Eczema is not contagious, but it can be persistent and have periods of flare-ups.

Symptoms of Eczema

Eczema symptoms can vary from person to person and can appear anywhere on the body. Common symptoms include:

• Dry, cracked skin: The skin may feel rough and scaly.
• Itchiness (pruritus): This can range from mild to severe and often worsens at night.
• Rash: The appearance of the rash can vary depending on your skin tone. On lighter skin, it may appear red or pink. On darker skin, it may look purple, brown, or gray.
• Small, raised bumps: These may occur, particularly on brown or Black skin.
• Oozing and crusting: In some cases, the rash may leak fluid and develop a crust.
• Thickened skin: Over time, areas affected by eczema may become thickened and leathery (lichenification) due to chronic scratching.
• Discolored skin: The skin around the eyes may darken. After a flare-up, the affected skin may be lighter or darker than the surrounding skin (post-inflammatory hyperpigmentation or hypopigmentation).
• Raw, sensitive skin: Scratching can lead to open sores and make the skin more sensitive.

Diagnosis of Eczema

Diagnosing eczema typically involves a physical examination of the skin and a review of your medical history and symptoms by a healthcare provider. They may ask questions about:

• When the symptoms started and how long they've lasted.
• Where the rash appears on the body.
• Factors that make the symptoms better or worse (triggers).
• Personal or family history of eczema, asthma, or allergies.
• Your skincare routine and products you use.

In some cases, the doctor may recommend:

• Patch testing: To identify specific allergens that may be triggering contact dermatitis, a type of eczema.
• Skin biopsy: A small sample of the affected skin is examined under a microscope to rule out other skin conditions.
• Allergy testing: To identify potential food or environmental allergies that might be contributing to eczema flares.

Treatment of Eczema

There is currently no cure for eczema, but various treatments can help manage symptoms, reduce inflammation, and prevent flare-ups. Treatment plans are tailored to the individual's age, severity of eczema, and specific needs. Common treatments include:

• Moisturizers: Regular and liberal use of fragrance-free moisturizers is crucial to hydrate the skin, repair the skin barrier, and reduce dryness and itching. Ointments and creams are generally more effective than lotions.
• Topical corticosteroids: These prescription medications come in various strengths (creams, ointments, gels, solutions) and help reduce inflammation and itching during flares.
• Topical calcineurin inhibitors (TCIs): These non-steroidal prescription creams or ointments (tacrolimus, pimecrolimus) also reduce inflammation and can be used on sensitive areas.
• Topical phosphodiesterase-4 (PDE4) inhibitors: Crisaborole is a non-steroidal prescription ointment that helps reduce inflammation.
• Oral antihistamines: These can help relieve itching, especially at night, and can be useful if allergies contribute to eczema.
• Systemic medications: For severe eczema, oral corticosteroids or immunosuppressants may be prescribed for short periods to control inflammation.
• Biologics: Injectable medications like dupilumab and tralokinumab target specific parts of the immune system and are used for moderate to severe eczema that hasn't responded well to other treatments.
• Phototherapy (light therapy): Exposing the skin to controlled amounts of ultraviolet (UV) light can help reduce inflammation and itching in moderate to severe eczema.
• Wet dressings: Applying corticosteroid ointments under wet wraps can be an intensive treatment for severe flares.
• Trigger avoidance: Identifying and avoiding substances or conditions that trigger eczema flares (e.g., certain soaps, detergents, allergens, stress, temperature extremes) is an important part of management.

Self-Care Measures:

In addition to medical treatments, self-care strategies can significantly help manage eczema:

• Gentle bathing: Use lukewarm water and mild, fragrance-free cleansers. Avoid hot water and harsh soaps.
• Pat dry: Gently pat the skin dry after bathing and apply moisturizer immediately while the skin is still damp.
• Avoid scratching: Keep fingernails short and consider wearing soft gloves at night to prevent scratching.
• Wear soft clothing: Choose loose-fitting clothes made of soft, breathable fabrics like cotton. Avoid wool and synthetic fabrics that can irritate the skin.
• Manage stress: Stress can trigger flares. Practice relaxation techniques.
• Identify and avoid irritants and allergens: Pay attention to products and environmental factors that seem to worsen your eczema.

Managing eczema is often an ongoing process that may require adjusting treatment plans over time. Working closely with a healthcare

provider, such as a dermatologist or allergist, is essential for developing an effective management strategy.