Eczema / Atopic Dermatitis

Eczema is a chronic, inflammatory skin disease that is related to other conditions such as asthma, hayfever, and allergic conjunctivitis. Hereditary factors and environmental conditions such as pollen, stress, cold temperatures contribute to expression of the disease. Itching is the main symptom. Atopic dermatitis may appear as red itchy patches of skin, or scaling and crusted areas of skin. Itching can be so severe that it interferes with one’s sleep.

Atopic dermatitis is caused by an inherited defect in the gene that controls the production of a special lipid protein called filaggrin. This protein functions as “the glue” between the cells in the top layers of the skin. The top layer of skin functions as a sealant. It protects the deeper cell layers from irritating or allergic causing chemicals, foreign proteins, and bacteria. If your skin cells produce an insufficient amount of filaggrin or synthesize defective filaggrin, the skin barrier will be weakened and will allow foreign proteins and chemical irritants to enter the skin and cause inflammation. Initially, the skin may be red, itchy, and scaly. If it is not treated, the eczema may progress to a chronic form, and the skin will thicken, become raised, and discolored.

A dermatological evaluation is necessary to determine if you have atopic dermatitis. Once the diagnosis is established, a treatment regime can be recommended to keep your skin healthy and stop the itching. There are many effective treatments available, ranging from topical creams to phototherapy to systemic and biologic medications. Frequently, a combination of therapies works best. The goals are to eliminate inflammation and itching, to restore hydration in the skin, to repair the protein-lipid in barrier, and to identify and remove environmental irritants. Dr. Wong will educate you on how to treat your eczema flares and determine the best maintenance skin care regimen to keep the dermatitis in remission.