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Living With Eczema

Q. Almost since birth, my son has had eczema, a red, itchy condition so intense he scratches himself until he bleeds. I take precautions to prevent flare-ups, but still my baby has had to be hospitalized because of bacterial skin infections resulting from eczema. At times, strangers will ask if my son has fallen or been burned. Please explain this disorder to your readers.

A. Eczema, also known as atopic dermatitis, is a skin disorder that can cause intense itching and inflammation, oozing blisters, crusting and scaling of the skin, and infections.

Eczema affects about 10 percent of children, with 60 percent of cases becoming evident in the first year. In babies, it begins on the face and then appears on the trunk and limbs, usually sparing the diaper area.

Although the exact cause of eczema is unclear, it's related to the body's immune system and an abundance of damaging inflammatory skin cells in the affected area. Eczema occurs more often in families with allergic disorders, such as asthma, hay fever, or food sensitivities.

Routine treatment involves avoiding triggers  -- overly dry skin, irritating clothing, allergenic foods  -- and applying an emollient to the skin two or three times a day, including when the skin is still damp after the recommended daily bath. Good over-the-counter emollients include Eucerin, Aquaphor, Moisturel, and Cetaphil.

During flare-ups of itching and inflammation, your doctor may prescribe topical steroid cream and oral antihistamines. If your child doesn't respond to these treatments, ask for a referral to a pediatric allergist or dermatologist.

Bacterial skin infections, which require a course of antibiotics and sometimes, although rarely, hospitalization, are eczema's main complication. That's because skin damaged by eczema and scratching is more susceptible to bacteria on the skin's surface, such as staph.

Thankfully, most cases are not severe, and symptoms tend to decrease with age. Chances are, that will happen with your child. In the meantime, I applaud you for your efforts to treat your son and to lessen his discomfort.