Scratching Increases Eczema Rash

Ask The Expert Dr. Mark Lowitt, Greater Baltimore Medical Center

July 27, 2009

Eczema is the name for a group of skin diseases characterized by dry sensitive skin; red, scaly rashes; and severe troubling itch.

Dr. Mark Lowitt, a dermatologist at Greater Baltimore Medical Center, discusses the condition:

* The most common type of eczema, called atopic dermatitis, is seen in both children and adults, and often occurs in people with a personal or family history of allergic disease such as hay fever, allergies, or asthma.

* The most remarkable symptom of eczema is itch. The classic rash from eczema consists of poorly defined pink or red dry patches, most commonly in the creases of the arms, knees and neck.

* When it is severe, the rash from eczema can occur all over the body. In large part, the rash is actually caused by the scratching that results from severe, unrelenting itch.

* Treatments for eczema are all geared toward minimization of itch, and include 1) bathing with nonsoap cleansers such as body washes so as not to remove too much of the skin's protective oil; 2) using moisturizing creams liberally and often to keep the skin moist, 3) applying prescription cortisone creams to calm down the skin's inflammation, and 4) taking oral antihistamines to relieve the itch.

* When continuously scratched, the skin can become thickened and leathery (called lichenification) and the surface of the skin can be broken by scratching, which can lead to cutaneous bacterial, fungal, and viral infection. The constant itch can lead to poor sleep and irritability.

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