Eczema

Eczema Treatment
Advanced Treatment Options in the San Diego Area

For Eczema treatment, Dr. Melanie Palm is a nationally recognized dermatologist practicing in the San Diego area. She specializes in the diagnosis and treatment of many skin conditions, including eczema, dermatitis, and skin rashes. Dr. Palm’s offices are located in Solana Beach, just north of San Diego, CA.

What is Eczema?

Eczema (atopic dermatitis) is often referred to as the “itch that rashes.” It almost always begins in childhood, frequently during infancy, and can persist into adulthood. The overall incidence of eczema is increasing, and a family history of eczema greatly increases the chances of developing this skin condition. Eczema is often one of three health conditions that run together in families called the "atopic triad." The atopic triad consists of eczema, allergic rhinitis (seasonal allergies), and asthma.

There are three stages of eczema that can occur, depending on the age of the affected individual:

  • Infant or baby eczema - occurs from 2 months to 2 years of age
  • Childhood eczema – occurs from 2 to 10 years of age
  • Adult eczema – occurs as an individual reaches adulthood

In infants and young children, eczema frequently appears on the cheeks, face, and neck while adults are often affected on the hands, elbows, knees, and even eyelids. The itching associated with eczema can often disturb one’s sleep in severe cases. Scratching the areas of eczema often leads to skin thickening called lichenification.

Worsening of eczema can occur after immunizations and viral infections. Stress and staph bacterial infections can exacerbate the condition. Super infection of eczema patches with staph bacterial infection is referred to as impetiginization.

Eczema may also be demonstrated by other findings on the skin such as pityriasis alba, patchy white flaky areas that appear on the cheeks. The area around the mouth may appear whiter than the rest of the skin and is called "perioral pallor." Frequent drippy noses and irritation cause rubbing of the nose resulting in a crease over the nasal bridge called a nasal crease. Extra skin folds around the eyes are termed Dennie Morgan folds. One percent of patients also have a cone-shaped deformation of the cornea of the eye called keratoconus.

How is Eczema Treated?

While there is no cure for eczema, there are several effective treatment options available. Successful eczema treatment begins with repairing the damaged and disrupted skin barrier using appropriate, gentle cleansers and adequate moisturizers, especially those that contain ceramides (CeraVe,™ Cetaphil®).

Topical steroids, and non-steroid topical calcineurin inhibitors (Protopic® ointment, Elidel® cream) and anti-inflammatories such as Eucrisa (crisaborole) are used as prescription medications to treat flare ups. Oral anti-histamines are important to control itching and stop the itch-scratch cycle. Very dilute bleach baths (the concentration is carefully explained by a dermatologist and should be done only under physician advisement) several times a week suppresses Staph bacteria on the skin and can help to control severe eczema flare ups in select cases. Extremely severe cases of atopic dermatitis necessitate systemic treatment which may include oral pills or injectable prescriptions (aka “Biologics”) that correct abnormal immune function caused by eczema.

If you are in the San Diego area and suffer from eczema, call Dr. Melanie Palm at 858.792.SKIN (7546) to schedule an appointment to discuss your treatment options.