Eczema, affecting 16.5 million adults in the U.S. alone, is more than just dry skin—it’s a chronic inflammatory condition that causes relentless itching, visible rashes, and significant disruption to daily life. For 7.7 million Americans, this condition is moderate-to-severe, demanding effective management strategies. Dermatologist Ruth Ann Vleugels, MD, explains the latest insights into eczema, from underlying causes to modern treatment approaches.
What Drives Eczema Flare-Ups?
Atopic dermatitis, the most common form of eczema, isn’t caused by improper skincare; it’s rooted in biology. Genetic predisposition plays a major role : having a family member with eczema increases your risk by 75%. The condition arises from a complex interplay of genetics, immune system dysfunction, and environmental triggers.
Eczema often manifests in areas where skin folds or rubs—eyelids, hands, elbows, knees—reflecting constant friction. Identifying triggers is key: fragrances, detergents, and certain materials can exacerbate symptoms. Dermatologists use patch testing to pinpoint specific allergens and tailor treatment accordingly.
Recognizing Eczema Across Skin Tones
Eczema doesn’t always present the same way. The condition’s appearance varies drastically with skin tone : red or pink rashes on lighter skin may appear violet or purple on darker skin, leading to underdiagnosis in people of color. Clinicians are working to improve awareness and include diverse skin tones in medical resources. If you suspect eczema, seeking a dermatologist’s diagnosis is crucial for accurate treatment.
Modern Treatment Options for Moderate-to-Severe Eczema
Historically, eczema management relied on reactive treatments like topical steroids. Today, the landscape is changing. Biologics, a newer class of medications, target the underlying inflammation —a breakthrough for those with moderate-to-severe cases. One FDA-approved biologic, EBGLYSS, offers a first-line treatment option for adults and children over 12 (weighing at least 88 lbs) after conventional therapies fail. The injection can be administered monthly at home, and may be used with or without topical corticosteroids.
Recent updates to American Academy of Dermatology (AAD) guidelines emphasize the growing role of biologics in eczema care. However, potential risks exist, including severe allergic reactions, eye problems, parasitic infections, and impacts on vaccination effectiveness.
Living with Eczema Long-Term
Eczema is often a lifelong condition, with symptoms fluctuating over time. Long-term management focuses on trigger avoidance, barrier repair, and consistent skincare : fragrance-free cleansers, gentle detergents, and diligent moisturizing are essential. Despite the chronic nature, ongoing research and novel treatments, like EBGLYSS, offer hope for improved control and quality of life.
Eczema may never be fully cured, but with current treatments, many patients can finally break the relentless itch-scratch cycle and regain comfort.
