What Do We Treat?
Rashes, Including Eczema and Psoriasis
Atopic dermatitis, commonly referred to as eczema, is a chronic skin disorder categorized by scaly and itching rashes. People with eczema often have a family history of allergic conditions like asthma and hay fever. Eczema is most common in infants, and at least half of those cases clear by age 36 months. In adults, it is generally a chronic or recurring condition.
Eczema treatment varies depending on the appearance (stage) of the lesions – acute “weeping” lesions, dry scaly lesions, or chronic dry, thickened lesions are each treated differently. Anything that aggravates the symptoms should be avoided whenever possible, including any food allergens and irritants like wool and lanolin. For weeping lesions, we recommend soothing moisturizers, mild soaps or wet dressings. We also recommend mild anti-itch lotions or topical corticosteroids (low potency) to soothe less severe or healing areas, or dry scaly lesions. For chronic thickened areas, we often recommend ointments or creams that contain tar compounds, corticosteroids (medium to very high potency), and ingredients that lubricate or soften the skin. We may also prescribe systemic corticosteroids to reduce inflammation in some severe cases. The latest treatment for eczema is a new class of skin medications called topical immunomodulators (TIMs). These medications are steroid-free. Studies have shown as high as an 80% success rate using these new medications.
Psoriasis is a common skin inflammation (irritation and swelling) affecting approximately 3 million Americans, characterized by frequent episodes of redness, itching, and thick, dry, silvery scales on the skin. In many cases, psoriasis goes away and then flares up again repeatedly over time. It may affect people of any age, but most commonly begins between ages 15 and 35. Psoriasis seems to be an inherited disorder, probably related to an inflammatory response in which the immune system accidentally targets the body’s own cells. It is most commonly seen on the trunk, elbows, knees, scalp, skin folds, or fingernails, but may affect any or all parts of the skin. Medications, viral or bacterial infections, excessive alcohol consumption, obesity, lack of sunlight, sunburn, stress, general poor health, cold climate, and frequent friction on the skin are also associated with psoriasis flare-ups. Psoriasis is not contagious.
Mild cases are usually treated at home using topical medications. For very severe cases we will prescribe oral or injected immunosuppressive medications (such as corticosteroids or methotrexate). Other treatments may include moderate exposure to sunlight or phototherapy (the skin is sensitized by the application of coal tar ointment or by taking a medication that causes the skin to become sensitive to light and you are then exposed to ultraviolet light).