What is eczema and atopic dermatitis?
If you’re experiencing dry, red, scaly, itchy patches at the bend of your elbows and behind your knees, along with generalized dry and itchy skin with red patches that come and go, you likely have eczema—also called atopic dermatitis. This chronic inflammatory skin condition affects approximately 10% of the population and can develop at any age, though it most commonly begins in infancy or early childhood.
Eczema often follows a pattern of flare-ups and remission. Many patients find their condition improves during certain seasons or life stages, only to return and become chronic during high-stress periods or when exposed to triggering factors. While eczema can improve with age, it frequently persists into adulthood, affecting the hands, feet, face, and body.
If you’ve tried multiple treatments without relief, you’re not alone. Many patients struggle to find effective eczema management. Dr. Snyder specializes in treating resistant eczema cases where other dermatologists have failed.
Why does eczema develop and what triggers flare-ups?
Eczema results from a combination of genetic, immune, and environmental factors:
- Genetic predisposition—eczema often runs in families; if parents have eczema, allergies, or asthma, children have higher risk
- Immune system dysfunction—the immune system overreacts to irritants, triggering excessive inflammation
- Skin barrier defect—the outer skin layer (stratum corneum) doesn’t retain moisture properly, allowing water to escape and irritants to penetrate
- Filaggrin protein abnormality—genetic mutations affecting this crucial skin barrier protein are common in eczema patients
Common eczema triggers include:
- Irritants: harsh soaps, detergents, fragrances, alcohol-based products, chlorine, wool
- Allergens: dust mites, pet dander, pollen, mold, certain foods (though food allergies are less common than traditionally thought)
- Environmental factors: extreme temperatures, low humidity, air pollution, wind
- Stress and emotions: stress, anxiety, and emotional upset commonly trigger or worsen flares
- Skin infections: bacterial infections like staph can worsen eczema
- Sweat and heat: perspiration and overheating can trigger itching
- Overwashing: frequent bathing or showering strips natural oils and worsens dryness
Identifying and avoiding your personal triggers is crucial for successful eczema management.
The itch-scratch cycle: how scratching worsens eczema
Eczema creates a vicious cycle that’s difficult to break:
- Dry, inflamed skin is itchy
- Scratching provides temporary relief but damages the skin barrier
- Damaged skin becomes more irritated and inflamed
- Inflammation triggers more itching
- More scratching causes further damage, lichenification (thickening), and potential infection
Breaking this cycle is essential. Dr. Snyder will help you develop strategies to resist scratching, including proper moisturizing, appropriate topical medications, and in some cases, prescription oral medications to reduce the urge to scratch.
Types of eczema: where it appears and what it looks like
Eczema can appear in different locations and presentations:
- Atopic dermatitis (most common)—generalized dry, itchy skin with red patches, often on face, hands, feet, elbows, and behind knees
- Hand eczema—severely dry, cracked, irritated hands; common in people with frequent water exposure or irritant exposure
- Dyshidrotic eczema—small, intensely itchy blisters on palms and soles; worse in summer
- Nummular eczema—coin-shaped patches of irritated skin, often on legs
- Eyelid dermatitis—redness, itching, and swelling of eyelids and surrounding skin
- Seborrheic dermatitis—oily, scaly, irritated patches on scalp, face, and chest
Regardless of type, Dr. Snyder provides comprehensive evaluation and personalized treatment.
Dr. Snyder’s comprehensive approach to eczema treatment
Dr. Snyder’s approach differs from standard dermatology because he takes time to truly understand your unique eczema:
- Thorough listening and examination—understanding your history, triggers, and specific symptoms
- Identifying personal triggers—working with you to recognize and eliminate your specific eczema triggers
- Education—ensuring you understand your condition and why certain treatments and behaviors matter
- Hands-on instruction—demonstrating proper application of topical medications and skincare techniques
- Multi-pronged combination therapy—there’s no one-size-fits-all solution; your plan is customized
- Long-term management—working with you to achieve and maintain control, not just temporary relief
Dr. Snyder has successfully treated cases where multiple other dermatologists have failed, including patients carrying “bags full” of ineffective prescriptions.
Eczema treatment options
Dr. Snyder may recommend combination therapy tailored to your severity and triggers:
- Prescription topical medications—corticosteroids, calcineurin inhibitors (tacrolimus, pimecrolimus), phosphodiesterase-4 inhibitors, and other targeted anti-inflammatory creams
- Intensive moisturizing regimen—customized bathing and moisturizing routine specific to your skin type and climate
- Gentle cleansing products—prescription or recommended pH-balanced cleansers that don’t strip natural oils
- Prescription oral medications—antihistamines to control itching, antibiotics if infection develops, and in severe cases, systemic anti-inflammatory medications
- Ultraviolet (UV) light therapy—narrowband UVB or PUVA therapy for extensive body eczema unresponsive to topical treatments
- Professional in-office treatments—cosmeceutical applications and specialized facials for facial eczema
- Trigger identification and avoidance—working with you to recognize and eliminate personal triggers
- Stress management counseling—because stress significantly impacts eczema severity
How to properly care for eczema-prone skin
Daily eczema skincare is critical. Improper care can worsen your condition significantly:
- Bathing frequency—shorter, lukewarm (not hot) baths or showers limit water loss; daily bathing may dry skin excessively
- Cleansing products—use gentle, fragrance-free, non-soap cleansers (like CeraVe, Vanicream, or Cetaphil) instead of harsh soaps
- Moisturizing timing—apply moisturizer within 3 minutes of bathing while skin is still damp to seal in hydration
- Moisturizer type—thick creams and ointments (not lightweight lotions) are most effective; Dr. Snyder can recommend specific products
- Avoiding irritants—fragrance, dyes, alcohol, sulfates, and wool worsens eczema; choose hypoallergenic products
- Humidity control—use a humidifier in winter when air is dry; avoid overheated, dry indoor environments
- Nail care—keep nails short and smooth to minimize damage from scratching
- Clothing—wear soft, breathable fabrics (cotton) instead of wool or synthetic materials
Eczema in children vs. adults
Childhood eczema commonly begins at 2-3 months old and may improve by school age, though many children continue having flares into adolescence and adulthood. Pediatric eczema often triggers food allergies (especially eggs, peanuts, milk, fish).
