If you have dry skin and rough, red patches that itch, you may have one of several common skin problems called eczema. "Eczema is a very broad term," says Dr. Richard Caplan, professor emeritus of dermatology at the University of Iowa College of Medicine. "It includes many different skin problems and is no more specific than saying someone has a 'viral infection.' In order to be treated it has to be translated into a particular type of dermatitis," explains Caplan, also a staff physician at UI Hospitals and Clinics.
Dermatitis is the clinical term for itchy, inflamed skin. Atopic eczema commonly occurs in young people and is usually found inside the elbows, on the face, wrists, ankles, hands, or backs of the knees. Seborrheic eczema, or severe dandruff, is also a common type of dermatitis. Contact eczema is the rash from poison ivy or poison oak, for example. Another type, stasis eczema, often occurs among older adults and is characterized by a rash around the ankles. "When most people talk about eczema, though, they are referring to atopic dermatitis," he notes.
A number of things can irritate the skin and cause dermatitis. "Many people may think that this problem is related to food. In infants, food may trigger eczema, but after age one it's much less likely that food causes the problem, " he says.
Many people who have atopic eczema come from families with a history of similar skin problems or respiratory allergies. "These people are born 'itchish.' They tend to have dry skin and the drier the skin, the more likely they are to scratch and aggravate the problem," Caplan explains. People with this type of skin should avoid wearing irritating fabrics such as wool and avoid getting too warm, he suggests.
People with respiratory allergies also tend to have eczema, especially during allergy season. "If someone is allergic to ragweed, then he or she might itch a lot during ragweed season. Animal dander and dust can also have the same effect," he notes.
Emotional stress is another important factor. If you're under a great deal of pressure and don't get enough sleep, the skin condition can worsen.
Because the causes of dermatitis are sometimes difficult to pinpoint, a doctor may prescribe various treatments. "For a baby, a change of diet might be the first treatment. A switch from regular formula to soybean milk or goat's milk might help," Caplan explains. He also stresses the importance of keeping the skin lubricated with creams or lotions. If neither of these treatments work, there are a number of topical medications that can help, depending upon the type of eczema, the age of the patient and the part of the body affected. In rare cases when the problem is severe, a patient may be hospitalized for supervised treatment, he notes.
If you think you might have some type of eczema, consult your family physician or a dermatologist.
University of Iowa Health Science Relations and Richard Caplan, MD
Professor Emeritus of Dermatology