Eczema and Atopic Dermatitis
Dermatitis just refers to inflammation of the skin. Sometimes dry skin turns into very red and very itchy skin. This might be a clue that you have eczema or atopic dermatitis, which is an inflammatory condition affecting the skin. Sometimes there is an underlying culprit such as medications or taking too hot/too long showers, but a lot of times there is a dysfunction in the epidermal (top layer of skin) moisturize barrier of your skin. This dysfunction in the skin can occur at a very young age and be a life-long condition. Some patients also have a history of asthma and seasonal/year-round allergies, which can clue us in on the diagnosis.
Clues that you might have more than dry skin can include redness or even oozing and crusting of the skin. If you notice that no matter how much you moisturize and how cool a shower you take your skin is still itchy, red, and even oozing it is time to make an appointment. Left untreated, it is possible to develop a skin infection.
There are treatment options that can really make a difference. Along with moisturizers, luke-warm showers, we can add prescription medications to the treatment plan. Topical steroid creams such as triamcinolone, or non-steroid creams such as pimecrolimus (Elidel) and Crisaborole (Eucrisa) to oral medications such as prednisone and even injectable medications like dupilumab (Dupixent) are all potential treatment options. In rare cases nonsteroidal immunosuppressive medications such as methotrexate or mycophenolate could be utilized. Depending on the severity of your dermatitis we may combine treatments to get the best outcomes and even add on an antibiotic if there is a skin infection.
If itching is a main concern of the patient additional medications may be offered. Sometimes a simple over the counter or OTC antihistamine such as fexofenadine (Allegra) may be recommended. If that’s not doing the trick prescription medications such as hydroxyzine (Atarax) may be an option. There are also topical medications that can help with itch. A great over the counter option is Sarna Sensitive Lotion that has the ingredient with pramoxine. If you see the store brand next to it, that is ok to purchase as long as it has the same active ingredients. Pramoxine is powerful anti-itch medication that can also help moisturize the skin.
With an arsenal of treatment options, we can find something to help control your red and itchy skin. Sometimes several medications need to be tried before finding the right combination of treatments that help heal your skin. Remember that eczema or atopic dermatitis tends to be a life-long battle. Over time we can usually decrease the amount of prescription medications that are needed.