Atopic Dermatitis (Eczema)

Atopic dermatitis is also known as eczema. It is a chronic condition which causes red, itchy skin due to dryness. Atopic dermatitis is not a reaction to outside stimuli and is not contagious.

What Causes Atopic Dermatitis?

Atopic dermatitis is related to genetic factors. The condition often runs in families, and a family history will increase a patient’s likelihood of having eczema. Other risk factors include allergies, hay fever and asthma, as these conditions are common comorbidities of atopic dermatitis.

Atopic Dermatitis Symptoms

Atopic dermatitis causes several symptoms which can range from mild to severe. Not all patients will experience the same set of symptoms. Atopic dermatitis symptoms typically begin before the age of five and may flare periodically throughout a patient’s life.

Some common symptoms include:

Dryness
Itchiness, which can be severe and is often worse at night
Red or brown/gray patches
Small, raised bumps which may leak or weep fluid or crust when scratched
Thick, cracked or scaly skin
Raw or sensitive skin
Swelling, especially due to scratching

Untreated atopic dermatitis can lead to several potential complications. For example, frequent scratching may result in skin infections. Itchiness can also result in poor sleep quality or difficulty sleeping. Atopic dermatitis may also precede conditions including asthma or hay fever, neurodermatitis, allergic contact dermatitis or irritant hand dermatitis.

Contact Dermatitis

Contact dermatitis is an allergic reaction or irritation of the skin caused by direct contact with a substance that is typically harmless to your health. This condition results in a red, itchy rash among other potential symptoms. There are two basic types of contact dermatitis: irritant contact dermatitis and allergic contact dermatitis. These are differentiated primarily by the source of the reaction.

What Causes Contact Dermatitis?

Contact dermatitis is caused by direct contact with an irritating substance or allergen. There are thousands of known irritants and allergens that can cause contact dermatitis, meaning that it can be difficult to identify the source of the symptoms. In the case of irritant contact dermatitis, symptoms are often the result of frequent or repeated exposure to the irritating substance, which could include solvents, rubbing alcohol, bleach or similar everyday products. Allergic contact dermatitis is triggered by an allergen that may be introduced through either direct contact or ingestion.

Some common irritants and allergens which may cause contact dermatitis include:

Airborne substances, such as dust or pollen
Bleach
Detergents
Fertilizers
Formaldehyde (which can be present in cosmetics, preservatives or disinfectants)
Fragrances
Medications (including both oral or topical medications)
Nickel (commonly present in jewelry)
Personal care products (including soap, shampoo, deodorants and cosmetics)
Plants (such as poison ivy)

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What You Should Know

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What are the Atopic Dermatitis Treatment Options?

Prior to treatment, your provider will likely offer advice to help control your atopic dermatitis symptoms through some simple lifestyle changes. This can include frequently moisturizing using non-irritating products, identifying and avoiding triggers or taking shorter baths or showers.

Several treatment options are available for eczema. Corticosteroid creams or ointments are frequently recommended to help moisturize the skin and control inflammation. Oral corticosteroids may be recommended for some patients. Calcineurin inhibitors may also be used to reduce immune response and calm irritation. If you have a skin infection as a result of eczema, your provider may also recommend a topical or oral antibiotic. An injectable biologic treatment called dupilumab (Dupixent) to treat eczema.

Aside from these medications, several in-office treatment methods are available. Phototherapy can be used to treat atopic dermatitis flares. In the case of severe atopic dermatitis, your provider may also recommend wet dressings, which involve wrapping the affected area with topical corticosteroids and wet bandages to relieve symptoms.

What are Symptoms of Contact Dermatitis?

Contact dermatitis symptoms will usually be localized to the area of the body which was in direct contact with the allergen or irritant. Most patients will experience a red and itchy rash. Symptoms may also include dryness, cracking or scaling, bumps or blisters, swelling, burning or tenderness. While some contact dermatitis will subside quickly by removing the irritating substance, other patients may find persistent or severe symptoms.

What are Contact Dermatitis Treatment Options?

If you experience frequent or persistent contact dermatitis, your provider may recommend patch testing or other methods of allergy testing to determine the cause of your symptoms. This can help you avoid the allergens in the future.

Treatment for contact dermatitis usually consists of topical steroid creams or ointments. Your provider will instruct you on how often to apply these medications, but most patients should apply steroid creams or ointments once or twice per day. Oral corticosteroids can also be used to reduce inflammation for those with extreme reactions. Your provider may also recommend antihistamines to relieve itching and allergic reaction or antibiotics in cases of bacterial infection.