Eczema

What is Eczema?

Generally speaking, it’s a mild to severe itching (pruritic) skin disease that can start at any age, in both men and women, youth and adults, and in all skin types. Technically, it’s a complicated cluster of separate skin diseases that have common symptoms.  They itch, tend to weep and crust, and look similar under the microscope when they’re biopsied.  Eczema conditions can vary by where they’re located on the body, the age when it begins, other skin conditions a patient may also have and whether the symptoms come and go, or are chronic and consistently present.

We know eczema can be a frustrating condition that affects our patients’ quality of life.  With so many eczema types and treatments, we recommend you see a dermatology provider for a medical evaluation. That’s important to properly diagnose eczema and because, ultimately, this is a treatable and controllable condition.

What are the different types of Eczema and how do you treat them?

In managing eczema it’s important to first rule out other itching skin diseases.  We follow that up with a thorough investigation of probable triggers, and then create an individualized treatment plan for effective control that’s unique to each patient, their age, skin type, lifestyle and preference.  No one treatment plan is always effective, so we use a wide array of the safest, most current treatment options available.

Contact dermatitis is often due to an allergic reaction to things like poison oak, a fragrance or preservative in a topical preparation, or a metal like nickel in jewelry.  It can also be due to an irritant, which can happen abruptly if the cause is strong, like exposure to bleach or gasoline, or more chronic as with “dishwater hands” due to over exposure to soap or cleansers.  Avoiding what’s irritating the skin helps but might be difficult to accomplish.

At Olympic Dermatology we perform skin patch testing to confirm a suspected allergic reaction.  If one or more are suspected, we’ll make a patient-specific recommendation for avoiding identified strong irritants and minimizing repeat exposure to weaker irritants like soap.  Moisturizers are always beneficial for chronic irritant dermatitis, and we carry many products that are scientifically tested for effectiveness to help our patients with eczema.

We also treat the contact dermatitis form of eczema with topical steroid medication (lotions or gels in varying strengths).  Non-steroid medications, like Protopic or Elidel, are used for stubborn areas, and oral steroids in pill form are used when necessary to decrease the body’s inflammatory response.

Atopic dermatitis is a specific type of eczema that generally appears in childhood.  It is a “patterned” skin disease, with the itching and rash classically appearing in the skin crease areas like elbows and behind the knees, but is also often widespread over the body.  There is no primary lesion in atopic dermatitis; instead the problem begins with chronic itching.  Prolonged scratching breaks and irritates the skin, which becomes red, thick and coarse (lichenification) and is often painful.

This kind of eczema is associated with asthma and allergic rhinitis, and is often genetically passed from parent to child.  It tends to improve in children as they get older but some lingering itching, often of the hands, is common.  It’s sometimes triggered by food allergies, which may fade over time.  We manage this condition for our patients, similar to contact dermatitis, with moisturizers, avoidance of skin irritants, and topical steroid medication.  Severe atopic dermatitis may also require non-steroid medications like Protopic or Elidel, otherwise known as immune modulator drugs.

Asteatosis is the “winter itch” sometimes experienced by our mature patients.  As your skin ages it becomes thinner, drier and more sensitive to irritants.  The itching is often worse in the colder months as heated indoor air dries out our skin.  Again, avoidance of irritants, moisturizing and topical steroids are used to treat and relieve this condition.

Stasis dermatitis is a type of eczema associated with varicose veins.  It appears on the lower legs where there’s often high venous pressure in the leg veins.  This condition includes swelling of the legs, dry skin changes and, at times, chronic skin ulcers because of poor healing.  Managing the high venous pressures and swelling is very important when treating stasis dermatitis, so compression stockings are generally used, along with moisturizers and topical steroids.

We’re here to help and understand how frustrating eczema can be.  We invite you to schedule an appointment online with the button on this page or call us at 360-459-1700.  Together we can get your eczema under control.  We are the leading dermatology center serving Olympia, Lacey, Tumwater, DuPont, Steilacoom, Centralia, Chehalis, Aberdeen, Hoquiam, Shelton and the South Sound region.