|
FAQs
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:
-
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.
More Information
Medications and Other Therapies Used to
Treat Eczema
Describes
the medications that dermatologists may prescribe to treat eczema and
two topical therapies, moisturizers and cold compresses
Phototherapy: A Treatment Option for
Atopic Dermatitis
Discusses
the types of phototherapy used to treat atopic dermatitis as well as the
benefits and drawbacks
|
