Eczema is complex skin affliction

This week's expert: Dr. Mary Jo Fisher, associate program director with Cox Family Medicine Residency.

Q. What is eczema?

A. Eczema is a condition rather than a disease. It is a description of a skin condition that can be caused by many different things including allergic reactions, caustic chemicals and even dry skin.

There are three stages of eczema. Acute eczema is the earliest stage; it usually lasts a few days. The skin may blister and turn red, looking like early poison ivy. It often itches intensely. The next stage is sub-acute and can last weeks. There is less itching and redness and the affected areas may be covered with a fine white scale. The last stage is chronic. Not all eczema goes through this stage. In this stage there may be cracks in the thick dry skin and the scale is thicker. Many people have seen their hands or feet look like this in the winter.

Q. What can trigger eczema?

A. Eczema can be the result of dry skin, irritating chemicals and allergic reactions to substances. Some people are much more prone to eczema and can break out from stress, heat, cold and certain foods and materials.

Q. Is eczema genetic?

A. The most common eczema in this country is atopic eczema, and it is genetic. Atopic means an extra sensitivity to substances (allergens). It is a dominant trait, but the same gene may show up differently and to different degrees in different people. Asthma, eczema and allergies are all from that same gene.

Q. How does eczema differ from psoriasis?

A. There are some similarities between eczema and psoriasis, and it is not always easy to tell them apart. In general, psoriasis will be pink rather than red, will form a thick plaque and will have a medium to thick white scale over the top. Although it can occur anywhere on the skin, it tends to be found on the skin of the back of the elbow, the front of the knee, the buttocks — in other words, places where joints bend out rather than in. Like eczema, psoriasis has several forms and can be found anywhere on the body.

Q. Does eczema affect any specific age group?

A. Atopic eczema is usually worse in early childhood and improves toward adulthood but it can be present at any age. Eczema from other causes is not so age-dependent.

Q. What are the available treatments? Can it be cured?

A. There are many nonmedical measures that can treat eczema, as well as several prescription medications that a family doctor or dermatologist can recommend. Most eczema will respond to lubrication with hand cream or even petroleum jelly. Steroid creams, steroid pills or other medications may be recommended for resistant cases.

Atopic eczema is a chronic condition and cannot be cured. Eczema from a specific source, such as poison ivy, is a self-limiting illness and can be "cured" with appropriate treatment.

Q. How can the symptoms be lessened?

A. The itching associated with acute eczema can be lessened with cool soaks of the affected area several times daily. Over-the-counter antihistamines may give additional relief.

Again, lubrication of the affected areas gives relief to most people. Steroid creams may give additional relief. Using over-the-counter anti-itch, or medicated, creams and powders can make the condition worse as they may have perfume or other irritating ingredients.

Children with atopic eczema should stay cool and (preferably) wear cotton and polyester. They should avoid frequent bathing, sweating, wearing wool and eating foods or handling materials known to trigger their eczema.

Article published in www.news-leader.com