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Eczema

The presence of an itchy, red rash, which may vary from mild to severe, and can appear all over the body, often exhibiting in different locations, may be eczema, also known as Atopic Dermatitis. Eczema is a common condition, so if you are experiencing  symptoms of eczema, you are not alone, and there is no need  to be embarrassed. At Johns Creek Dermatology, Dr. Shereen Timani can diagnose your type of eczema and prescribe the appropriate treatment program. Although eczema is typically diagnosed on babies and young children, with symptoms usually decreasing as the child ages, eczema may continue into adulthood. The condition may also be triggered in an adult. Dr. Timani treats all stages of eczema, with particular focus on the management of childhood eczema.

The definition of  eczema is derived from a Greek word translating to “effervesce or bubble or boil over”.  Eczema symptoms differ from person to person, and the exact causes are not known. It is theorized that certain types of eczema may have a tendency to be inherited. and that there may be a link between allergic disease, such as hay fever or asthma, as a trigger for the skin condition.  All types of eczema cause redness and itching, and in some cases the skin blisters, weeps or peels. Most often the rash appears within the insides of the elbows, on the backs of the knees, and on the hands, neck or face, or anywhere on the body where skin may fold or crease.  In extreme cases, the majority of the body may be covered in the rash. You may exhibit one or more of the following symptoms:

  • Dry, sensitive skin
  • Intense itching
  • Red, inflamed skin
  • Recurring rash
  • Scaly areas
  • Rough, leathery patches
  • Oozing or crusting
  • Areas of swelling
  • Dark colored patches of skin

Types of Eczema

Although the exact causes of eczema are undetermined, many factors may trigger the flare of eczema, or increase the intensity and areas impacted. These may include: irritants; allergens; microbes; temperature; food allergy; stress; and hormones. There are several itchy rash type skin diseases that are considered eczema. Dr. Timani will evaluate your specific condition to determine the classification of eczema and appropriate treatment. Very importantly, one of the primary goals of treatment, no matter what the trigger or manifestation of the dermatitis, is to break the inflammation- itch- scratch- symptom intensification cycle.  Categories of eczema are described briefly below.

  • Atopic dermatitis affects the majority of patients from childhood, and is typically a chronic condition which may develop into a severe, widespread rash.
  • Hand eczema usually is confined only to the hands and affects up to 10% of the population.
  • Contact dermatitis occurs when the skin comes in contact with certain substances, causing a reaction resulting in skin inflammation.
  • Seborrheic dermatitis is a common skin condition that may occur simultaneously in patients with eczema, having similar symptoms to eczema, which may make a specific diagnosis difficult.
  • Dyshidrotic eczema causes blisters on the fingers, palms and soles of the feet, and women are two times more prone to this disorder.
  • Nummular eczema appears as well-defined coin-shaped spots on the skin which are either very dry and scaly or wet and open, depending on the itch factor.  Unlike atopic dermatitis, heredity is not usually a factor.  As it resembles ringworm, it is important to visit Johns Creek Dermatology to rule out a fungal infection.
  • Neurodermatitis,  tends to result in a single or several patches—one or many— which result from frequent rubbing or consistent irritation.
  • Stasis dermatitis is associated with a circulation problem most often affecting the veins in the lower legs. This type of dermatitis can result in more permanent changes in the skin over time.

 Treatment Options

Following your diagnosis, Dr. Timani will craft a treatment plan to resolve the inflammation-itch-scratch cycle and normalize your skin. Although there are multiple subtypes of the condition, an underlying origin of the symptoms is that the immune system is causing skin inflammation. A basic component of your treatment program, no matter what the appearance or trigger,  is moisturizing the area to keep the skin from becoming dry and prone to flare-ups. In most cases,  in order to foster the recovery of the skin, Dr. Timani will prescribe a topical steroid in cream, lotion or ointment form to reduce inflammation and irritation, and diminish itching while relieving the urge to scratch. In cases of sensitivity to steroids, she may prescribe a topical calcineurin inhibitor which is a non-steroidal prescription eczema drug  in order to reduce the potential for side effects often associated with long-term use of topical steroids, such as thinning of the skin, stretch marks, spider veins or discoloration of the skin.  In extremely severe cases, it might be necessary to employ the use of immunosuppressant medications to halt the immune system’s attack on the skin.