University of Iowa Health Science Relations and
Richard Caplan, MD
Professor Emeritus of Dermatology
First Published: 1995
Last Revised: 2002
Peer Review Status: Internally Peer Reviewed
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.
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