(BlackDoctor.org) — Eczema has been called “the itch that rashes” because the itching usually occurs first. This group of skin rashes may first appear in babies and toddlers, becoming a drier, flaky rash in older children. Adults may see scaly, leathery patches or a stubborn hand eczema. Atopic dermatitis is a common, often inherited form, but there are other types, as well as many treatment options.
Stop the Scratching
People with atopic dermatitis may scratch as many as 500 to 1,000 times a day. That scratching worsens the rash and can increase the risk of infection due to breaks in the skin. Use a cold compress to lessen the itchy feeling. Distract children with activities. Moisturizers are soothing, and some medicated creams or ointments may help, too.
Over-the-counter hydrocortisone creams or ointments may help mild cases of eczema but should not be used on children under 2 or for more than seven days without consulting a doctor. Stronger corticosteroid products may be necessary to control the inflammation. Side effects from extended use include skin thinning, infection, and stretch marks. In rare cases that haven’t responded to other treatment, a doctor may prescribe oral or injectable corticosteroids.
Antihistamines may provide relief from the vicious cycle of itching and scratching for some, but not all, people with the atopic dermatitis type of eczema. Many OTC and prescription-only options are available, each with slightly different dosing and side effects. Check with your health professional for a recommendation.
Prescription topical medicines that calm an overactive immune system, such as Elidel and Protopic, may help treat eczema from atopic dermatitis. Doctors generally prescribe them only when other treatments have failed, for short-term use, in certain patients. They’re required by the FDA to carry a “black box” warning due to concerns about an increased risk of cancer. However, the American Academy of Dermatology disagrees with the FDA’s safety warning. It’s best to discuss the risks and benefits with your health care provider.