Eczema

Eczema is an umbrella term for several inflammatory skin conditions, but atopic dermatitis is the most common and well-known type. The condition often runs in families, particularly among individuals with a personal or family history of asthma, hay fever, or other allergies. Eczema primarily affects the skin’s ability to act as a barrier, leading to moisture loss, increased sensitivity, and greater vulnerability to irritants and allergens.

The term “atopic” refers to a genetic tendency to develop allergic diseases, while “dermatitis” means inflammation of the skin. In people with eczema, the immune system overreacts to internal or external triggers, resulting in inflammation, itching, and skin damage.

The exact cause of eczema is not fully understood, but it is believed to result from a combination of genetic and environmental factors. A key feature of eczema is a defective skin barrier, which allows irritants, allergens, and microbes to penetrate the skin more easily while also causing increased water loss. Several contributing factors include:

• Genetics: Individuals with a family history of eczema, allergies, or asthma are more likely to develop the condition.
• Immune system dysfunction: An overactive immune response can trigger inflammation and skin irritation.
• Environmental triggers: Common irritants include harsh soaps, detergents, fragrances, smoke, and certain fabrics. Allergens such as dust mites, pet dander, mold, and pollen can also exacerbate symptoms.
• Weather and climate: Cold, dry air or sudden changes in temperature and humidity can worsen eczema.
• Stress: Emotional stress can trigger or worsen flare-ups, although it is not a direct cause.

Eczema symptoms can vary widely depending on age, the severity of the condition, and environmental factors. Common symptoms include:

• Itching: Often intense and can worsen at night or after scratching.
• Dry, scaly skin: The skin may appear rough, cracked, or flaky.
• Redness and inflammation: Inflamed patches may look pink or red on lighter skin and darker brown or gray on deeper skin tones.
• Thickened or leathery skin: Repeated scratching and rubbing can lead to skin thickening, known as lichenification.
• Oozing and crusting: In severe cases, blisters may form, ooze fluid, and become crusted or infected.
• Skin discoloration: Healing eczema patches may leave areas of lighter or darker skin, especially in individuals with deeper skin tones.

Eczema commonly affects the face, neck, inner elbows, backs of the knees, wrists, and ankles. However, it can appear anywhere on the body.

Diagnosis is primarily based on a detailed medical history and physical examination of the skin. Dr. Hibler carefully evaluates the appearance and distribution of skin changes.  He will inquire about symptom patterns, family history of allergic conditions, and environmental or lifestyle triggers. In some cases, additional tests may be recommended to rule out other skin conditions or identify specific allergens.

With proper management, most people with eczema can achieve good control over their symptoms and experience long periods of clear or nearly clear skin. Treatment plans often require a combination of skincare maintenance, targeted therapies during flare-ups, and long-term prevention strategies. Dr. Hibler works closely with patients to identify the specific factors contributing to their eczema and provides guidance to improve skin health, comfort, and overall quality of life.