Eczema

Clinical Presentation and Symptoms

Eczema can vary in appearance and severity but often includes:

• Dry, flaky, or scaly skin

• Intense itching (pruritus), especially at night

• Red or inflamed patches, sometimes with weeping or crusting

• Thickened or leathery skin (lichenification) from chronic scratching

• Color changes in the skin (hyperpigmentation or hypopigmentation)

• Secondary infections, particularly with Staphylococcus aureus

Commonly affected areas include the face, neck, hands, wrists, ankles, and inside of the elbows and knees, although eczema can occur anywhere on the body.

Types of Eczema

Understanding the specific type of eczema is critical for effective treatment. At CoCo Dermatology, we perform a comprehensive skin evaluation to determine the appropriate diagnosis and therapeutic plan.

1. Atopic Dermatitis

• The most common form

• Associated with a personal or family history of asthma, hay fever, or food allergies

• Chronic, relapsing, and typically begins in childhood

2. Contact Dermatitis

• Caused by direct skin exposure to irritants or allergens

• Irritant (e.g., soaps, chemicals) or Allergic (e.g., nickel, fragrances)

3. Nummular Eczema

• Coin-shaped plaques, often oozing or crusted

• Typically found on arms, legs, or torso

4. Dyshidrotic Eczema

• Characterized by small, itchy blisters on palms, fingers, and soles

• Often worsens with stress or excessive sweating

5. Seborrheic Dermatitis

• Affects oil-rich areas like the scalp, nose, and chest

• Presents as greasy, flaky, and inflamed skin

Therapeutic Approaches

Our treatments are designed to reduce inflammation, relieve itching, restore the skin barrier, and prevent recurrence.

Topical Therapies

• Corticosteroids: Reduce redness and inflammation

• Calcineurin inhibitors (e.g., tacrolimus, pimecrolimus): Effective for sensitive areas like the face and eyelids

• Topical PDE4 inhibitors (e.g., crisaborole): Non-steroidal anti-inflammatory option

• Moisturizers and barrier repair creams: Essential for daily care and flare prevention

• Antiseptics or antibiotics: Used when infection is suspected

Systemic and Biologic Therapies

• Antihistamines: Help manage itching and improve sleep

• Immunosuppressants (e.g., cyclosporine, methotrexate): Reserved for severe or refractory eczema

• Biologic therapy (e.g., dupilumab): A revolutionary treatment targeting the type 2 immune pathway involved in moderate-to-severe atopic dermatitis

Phototherapy

• Narrowband UVB: Used in moderate to severe cases when topical therapies are inadequate

• Helps decrease inflammation and improve skin appearance with minimal systemic effects

Lifestyle and Supportive Measures

A holistic approach is critical in eczema management:

• Daily use of fragrance-free moisturizers

• Avoidance of triggers (e.g., soaps, allergens, fabrics, climate extremes)

• Short, lukewarm baths or showers with gentle cleansers

• Stress management techniques such as mindfulness or counseling

• Nutritional support for anti-inflammatory dietary habits

Ongoing Management

Living with eczema can be physically and emotionally challenging, but you don’t have to manage it alone. At CoCo Dermatology and Cosmetics, we’re dedicated to offering compassionate, comprehensive care using the latest therapies and insights in dermatologic science.

We work closely with each patient to design a custom treatment plan that aligns with their symptoms, lifestyle, and long-term skin goals.

Take the First Step Toward Healthier Skin

To begin your personalized eczema care plan, contact our office by phone or book a consultation online today. We’re here to help you achieve lasting skin comfort and confidence.