A:
Most skin problems, like rashes, itchiness, or redness, go away on their own. Eczema, also known as atopic dermatitis, is different. Depending on the type of eczema, symptoms may go away after a week or two, or last for years.
Lots of people have eczema. It is still not clear what causes it. There usually is a family history of allergy or eczema. Maybe it is passed on in the genes (hereditary).
The skin of people with eczema does not block germs and irritants as well as usual. Without this protection, the skin can become red, dry, scaly and/or itchy.
The symptoms of eczema may be different for each person. Most of the time eczema causes:
- Dry, scaly skin
- Plugged hair follicles that make bumps (usually on the face, upper arm and thighs)
- Swelling around the lips
- Darkening of the skin around the eye
Eczema tends to cause itchiness -- on and off -– that can last a long time. One way to control eczema is to keep away from things that are irritating and make the symptoms worse, such as:
- Temperature extremes, like heat and dryness
- Too many baths or showers
- Chemicals, cleaning agents or toiletries, like harsh soaps, detergents, or perfumes
- Fabrics like wool
Eczema is worse when the skin dries out. You can help your grandson by keeping his skin moisturized (hydrated). To avoid a flare-up, pat the skin dry (rather than rub it) after bathing. This helps leave a little moisture on the skin. Then apply a moisturizing cream to trap moisture in the skin.
The use of emollients -– creams or ointments that stop the skin from drying out –- is very helpful. Lotions are not as effective because they have more water than creams or ointments. In addition, use a humidifier to add moisture to indoor air during the winter heating season.
Topical steroids can control the symptoms of eczema when it flares up. Steroids come in a range of strengths. Doctors tend to recommend the lowest strength cream that helps. Higher strength steroids can be used carefully during very bad episodes of eczema.
Lastly, there is a promising new form of treatment called calcineurin inhibitors that might be helpful when steroids do not work. Since this is a new treatment, the doctor will need to decide of it is right for your grandson.
Henry H. Bernstein, D.O., is a senior lecturer in Pediatrics at Harvard Medical School. In addition, he is chief of General Academic Pediatrics at Children's Hospital at Dartmouth and professor of pediatrics at Dartmouth Medical School. He is the former associate chief of General Pediatrics and director of Primary Care at Children's Hospital Boston. 
