Atopic Dermatitis / Eczema

Eczema — also called dermatitis — is an umbrella term for a group of conditions in which the skin becomes inflamed, itchy, dry, and irritated. The skin barrier does not hold moisture the way it should, which allows irritants and allergens in and sets off a cycle of itching and scratching.

Eczema is not contagious. It ranges from a small patch of dry, scaly skin to widespread, intensely itchy inflammation that disrupts sleep and daily life. Identifying which form you have matters, because the treatments differ.

Atopic dermatitis is the most common form. It is a chronic condition that often begins in childhood and is associated with asthma and seasonal allergies, though it can appear at any age. It typically affects the creases of the elbows and knees, the hands, the face, and the neck, and tends to flare and settle over time.

Allergic contact dermatitis develops when the skin reacts to a specific allergen, such as nickel, fragrance, hair dye, or poison ivy, usually a day or two after exposure. Irritant contact dermatitis is more common and results from repeated contact with soaps, solvents, sanitizers, or water — frequently seen on the hands.

Dyshidrotic eczema causes deep, intensely itchy blisters on the palms, sides of the fingers, and soles. Nummular eczema forms coin-shaped, well-defined plaques, often on the arms and legs. Asteatotic eczema produces the dry, cracked, cobblestone appearance seen on the lower legs, particularly in older adults and in dry conditions.

Treatment begins with restoring the skin barrier through gentle cleansing and consistent moisturizing, then adds anti-inflammatory therapy as needed: topical steroids, non-steroidal creams, phototherapy, and newer oral and biologic medications for moderate to severe disease. Most cases of contact dermatitis can be diagnosed and managed in our office through a careful history and examination. In the small number of cases where formal patch testing is warranted, we coordinate that testing for you and continue to direct your care and treatment plan throughout.