How is eczema diagnosed?
In most cases, eczema is diagnosed from the person’s history of symptoms and by examining the skin. The doctor might test an area of scaly or crusted skin to rule out other skin diseases or infections.
How is eczema treated?
Treatment varies depending on the symptoms (for example, dry skin is treated differently than oozing blisters), as well as the factors that trigger or worsen symptoms. No one treatment is best for all people. The goal of treatment is to reduce itching and discomfort, and to prevent infection and further flare-ups.
Treatment options include:
Preventing flare-ups is the best way to manage eczema. For that reason, it is important to try to identify and avoid symptom triggers, such as particular detergents or food allergens.
Keeping your skin moist is important, because itching increases when the skin is dry. Use a moisturizing cream or lotion several times a day — including after bathing/showering — to keep your skin moist. Use mild soaps and products that are free of perfumes. Avoid skin care products with alcohol, because alcohol can dry your skin.
Over-the-counter creams and ointments containing the steroid cortisone — such as hydrocortisone (Cortisone 10) and hydrocortisone acetate (Cort-Aid) — may be used to help control the itching, swelling, and redness associated with eczema. Prescription-strength cortisone creams, as well as cortisone pills and shots, are also available for more severe cases of eczema, although long-term use of cortisone is not recommended because of the possible side effects, which include high blood pressure, weight gain, and thinning of the skin.
Newer medications, called topical immunomodulators (TIMs), are showing progress in treating patients with moderate to severe eczema, particularly those patients who do not respond to traditional treatment. TIMS — such as tacrolimus (Protopic) and pimecrolimus — work by modulating (altering) the body’s immune response to allergens. TIMs also have fewer side effects than steroids. The most common side effect reported with tacrolimus is a temporary stinging or burning sensation that generally improves after a few days of use.
Other medications that might be used for patients with eczema include antibiotics if the skin becomes infected and antihistamines to help control itching.
The ultraviolet light waves found in sunlight have been shown to benefit certain skin disorders, including eczema. Phototherapy uses ultraviolet light, either ultraviolet A (UVA) or ultraviolet B (UVB), from special lamps to treat people with severe eczema. In some cases, a medication called psoralens is prescribed before phototherapy to make the skin more sensitive to the effects of the ultraviolet light. This treatment is called PUVA (psoralens plus ultraviolet A).