How Is Eczema Diagnosed and Treated?

To diagnose eczema, your doctor will first talk to you about your symptoms and medical history.

He or she will also ask about your family's history of rashes and other allergy-related medical conditions, such as asthma and hay fever.

While there is no single test to diagnose eczema, a good medical history and an exam of your skin are usually all that is needed.

What Are the Treatments for Eczema?

Good skin care is a key component in controlling eczema. For some people with mild eczema, modifying their skin care routine and making a few lifestyle changes may be all that is needed to treat eczema. Other people with more severe eczema may need to take medications to control their symptoms.

Non-drug treatments for eczema include:

• Mild soap and moisturizer. It's best to use a mild soap or soap substitute that won't dry your skin. Gentle soaps, known as syndets, are available at the drugstore (brand names can be recommended by your doctor or pharmacist). A good moisturizer (in cream, lotion, or ointment form) helps conserve the skin's natural moisture and should be applied immediately after a shower or bath, as well as one other time each day. Some people with severe eczema may benefit from taking baths with a small amount of bleach added to the water. The bleach helps to kill bacteria that live on the skin of people with eczema.

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• Short, warm showers. People with eczema should avoid taking very hot or very long showers or baths, which can dry out your skin.

• Reduce stress . Take steps to reduce stress. Get regular exercise and set aside time to relax.

• Get a humidifier.

Medications and other treatments for eczema include:

• Hydrocortisone . Over-the-counter hydrocortisone cream or ointment may help mild eczema. Prescription steroid cream may be needed for more severe eczema.

• Antihistamines . Oral antihistamines such as Benadryl are available over-the-counter and may help relieve symptoms. Some of these cause drowsiness, which may be of benefit if nighttime itching is a problem. There are also non-drowsy antihistamines.

• Corticosteroids. If other treatments fail, your doctor may prescribe oral corticosteroids. Always follow your doctor's directions when taking oral steroids.

• Ultraviolet light therapy. People with very severe eczema may benefit from therapy using ultraviolet light.

• Immunosupressants. Drugs that suppress the immune system may also be an option. These medicines, such as cyclosporine, azathioprine, or methotrexate, may be used when other treatments have failed.

• Immunomodulators. This type of medicated cream helps treat eczema by controlling inflammation and reducing the immune system reactions. Examples include Elidel and Protopic.

• Prescription-strength moisturizers. These replace the barrier of the skin. Examples include Hylatopic Plus, Mimyx, and Epiceram.

WARNING: The FDA has issued its strongest "black box" warning on the packaging of Elidel and Protopic. The warning advises doctors to prescribe short-term use of Elidel and Protopic only after other eczema treatments have failed in adults and children over age 2. Younger children should not take these medications.

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