Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis
Eczema is a chronic skin condition characterized by reddened, dry, itchy, scaly skin. Several types of eczema are known, the most common being atopic dermatitis, hand eczema, and nummular eczema. These may result from hypersensitive skin or chronic irritation; however, often no clear cause can be determined. Eczema is not contagious, but some cases do “run in families.” It is not curable, but careful treatment can minimize the itching and dryness of the skin, and prevent complications such as infection. Various forms of eczema affect between 5% and 10% of all Americans each year.

Living With Your Diagnosis
Eczema may first appear in infancy or childhood. Reddened, scaly patches appear on the face, forearms, and lower legs. After school age, patches are more common behind the knees and in the folds of the elbows. Eczema almost never affects the back. Hand eczema usually involves the fingers and palms. Nummular eczema can occur on any body surface but is most common on the chest, arms, and abdomen. Symptoms of eczema include intense itching and irritability. Often no visible rash is noted until after the patient has begun scratching. If untreated, the skin will be damaged by the scratching and can become thickened with scars. Infection can also occur because the scratching can decrease the skin’s ability to fight bacteria.

All treatment is aimed at breaking the itch-scratch cycle. Avoid irritants such as hot water, detergents, and other chemicals as much as possible. Keep children’s fingernails short, and put mittens on young infants to prevent scratching. Antihistamine medicines, taken by mouth, can decrease the itching. However, these medicines are very sedating (sleep inducing), and you must be careful to avoid driving, cooking, or working with machinery while using them. Use antihistamines cautiously in children as well, because school performance may suffer if the child is too sleepy in class. Other treatments include lubricating and moisturizing the skin, which also helps minimize the itching. Use mild, hypoallergenic, over-the-counter skin creams or ointments to prevent excessive skin dryness. Use prescription steroid creams for more resistant cases of irritation and scaling as directed by your doctor. (Do not use these creams on your face unless specifically prescribed for facial rash. The facial skin is fragile and can be thinned by overuse of steroid creams.) Occasionally your doctor may prescribe oral steroids (tablets or syrup) for a severe episode of inflammation. These are powerful anti-inflammatory drugs and can have serious side effects if used frequently. These side effects include stomach irritation, ulcers, and osteoporosis. Be sure to use these medicines carefully and exactly as directed by your doctor. If infection is present, your doctor will prescribe oral antibiotics to fight the bacteria. Over-thecounter antibiotic creams will not fight the infection adequately, so be sure to complete your oral antibiotics as prescribed.

The DOs
• Do follow a daily skin wellness regimen, even when your skin is free of itching.
• Do lubricate your skin after each exposure to water.
• Do use the mildest soap and shampoo available.
• Do keep fingernails short, and bandage areas of severe itching if possible to keep the risk of scratching minimal.
• Do use long sleeves and long pants to help prevent the itch-scratch cycle, especially in children.
• Do double-rinse clothing to minimize irritation.

The DON’Ts
• Don’t bathe with hot water because it will dry the skin and increase irritation.
• Don’t use steroid products on the face or near the eyes unless specifically directed to do so by your doctor.

When to Call Your Doctor
• If you have fever or chills.
• If you have nausea or vomiting.
• If you have increased redness, bleeding, or discharge around the rash.

For More Information
American Academy of Dermatology
930 N. Meachum Road
Schaumburg, IL 60173
National Eczema Association
1221 S.W. Yamhill, #303
Portland, OR 97205
Inflamed hand eczema with early fissure. (From Goldstein BG,
Goldstein AO: Practical Dermatology, vol 1. St. Louis, Mosby–Year
Book, 1992. Used by permission.)