What it is
Eczema is inflamed, dry, intensely itchy skin that comes in flares and settles between them. Atopic dermatitis is its most common form and usually starts in childhood, while the forms adults present with most often are caused by repeated contact — water, detergents, sanitizer, gloves — or by a delayed allergy to a specific substance. Treatment is built on continuous emollient use, an anti-inflammatory ladder for the flare, and identifying what in the patient's actual day is keeping it going.
What this page covers
- Atopic dermatitis and eczema in adults
- Atopic dermatitis and eczema in children, managed with the parent, including bathing quantity and potency
- Emollient and barrier-repair routine
- The topical corticosteroid ladder, with steroid-phobia counseling and safe quantities
- Topical calcineurin inhibitors and non-steroid maintenance for the face, eyelids and flexures
- Hand eczema and chronic hand dermatitis, built around wudu, sanitizer, dishwashing and glove use rather than against them
- Irritant contact dermatitis, including the self-inflicted form from acids, scrubs and at-home peels
- Allergic contact dermatitis — jewelry, fragrance, preservatives, hair dye, nail products, topical medicines
- Patch testing for contact allergy, with paraphenylenediamine (black henna and hair dye) and gel and acrylic nail (meth)acrylates named in every panel
- Paraphenylenediamine and black henna reaction management, and lifelong cross-sensitization counseling
- Lichen simplex chronicus and prurigo nodularis from the scratch-itch cycle
- Recognition and treatment of infected eczema
- Severe eczema: the systemic and biologic referral pathway, with baseline screening and monitoring
Honestly
Eczema is a relapsing condition managed with a written plan rather than a course that ends, and the pale or dark patches left behind after a flare are the eczema's shadow rather than a new disease — they settle slowly on deeper skin and often distress the patient more than the flare did. Treatment fails most often here because a parent or patient stops the steroid out of fear and reaches for an unlabeled herbal cream that usually contains a stronger one.