Adult eczema may persist from childhood or develop for the first time in adulthood (often age 20-40). Adult eczema is frequently triggered by occupational irritants, stress, or hormonal changes rather than food.
Both require individualized treatment plans. If your child has eczema, early, aggressive treatment prevents permanent skin damage and improves long-term outcomes. If you developed eczema as an adult, Dr. Snyder can identify triggers and establish effective control.
When does eczema require systemic (whole-body) treatment?
Topical treatments are first-line, but some patients require systemic medications:
- Extensive body involvement—eczema covering more than 10% of body surface area may benefit from oral medications
- Failed topical therapy—when topical treatments provide insufficient relief despite proper use
- Hand/feet eczema—particularly severe cases may require oral medications
- Severe itching—oral antihistamines and sedating medications help break the itch-scratch cycle
- Infection risk—if eczema is severe enough to risk bacterial superinfection, systemic antibiotics may be needed
Dr. Snyder will determine if systemic therapy is appropriate for your case.
Is eczema contagious?
No. Eczema is not contagious. It’s a chronic inflammatory condition resulting from genetics and immune function, not infection. You cannot catch eczema from someone else, and your eczema cannot spread to other people. However, if eczema becomes infected (secondary bacterial infection with staph or strep), the infection itself could theoretically be contagious until treated.
Can eczema be cured?
Eczema cannot be cured permanently, but it can be very effectively controlled and managed. Many children experience significant improvement or remission as they age. Adults can achieve excellent control through proper trigger avoidance, skincare regimen, and appropriate medications. Some patients eventually discontinue treatment and remain clear; others require ongoing maintenance therapy. Dr. Snyder will work with you to achieve the best possible control.
Is eczema related to food allergies?
In some patients, food allergies trigger or worsen eczema, particularly in children. Common culprits include eggs, peanuts, milk, fish, and soy. However, not all eczema is food-related. Dr. Snyder will help determine if foods are triggering your eczema. If suspected, allergy testing or elimination diets may be helpful. Working with an allergist may be beneficial for food-related eczema.
Can stress cause eczema?
Stress doesn’t directly cause eczema in people without genetic predisposition, but it significantly worsens existing eczema. Stress triggers immune system activation and can cause flare-ups even when triggers are being avoided. Stress management, including exercise, meditation, adequate sleep, and stress reduction techniques, are important components of eczema management.
Is eczema worse in winter?
Yes, eczema frequently worsens in winter due to cold, dry outdoor air and dry indoor heating. Winter humidity drops to 10-20%, compared to comfortable 30-50% humidity. This extreme dryness worsens eczema significantly. Combat winter eczema by using a humidifier, avoiding overheated indoor environments, frequent moisturizing, and Dr. Snyder’s personalized winter skincare regimen.
Can I use regular moisturizers, or do I need special eczema products?
Regular lightweight moisturizers often aren’t effective enough for eczema. Eczema-prone skin needs heavier creams or ointments with specific ingredients that support skin barrier repair. Look for products containing ceramides, hyaluronic acid, glycerin, colloidal oatmeal, or petrolatum. Fragrance-free is essential. Dr. Snyder will recommend specific products most effective for your eczema and skin type.
What should I do if my eczema becomes infected?
Signs of infection include increased redness, warmth, swelling, oozing, crusting, pus, fever, or swollen lymph nodes. If infection is suspected, contact Dr. Snyder immediately. Infected eczema requires prompt antibiotic treatment (topical or oral) to prevent spread and complications. Do not delay treatment of suspected infection.
How long does it take to see improvement with treatment?
Response time varies. Some patients see improvement within 1-2 weeks of starting appropriate treatment; others require 4-6 weeks to see significant benefit. The longest patients typically benefit most—those with identified triggers eliminated and proper skincare established can see dramatic improvement within 2-3 months. Dr. Snyder will establish realistic timelines and monitor progress at follow-up visits.
Schedule your eczema consultation in Owings Mills
If you’re struggling with eczema that hasn’t responded to other treatments, or if you’re managing eczema but want expert guidance, Dr. Steven Barry Snyder offers comprehensive evaluation and personalized treatment plans. Dr. Snyder has successfully treated complex eczema cases where other dermatologists have failed.
Call (410) 356-0000 to schedule your eczema consultation. We’ll evaluate your skin, identify your triggers, and create a customized treatment plan designed to break the itch-scratch cycle and achieve lasting control.
Stop the itch and regain clear skin
Eczema doesn’t have to control your life. With proper diagnosis, trigger identification, and individualized treatment, most patients achieve significant improvement and many achieve complete control. Dr. Snyder specializes in eczema cases others haven’t been able to solve.