Understanding Eczema

Eczema—also called atopic dermatitis—is a common skin condition that affects millions of children and adults. While it can be frustrating, itchy, and sometimes disruptive to daily life, the good news is that there are many effective treatments available today. With the right combination of skincare habits and medications, most people can achieve meaningful relief and long-term control.

What Causes Eczema?

Eczema happens when the skin barrier doesn’t work the way it should. Healthy skin keeps moisture in and irritants out, but in eczema:

• The barrier is “leaky”

• Skin loses moisture easily

• Irritants and allergens penetrate more easily

• Inflammation develops

Genetics play a role—eczema often runs in families and is linked to asthma and allergies—but environmental triggers are important too.

Common triggers include:

• Dry weather

• Harsh soaps or fragrances

• Certain fabrics (like wool)

• Stress

• Food or environmental allergies

• Illness

Everyday Habits That Improve Eczema

Before prescription medications, dermatologists focus on strengthening the skin barrier. These habits can significantly improve symptoms:

1. Moisturize Daily (Sometimes Twice Daily): Thick creams or ointments (like CeraVe, Vanicream, Aquaphor, or Eucerin) lock in moisture far better than lotions.

2. Use Gentle, Fragrance-Free Products: Avoid scented soaps, detergents, body washes, and fabric softeners.

3. Take Short, Lukewarm Showers: Hot water can worsen dryness and itching.

4. Apply Moisturizer Immediately After Showering: This “soak and seal” method helps trap water in the skin.

5. Avoid Scratching When Possible: Scratching can worsen inflammation and cause infection.

Treatment Options Your Dermatologist May Recommend

1. Topical Steroids

   1. These reduce inflammation and itching quickly. They come in various strengths for different areas of the body. Short-term use is generally safe under medical guidance.

2. Topical Calcineurin Inhibitors (TCIs)

   1. Examples: Tacrolimus (Protopic) and Pimecrolimus (Elidel): These are non-steroidal and safe for long-term use, especially on the face or sensitive areas.

3. Topical PDE4 Inhibitors

   1. Example: Crisaborole (Eucrisa): Useful for mild to moderate eczema and safe for daily use.

4. Phototherapy

   1. Controlled UV light treatments can calm inflammation, especially for widespread eczema.

5. Biologic Therapy (Dupilumab / “Dupixent”)

   1. A breakthrough injectable medication that targets the root inflammation in eczema. Many patients see significant improvement within weeks. It’s considered for moderate-to-severe cases that don’t respond well to topical treatments.

6. JAK Inhibitors (Abrocitinib, Upadacitinib)

   1. A newer class of oral medications for more severe eczema that hasn’t improved with other treatments.

When to See a Dermatologist

You should seek medical care when:

• Symptoms interfere with sleep or daily activities

• Over-the-counter moisturizer routines aren’t enough

• Skin becomes painful, oozing, or crusted (signs of infection)

• You’re needing frequent steroid creams

• You’re curious about new treatment options

With today’s modern therapies, most patients can achieve excellent control of eczema and return to living comfortably in their skin.