Eczema is not contagious and it is not an infection, but prolonged scratching can allow bacteria to get through the skin and cause an infection. Some common triggers that cause eczema include:
- Heat and humidity
- Abrasive clothing
- Tobacco smoke and chemicals
- Some soaps and detergents
- Thickened, scaly, pink to red bumps (papules) and slightly elevated lesions (plaques) are seen in these areas.
- Mild eczema – few, scattered areas of involvement, which are easily treated with self-care measures
- Moderate eczema – more extensive involvement, which is more difficult to control with self-care measures and may require prescription therapy
- Severe eczema – diffuse involvement, which is difficult to treat even with prescription therapy
- Infants with eczema may have prominent involvement of the face, scalp, and the skin on the arms and legs overlying the elbows and knees.
- Areas with superimposed infection can develop thick crusts.
- Blacks frequently have extensive accentuation of the hair follicles and shininess without obvious thickened, raised areas.
- Moisturizing skin-care routines are essential.
- Non-soap cleansers, such as Cetaphil®, or moisturizing soaps, such as Dove®, are recommended.
- Thick moisturizers, such as petroleum jelly, Aquaphor® ointment, Eucerin® cream, CeraVe® cream, and Cetaphil® cream, should be applied daily to damp skin after bathing.
- Attempt to minimize exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress.
- Fragrance-free laundry detergent may be beneficial.
- Keep the home air from getting too dry by using a humidifier or by setting out bowls of water, especially in the bedroom.
- Topical steroid creams or ointments may be prescribed to treat active areas of localized eczema. Lower-strength steroids may be used on the face, and medium- to high-strength steroids may be used on the trunk and extremities.
- Care should be taken when using topical steroids in skin folds and obstructed areas due to the risk of thinning (atrophy) of the skin.
- Steroid-sparing agents, such as topical tacrolimus or pimecrolimus, may be prescribed for milder disease or for certain areas of involvement, such as the face. These medications are not approved for children under the age of 2. These medications have a warning about the risk of malignancy.
- Oral antihistamines may be prescribed to decrease itching.
- If a superimposed infection is suspected, topical or oral antibiotics may be prescribed.
- In patients who have multiple areas of broken skin or a history of bacterial skin infections, dilute bleach baths may be prescribed.