have atopic dermatitis manifested by patches of eczema on the hands, feet, and elsewhere. The hallmark symptom of atopic dermatitis is intense itching and dry skin. While up to a third of patients with atopic dermatitis have allergies, avoidance or exposure to these allergies is often unrelated to their skin disease, therefore allergy testing is not necessary for all patients. Allergy testing is usually reserved for those patients with severe or refractory disease.
No one thing can control atopic dermatitis. Successfully managing this complex condition requires a multi-faceted approach. Skin care is of the utmost importance and can provide longer periods between flares and help reduce the length of flares. The hallmarks of good skin care are using gentle cleansers, moisturizing frequently and avoiding scratchy materials. For flares, steroid creams and occasionally oral steroids are necessary. Other treatments can consist of non-steroidal anti-inflammatory creams like Protopic® (tacrolimus) and Elidel® (pimecrolimus). More severe cases may need light therapy or systemic immunosuppression. Oral anti-histamines may be necessary to control the itch. With proper skin care, using medication as directed, and avoiding common skin irritants such as wool clothing, most patients are able to control their eczema.