Atopic eczema is a recurrent inflammatory skin condition that produces redness, itching, and scaly patches. People who have atopic eczema also often have other allergic conditions, such as allergic rhinitis (see page 379) or asthma (see page 245), or are allergic to penicillin or sulfa. Atopic eczema is a very common condition that affects about 3 percent of Americans. The disorder can occur at any age but typically appears between infancy and young adulthood. The condition often improves on its own before puberty but also can persist throughout life.
Most people have dry skin at some point, but people with atopic eczema have periodic eruptions of red, scaly patches of skin. In adolescents and young adults the patches usually appear inside the elbows and behind the knees and at the ankles and wrists; in children they appear on the face and neck. But the eruptions can occur anywhere on the body and may not follow a pattern. The itching produced by the eruptions can be severe and prolonged.
People who have atopic eczema seem to have easily irritated skin, so anything that dries or irritates the skin may trigger a flare-up. They are often sensitive to low levels of humidity, and their skin condition may worsen in the winter. If this is true for you, try to bathe no more than once a day, avoid using very hot water, and use the mildest soap you can find. After bathing, pat your skin dry; do not rub it. Immediately apply a moisturizing lotion or oil to your skin, before it has completely dried. Avoid dressing in clothes made of rough or scratchy fabrics, which can aggravate the condition. Sweating also can make the condition worse.
Depending on the severity of the condition, your doctor may refer you to a dermatologist (a doctor who specializes in treating disorders of the skin). To distinguish atopic eczema from other types of skin conditions, the dermatologist will examine the skin eruptions, noting where on your body they appear and how often they occur. To control atopic eczema, the dermatologist probably will
Concerns prescribe a cream or ointment containing a corticosteroid, a drug that relieves inflammation. If any of the inflamed patches have become infected because of overly aggressive scratching, the doctor also may prescribe an antibiotic. Severe cases of atopic eczema may require treatment with ultraviolet light or oral corticosteroid medication.
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