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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
In children
Pregnancy and
eczema
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:
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Make lifestyle
modifications to prevent flare-ups
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See a
dermatologist for treatment
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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.
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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 |
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Using
a medication more frequently, or in greater amount than
prescribed, will not increase effectiveness and can
trigger a side effect. If uncertain about how often or
how much to use, be sure to ask your dermatologist. |
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