Understanding Atopic Dermatitis – Eczema

Hello, my name is Dr. Thomas Knackstedt, and I’m a board-certified dermatologist and board-certified, fellowship-trained Mohs surgeon at Peak Skin Center. In this video, I want to talk a little bit about intrinsic eczema, also known as atopic dermatitis. Be sure to distinguish this from an eczema like reaction caused by a contact allergy, skin irritation or medication reaction.

Eczema is a common, chronic inflammatory skin condition that causes dry, itchy, sensitive skin and recurrent rashes. It often starts in childhood, but it can occur at any age. The rash can look different from person to person, but it commonly appears as red or inflamed patches with scaling, roughness, and sometimes small cracks or oozing when it is flaring. In children it often involves the cheeks, arms, and legs, and in teens and adults it often affects the creases of the elbows and knees, the hands, the neck, and around the eyes.

Eczema is best understood as a combination of two main issues. First, the skin barrier does not hold moisture as well as it should, which makes skin more prone to dryness and irritation. Second, the immune system becomes overactive in the skin, which drives inflammation and itching. When itch leads to scratching, the barrier breaks down further, and that creates a cycle that can keep eczema flaring.

Common triggers include dry weather, hot showers, fragranced or harsh skin-care products, frequent handwashing, sweat, stress, and certain fabrics. Sometimes allergies play a role, but in many patients eczema is more about barrier sensitivity than a single specific allergen.

Treatment usually starts with the basics: gentle skin care and barrier repair. That includes short, lukewarm showers, fragrance-free cleansers, and applying a thick moisturizer regularly, especially right after bathing. During flares, prescription anti-inflammatory treatments are often used, such as topical corticosteroids, and there are also non-steroidal prescription creams and ointments that can be used in sensitive areas or for longer-term control. For more persistent or widespread eczema, additional options include light-based therapy and systemic treatments, including targeted biologic medications and other advanced anti-inflammatory therapies, selected based on the severity and the patient’s overall health.

Eczema is a long-term condition, but with a consistent routine and the right treatment plan, most patients can keep symptoms very well controlled.

I hope this information is helpful, and thank you for watching.

Living with eczema or atopic dermatitis can be challenging, but our experienced dermatologists at Peak Skin Center are here to help. Our medical dermatology specialists, serving Cary, Apex, Holly Springs, and Fuquay-Varina, offer customized treatment plans to manage eczema and relieve symptoms like itching and inflammation. With expert care available at multiple locations, we help patients find relief and improve their skin health. Schedule your eczema consultation today to take control of your symptoms with compassionate, professional support.