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Eczema

What Is Eczema?


Eczema or Atopic Dermatitis is a chronic skin disease that causes dry, irritated skin. The cause of eczema is unknown, but it is believed to run in families. It is often the first manifestation of a group of allergic disorders that may include asthma, allergic rhinitis, and food allergies. Eczema is not contagious. Eczema is diagnosed in 20% of children and up to 3% of adults, with the condition developing during the first 12 months of life in 75 % of children that are affected and clears completely at or shortly after puberty in up to 60%.

What Are The Symptoms?

The skin affected by eczema is usually red looking, dry and scaly and extremely itchy. Eczema most commonly occurs on the cheeks, chin, back, stomach, arms, hands, feet, the creases of the elbows, and behind the knees in children. In adults, eczema is commonly found on the eyelids, neck, hands, wrists, the inside of the elbows, and behind the knees.

What Are The Treatment Options?

Topical steroids are used only for acute flares to ease the scaling and itching that may occur. This is not a daily medication regimen due to the side effects from topical steroids. Even short-term use of topical steroids can be associated with side effects, specifically in the face, axillae (the space below the shoulder or armpit), and the groin. Children are more susceptible to side effects due to their larger skin surface to body mass ratio.

A topical steroid should never be used for longer than 10 consecutive days.

  • Local side effects include but are not limited to burning, itching, stinging, skin thinning, irreversible stretch marks, changes in skin color that do not always go away, secondary infection, and allergic contact dermatitis.
  • Systemic side effects include but are not limited to high blood glucose and manifestations of Cushing’s syndrome. Cushing’s syndrome occurs when your body is exposed to high levels of the hormone cortisol for a long time. The most common cause of Cushing’s syndrome, sometimes called hypercortisolism, is the use of oral and occasionally topical corticosteroid medications. Symptoms of Cushing’s syndrome include a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing’s syndrome can also result in high blood pressure, bone loss and, on occasion, diabetes.

    • Antibiotics are used when there is an infection, called impetigo, present during an acute eczema flare. The antibiotics given may be topical or oral based on the severity of the infection.

    Oral Antihistamines can be used to help reduce itching. Examples of antihistamines include Benadryl, Atarax, Zyrtec, Claritin, Clarinex, Xyzal and Allegra. Some antihistamines can be sedating and should be taken at bedtime.

    Immunomodulators such as Protopic and Elidel may be prescribed for severe atopic dermatitis. These medications may help maintain normal skin texture and reduce flares. These medications have a theoretical risk of immunosuppression, with resultant theoretical progression to skin cancers and lymphoma. The FDA recommends that these medications be used only when other treatments have failed or if the patient cannot tolerate other treatments.

    UV light therapy uses natural or artificial light exposed to your skin in controlled amounts. Though effective, long-term light therapy has many harmful effects, including premature skin aging and an increased risk of skin cancer.

    Biologics, specifically Dupixent, modifies part of the immune system to reduce the inflammation associated with eczema. Dupixent injections are usually once a month and can significantly reduce flare ups, medications, and use of topical and oral steroids. You can read more on our Biologics page.

    To find out more information about our eczema treatment options, please contact one of our offices at:


    New Braunfels office (830) 625-7612
    Schertz office (210) 654-0944
    San Antonio (210) 908-9230