Frequently Asked Questions About Eczema

This section answers questions frequently asked by parents, caregivers, and patients. If you have a question about eczema that is not answered below, you may submit it via “Tell Us About Yourself.” While ethical and legal considerations prohibit advice or comment regarding an individual case, the topic may be addressed in a FAQ or become the subject of an upcoming article.

General Information

• Is atopic dermatitis an allergy?

• Is eczema caused by “nerves”?

• How close are scientists to finding a cure for atopic dermatitis?

In children

• My child has eczema. Will he develop asthma?

• Will my child "outgrow" his eczema?

• What is done to relieve symptoms in children?

Pregnancy and eczema

• What eczema medications should not be taken during pregnancy?

• Does pregnancy cause atopic dermatitis to flare?

• I have atopic dermatitis. What can I do to lessen the chance that my baby will develop it?

Is atopic dermatitis an allergy?
Atopic dermatitis, the most common type of eczema, can be a chronic, itchy condition in which the skin is overly sensitive to many things. People with atopic dermatitis also often have a higher likelihood of developing certain allergic conditions, such as a food allergy, hay fever, and asthma. However, atopic dermatitis is not an allergy because it is not a specific response to a specific allergen, and very rarely will finding the allergy and eliminating it completely clear the eczema.

Is eczema caused by "nerves"?
While stress and other psychological factors can trigger a flare-up, they do not actually cause eczema. Research shows that having eczema may cause feelings of anxiety and anger, and these emotions can trigger a flare-up. Learning to manage emotions and reduce stress has been shown to be one of the most effective ways to lessen the frequency and intensity of flare-ups.

How close are scientists to finding a cure for atopic dermatitis?
While rapid advancements in medical research have been made in recent years, scientists do not expect to find a cure for atopic dermatitis any time soon. It is anticipated that current research will eventually lead to revolutionary new ways to diagnose, treat, and perhaps even prevent atopic dermatitis. These hopes are based on knowledge that surfaced during the Human Genome Project, an enormous 13-year effort with goals that included identifying the genes in human DNA and determining the sequences that make up human DNA. It was work on the Human Genome Project that led to the discovery of a gene mutation that can lead to melanoma. This same discovery has accelerated the search for gene mutations involved in three other inherited conditions - diabetes, leukemia, and atopic dermatitis. While this is promising, people with atopic dermatitis should not expect results in the near future. The research in progress takes years to conduct, and many more years of study are needed before a safe and effective therapy is available.

For people looking for relief from atopic dermatitis, the best advice continues to be:

• Make lifestyle modifications to prevent flare-ups

• See a dermatologist for treatment

• Use medication as prescribed

My child has eczema. Will he develop asthma?
While atopic dermatitis, the most common form of eczema, is associated with asthma and other atopic disorders, it does not directly cause them, and people with atopic dermatitis do not always develop other atopic conditions. However, a link exists between eczema and asthma. One study found that 46% of boys and girls with asthma also had eczema.

Will my child "outgrow" his eczema?
Currently, there is no way to determine whether or not your child will outgrow his eczema. In 90% of people, eczema develops before age 5. In 40% to 60% of these individuals, eczema persists beyond puberty and into adulthood. The good news is that many infants with eczema improve by age 2, and about 40% of patients outgrow the condition by the time they are young adults. Since there is no way to predict whether or not your child will outgrow eczema, it is important to seek medical treatment and not wait for your child to outgrow it. Controlling eczema early can prevent it from getting worse.

It also is important to know that eczema can be triggered by environmental factors later in life. Research shows that 80% of occupational skin disorders occur in individuals who had atopic dermatitis as a child. 

What is done to relieve symptoms in children?
Children are unique patients. It may be difficult for them to resist scratching, and scratching tends to make the condition worse. Fortunately, for mild to moderate cases, applying moisturizer regularly can be very helpful. And, in most cases, the eczema will disappear as the child ages. Until signs and symptoms disappear, parents should:

• Help the child avoid as many eczema triggers as possible.

• Keep the child’s skin moist. After bathing, be sure to apply moisturizer while the skin is still damp to retain the moisture in the skin.

• Help the child avoid sudden temperature changes.

• Keep the child’s bedroom and play areas free of dust mites (a common trigger).

• Use mild soaps – both on the child’s skin and clothing.

• Dress the child in breathable, preferably cotton, clothing.

If these methods fail to help your child, you should consult a dermatologist. After consultation, it may be recommended that your child use a topical corticosteroid or perhaps a prescription cream, ointment, antihistamine or antibiotic.

What eczema medications should not be taken during pregnancy?
Since many factors, including age, health, and family history, affect which medications a person should and should not take, this question is best asked of your dermatologist. Women being treated for eczema and who are pregnant, breast-feeding, or who may become pregnant should know the following about these medications used to treat eczema:

• Antibiotics. Some antibiotics may not be suitable for use during pregnancy. Check with your dermatologist if you are pregnant, become pregnant, or are breast-feeding.
   

• Calcineurin inhibitors. Research shows that the oral form of tacrolimus crosses the placenta and appears in breast milk, making it inappropriate for use by pregnant and breast-feeding women. While only small amounts of tacrolimus are absorbed when used topically, it is not known what effects this may have on the fetus or nursing child. The effects that pimecrolimus may have on pregnancy and nursing are not known.
   

• Corticosteroids. While not known to cause birth defects, these medications cross the placenta. Therefore, neither topical nor systemic corticosteroids are recommended for use during pregnancy or while breast-feeding.
   

• Cyclosporine. While more research is needed, current findings indicate that cyclosporine does not cause major birth defects; however, use may be associated with increased rates of prematurity.
   

• Interferon gamma. This medication may appear in breast milk so caution is advised. Ask your dermatologist for advice about using.
   

• Mycophenolate mofetil. In animal studies, mycophenolate mofetil has been shown to cause birth defects. Women are advised to use effective contraception before and during therapy and for six weeks after stopping therapy with mycophenolate mofetil.

Does pregnancy cause atopic dermatitis to flare?
Some patients have reported that their atopic dermatitis became worse while they were pregnant; others said that their atopic dermatitis cleared during pregnancy. Current studies do not exist to confirm that pregnancy contributes to either.

Female patients also have reported clearing or worsening of atopic dermatitis in association with their menstrual cycle, but no studies clearly document the menstrual cycle as a factor in atopic dermatitis. Women who notice changes with pregnancy or during the menstrual cycle should discuss this association with their dermatologist or other treating physician.

I have atopic dermatitis. What can I do to lessen the chance that my baby will develop it?
Over the years, a number of studies have suggested that breast-feeding may prevent atopic dermatitis from developing in a child. A systematic review of 18 of these studies confirmed that breast-feeding has a substantial protective effect against atopic dermatitis in children with a first-order family history - that is, a history of parents, brothers, or sisters having the condition. The protective effect was found to be less in children who did not have a first-order family history.

References:
Gdalevich M et al. “Breast-feeding and the onset of atopic dermatitis in childhood: A systematic review and meta-analysis of prospective studies.” J Amer Acad Dermatol 2001; 45:520-527.

Oz B et al. “Pregnacy outcome after cyclosporine therapy during pregnancy: A meta-analysis.” Transplantation 2001; 71:1051-1055.

All content solely developed by the American Academy of Dermatology