Eczema, or dermatitis, is a general term we use for rashes where the skin appears red, dry, scaly, and itchy. This condition can be caused by inherited issues with the skin, environmental factors, or underlying medical conditions. Dermatitis can severely disrupt our daily lives due to its annoying itch, uncomfortable appearance, and feel, and it can even cause sleep problems. Fortunately, we have many tools to improve the skin function, decrease itching, reduce infection, and help manage the condition. With a consultation at our Burr Ridge or Plainfield dermatology offices, we can determine which type of eczema you have and develop a treatment plan utilizing therapies that work for your lifestyle.
For more information about eczema and how we can manage the condition, call Burt and Will Plastic Surgery and Dermatology at 815.267.8830 or schedule a consultation today. We serve Plainfield, Naperville, Hinsdale, Burr Ridge, and surrounding areas.
The signs and symptoms of dermatitis vary from patient to patient. They include:
- Itchy inflamed areas of skin
- “Sensitive skin” that does not tolerate many lotions or products
- Cracked and scaly skin
- Small raised bumps that may leak fluid over the fingers
- Red to brown rashes in the skin creases
- Pink flaky eyelids
Before and after
Causes and Types
While to the untrained eye all eczema may look similar, there are a variety of different types. Your dermatologist can help with differentiating what kind you or your loved one has as a first step.
Atopic dermatitis (AD) is a common form of eczema that affects children, typically starting within the first two years of life. As an infant, AD rashes occur all over the body, and as kids grow it tends to localize to skin folds or the hands. Genetics can play a role, and often patients with atopic dermatitis go on to have asthma and seasonal allergies.
Allergic Contact Dermatitis
Our bodies can develop allergies to items in the environment, leading to allergic contact dermatitis. The most common scenario is with poison ivy, where the skin gets very itchy 24-48 hours after the initial exposure. At other times this association can be less obvious. We can help sort out what could be triggering the rash.
Irritant Hand Dermatitis
There are household and chemical products in the environment that contribute to eczema not as a true allergy, per se, but due to their abrasive nature. The exposures can break down our natural skin layers, bringing about inflammation and leading to hand dermatitis.
Seborrheic dermatitis is a type of rash that affects the scalp (commonly termed dandruff), but also shows itself as rashes on the face and chest. The skin will appear pink with a waxy, flaky texture.
This form appears as round, flaky rings on the skin, sometimes referred to as “coins.” Nummular dermatitis can be mistaken for ringworm (which is a fungal infection) but it requires a different treatment entirely.
Occasionally dermatitis can have a secondary infection that is on top of the rash itself. Eczema-affected skin tends to be cracked and more porous, making it susceptible to infections that penetrate the skin.
When bacterial infections occur on top of eczema, the skin tends to look yellow with crust and can be weepy. The skin can become red, warm and inflamed, and occasionally patients will develop a fever. A common type of bacteria that does this is staphylococcus aureus, which can be treated with antibiotics.
The herpes virus (aka the cold sore virus) can also grow on top of eczema-affected skin. This is termed “eczema herpeticum,” and can be widespread on the body. Similar to cold sores on the lip, eczema-prone skin that has a herpes infection on it may look like grouped, fluid-filled bumps.
Before and after – Treated with systemic agents (prednisone, topicals, etc.)
Eczema Treatment for Plainfield, Naperville and Burr Ridge Patients
The breadth of treatment options continues to evolve, with new research constantly giving us new medications and insight into our understanding of eczema. Our physicians at Burt & Will Plastic Surgery and Dermatology pride themselves on keeping pace with these changes to give you the best care available. Depending upon the type of dermatitis that you have, you may be recommended one or a combination of the following treatments:
Prescription Medications Applied on the Skin
Topical medications are those you apply on the skin and are available as creams, foams, lotions, ointments and even solutions. Generally, these have anti-inflammatory properties and help put the fire out of an angry, inflamed rash. The main topical classes for these medications are topical steroids, calcineurin inhibitors (Elidel and Protopic) and PDE4 inhibitors (Eucrisia). The key is picking what’s practical and safe to help your specific type of eczema.
Systemic Agents That Calm Down Inflammation
When topicals are not practical or simply aren’t doing the task, there are pills and biologics (specialized medications that target individual cell products) that can help out.
- Dupixent (dupilumab): a biologic medication FDA approved for atopic dermatitis. This blocks certain proteins that lead to inflammation and can significantly decrease eczema and itching.
- Prednisone: a steroid pill that can calm the skin down. This is usually used in the short-term as a “taper” to avoid any long-term side effects.
- Immunosuppressants: methotrexate, cyclosporine, and mycofenolate mofetil are older oral medications that block certain inflammatory pathways. These typically require lab work to ensure safe administration.
Home Treatments and Regimens
Knowing the right strategies at home can be half the battle. Dr. Dabade will help clarify what’s helping or hurting in your daily routine, and recommend specific over-the-counter products that complement the prescription medications you may need. He can incorporate alternative therapeutic approaches as well. Additionally, there are certain techniques in which he has expertise.
- Wet Wraps: a treatment commonly used for children with stubborn eczema where moist gauze is wrapped around medicated creams to heal the skin. Dr. Dabade has authored articles about this treatment.
- Light Treatment (Phototherapy): certain wavelengths of light, such as narrowband UVB, have anti-inflammatory properties and help with dermatitis
Treating Secondary Infections
As reviewed above, bacterial and viral infections can occur on the skin in addition to eczema and dermatitis. Treating these is important to prevent the spread of the infection, and can be done either with antibiotic creams or oral antibiotics, depending upon the type of infection. Certain eczema compounds, such as the Aron’s formula, also incorporate treating infections and eczema on an ongoing basis.