Atopic Dermatitis (Eczema)

Diagnosis

To diagnose atopic dermatitis, your healthcare professional will usually review your symptoms, examine your skin, and go over your medical history. In some cases, additional allergy tests may be recommended to help rule out other skin conditions.

If you suspect that a specific food trigger is causing your child’s rash, it’s important to discuss food allergy testing with your healthcare professional.

Patch testing may also be used to identify specific allergens. During this test, small amounts of potential irritants are applied to the skin and covered. Over the next few days, the skin is checked for any reaction. This test helps detect contact allergies that can worsen atopic dermatitis.

Treatment

Management of atopic dermatitis typically begins with moisturizing and daily skin care. If this doesn’t control symptoms, your healthcare professional may recommend medicated creams or additional treatments. Because atopic dermatitis can be chronic and relapsing, treatment may need to be adjusted over time.

Medications

Topical treatments: Prescription creams or ointments can help reduce itching and inflammation and repair the skin barrier. Options include corticosteroid creams and calcineurin inhibitors, such as tacrolimus (Protopic) and pimecrolimus (Elidel). These should be applied as directed and typically before moisturizing.

Antibiotics: If the skin becomes infected, oral antibiotics may be prescribed.

Oral anti-inflammatory medicines: For moderate to severe eczema, oral medications such as cyclosporine, methotrexate, prednisone, mycophenolate, or azathioprine may be used for short-term control due to possible side effects.

Biologic injections: For people with moderate to severe eczema who don’t respond well to other treatments, biologic therapies like dupilumab (Dupixent) or tralokinumab (Adbry) may be recommended. These are shown to be effective in reducing symptoms.

Therapies

Wet wrap therapy: This involves applying a corticosteroid ointment and wrapping the area with moist and then dry gauze. It’s often used for severe flares and may be done in a hospital setting or at home with guidance.

Light therapy (phototherapy): Controlled exposure to natural sunlight or artificial UV light may be recommended for those who don’t respond to topical treatment. While effective, it may carry long-term risks such as premature skin aging and increased skin cancer risk, so it’s used cautiously.

Behavioral and emotional support: For those who experience stress or frustration due to eczema, counseling, relaxation techniques, and behavior modification strategies can help reduce habitual scratching.

Baby Eczema

For babies with atopic dermatitis, management includes:

• Identifying and avoiding irritants.

• Avoiding extreme temperatures.

• Giving short baths in warm water and applying moisturizer while the skin is damp.

If these steps don’t help or the rash appears infected, your healthcare professional may prescribe medications or recommend oral antihistamines to ease itching, especially at night.