Eczema the itch that rashes

okay, I vowed to post weekly and I know that this one is a little early but hey, who cares.

Lets talk about eczema.  Now eczema is in reality, a wastebasket diagnosis.  Most eczema is either atopic dermatitis or sebhorrheic dermatitis.  I want to focus on atopic derm since this is most common to my patients here in the desert.

Atopic derm usually starts as dry skin that then becomes red and itchy, and occasionally flaky.  It can appear on the cheeks but typically appears in the inner folds to the elbows and the back of the knee.  In severe cases the entire body is involved.

First and foremost the skin must be hydrated.  This is best accomplished with vaseline 4-5 times per day.  If this is to greasy then aquaphore or eucerin cream (not the lotion) can often accomplish this for us.  If this step is skipped the eczema will never get any better.

For red itchy spots, steroid creams can be applied but these have significant side effects and should be used as little as possible.

Bathing should be limited to every other day.  After a bath the cream/vaseline should be applied immediately to the still wet skin.

If the eczema persists then infectious processes should be considered.  This includes staph which, as a localized infection, can produece the so called "stap superantigen" which can insite an immune response which casues eczema to flare across the body.  This can be treated with topical or oral antibiotics as appropriate.

Finally if all else fails consider allergies as a cause.  As the skin breaks down it becomes sensitized to many things and food items can be among them.  Certain blood tests to look at allergic response (called RAST or Immunocap tests) or scratch tests at the allergist's office can be helpful here.

If you are afraid that your child has eczema know that this is a very common occurance especially here in the desert.  Call us to look at your child if you are concerned- (775)- 395-7111