3330. Itchy inner elbows - atopic dermatitis in people

, becoming drier and flaky 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 and many treatments.

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Symptoms

Itching is the main one. And when you start to scratch, your skin becomes inflamed and even itchier. It can look different, but you may notice:  

• Red, scaly areas
• Small, rough bumps
• Thick, leathery patches
• Bumps that leak fluid and crust over

If you have dark skin, the affected area might be lighter or darker.


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Eczema in Children

Kids can get the rash on the inside of their elbows or behind the knees, around their mouths, on the sides of their necks, or on wrists, arms, and hands. Those with atopic dermatitis are more likely to have food allergies, including allergies to peanuts, milk, or other nuts. But you shouldn't restrict foods unless your doctor confirms a food sensitivity. It’s not contagious, either.

areas of the body, such as the inside of the elbows and back of the knees. But eczema can appear anywhere, including the neck, chest, and eyelids. People who had atopic dermatitis as a child may see drier, scaly rashes as adults. The skin may be discolored or thickened.

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Diagnosis

If a rash won’t go away, is uncomfortable, or develops a crust or pus-filled blister, see your doctor. She'll check your medical history, symptoms, and ask you about any allergies that run in your family. You may also get allergy tests or a microscopic exam of a skin scraping (seen here) to rule out infections.

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Eczema and Allergies

The triggers that bring on an allergy attack -- dust mites, pollen, animal dander, mold -- can cause some people with atopic dermatitis to break out in a rash. Food allergies also can set off a flare-up. These allergens cause the immune system to overreact, leading to skin inflammation.

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Eczema and Allergies

The triggers that bring on an allergy attack -- dust mites, pollen, animal dander, mold -- can cause some people with atopic dermatitis to break out in a rash. Food allergies also can set off a flare-up. These allergens cause the immune system to overreact, leading to skin inflammation.

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Other Triggers

Irritants can cause inflammation and itching, bringing on a bout of eczema. Touching harsh chemicals can cause a rash in anyone, but people with eczema may be sensitive to mild irritants, such as wool, detergents, astringents, or fragrances. Emotional stress can cause a flare-up, too. So can sweating and wetting and drying your skin a lot, such as when you wash your hands

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Try Not to Scratch

People with atopic dermatitis may scratch as many as 500 to 1,000 times a day. It worsens the rash and can make an infection more likely. Use a cold compress to ease the itchy feeling. Distract children with activities. Moisturizers are soothing, and some medicated creams or ointments may help, too.

Corticosteroids

Over-the-counter hydrocortisone products may help mild cases of eczema. Don’t use them on children under 2 or for more than 7 days unless your doctor says it’s OK. Sometimes, people need stronger corticosteroids to control the inflammation. Long-term use can have side effects, such as thinning skin, infections, stretch marks, and visible blood vessels. If other treatments don’t work, your doctor may recommend steroid shots or pills.

Antihistamines

These meds may provide relief from the cycle of itching and scratching for some people with atopic dermatitis. Many OTC and prescription-only options are available, each with slightly different dosing and side effects. Check with your doctor for a recommendation.

Treatment: Hand Eczema

Alitretinoin, a relative of vitamin A, can improve or even clear up this condition when other treatments don't work. It hasn’t yet been approved by the FDA for this use. It can give you headaches or dry, flushing, or sun-sensitive skin. Alitretinoin can cause severe birth defects, so you should not plan to get pregnant when you take it. It also helps to wear gloves outside in winter to protect your hands.

condition when other treatments don't work. It hasn’t yet been approved by the FDA for this use. It can give you headaches or dry, flushing, or sun-sensitive skin. Alitretinoin can cause severe birth defects, so you should not plan to get pregnant when you take it. It also helps to wear gloves outside in winter to protect your hands.

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Phototherapy

UV light affects the immune system. In some people, it can improve moderate to severe cases of eczema from atopic dermatitis or contact dermatitis. “PUVA” is a UV treatment combined with a drug called psoralen. But it doesn’t work for everyone, and it makes some people's eczema worse. Also, too much UV light is bad for your skin. So you should talk to your doctor about the risks and benefits.

Treatments for Children

Keep your child's fingernails short and their skin moisturized. Dress them in loose-fitting clothes and make sure they don't become overheated. Depending on how severe the condition is, your doctor may recommend corticosteroids to treat atopic dermatitis. There are also prescription skin treatments, pimecrolimus (Elidel) and tacrolimus (Protopic), for children 2 years old and up.

Bleach Baths

A small amount of household bleach in the bath may help control atopic dermatitis if someone has a staph infection, too. In one study, children with moderate to severe atopic dermatitis and staph soaked in diluted bleach baths and used an antibiotic ointment in their noses. These treatments improved their skin symptoms. Parents should talk to a dermatologist or other doctor first.

Natural Treatments

Some research shows that probiotics, oolong tea, or Chinese herbal medicine may ease symptoms. But other studies haven’t backed that up. Herbs and supplements can have side effects, so talk to your doctor first. Things that lower stress are a good idea to try.

Natural Treatments

Some research shows that probiotics, oolong tea, or Chinese herbal medicine may ease symptoms. But other studies haven’t backed that up. Herbs and supplements can have side effects, so talk to your doctor first. Things that lower stress are a good idea to try.

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Eczema and Infections

Almost all people with atopic dermatitis have “staph” (Staphylococcus aureus) bacteria on their skin, compared with just about 5% of people without the skin condition. Tell your doctor about symptoms of an infection, such as honey-colored crusts, pus- or fluid-filled blisters, scaly red patches, swelling, or a fever.

Dry Skin Care

Even when the eczema eases up, your skin may still be dry. Take short daily baths in warm water. Pat your skin partially dry and use a thick moisturizer, as well as any medication right after your bath. Moisturize throughout the day and stick to mild soaps or cleansers. Look for fragrance-free products to help prevent a reaction. Remember, "unscented" may just mean the product contains another ingredient to mask the scent.

Living With Eczema

Does your child feel self-conscious about his rashes? Help him avoid triggers and tame stress. The American Academy of Dermatology hosts Camp Discovery for kids with skin conditions. Adults with the condition may need to make some changes. Jobs that need a lot of hand-washing or involve exposure to chemicals or other irritants -- such as health care, housecleaning, or hairdressing -- may not be a good choice if you have eczema.

You Can’t Catch It

Red, itchy eczema patches may look contagious, but they’re not. “Eczema is basically an allergy in the skin that starts out as an itch that turns into a rash,” says Jennifer Haley, MD, a dermatologist in Scottsdale, AZ, who had the condition as a child. Just like you can’t catch someone else’s hay fever, you can’t catch eczema.