Atopic Dermatitis and Contact Dermatitis

Overview of Eczema (Atopic Dermatitis)

Eczema is a common skin condition which presents with itchy, red, inflamed skin. Up to 10% of Americans will experience eczema in their lifetime, and it is most common in childhood. It is a chronic condition that can come and go for years. In babies and children, it often affects the face. In adults, it generally affects the inside of the elbows and backs of the knees. Many other areas can also be affected. The first step of treatment is to hydrate the skin and use moisturizing creams. If this does not work, prescription topical creams and ointments including steroids can be used. For some patients, this remains ineffective, and use of biologic medications is indicated. Allergists are well-suited to treat this condition, and we can work in conjunction with your primary care physician or your dermatologist to optimize your regimen.

Comprehensive, Multidisciplinary Care for Eczema

Patients with eczema will benefit from consultation with an allergy physician, whose expertise includes not only the diagnosis and treatment of eczema but also the management and prevention of other allergic diseases such as allergic rhinitis due to environmental allergies. As eczema and/or contact dermatitis may be related to this condition.

Our highly trained physicians will ask you questions to better understand your history, consider skin testing and are dedicated to managing and mitigating the impact of your eczema on your well-being and quality of life.

Contact dermatitis can be associated with eczema. If this is deemed appropriate, your provider will ask questions related to the possibility of this condition. Possibly, the provider may recommend patch testing to diagnose causes of contact dermatitis.

State-of-the-Art Care in Boston & Waltham

A full range of allergy-related services is available at Mass General's downtown Boston campus serving primarily adult patients, and at Mass General Brigham Healthcare Center (Waltham), serving both adult and pediatric patients. Services include:

• Expert evaluation and diagnosis by allergy specialists
• Comprehensive allergy evaluation and testing onsite including patch testing.
• Patient-specific allergen immunotherapy (allergy shots) supervised by experienced clinicians
• A staff physician and fellow on call 24/7 for patients with urgent conditions

What to Expect

At your first appointment, you can expect a thorough history and evaluation by one of our allergy specialists. To diagnose your eczema, we conduct a thorough review of your medical history, including recent changes in symptoms, and exposures in your home, workplace and elsewhere, including personal care products. In addition to a physical examination, we may also perform:

• Environmental allergy skin testing to determine which allergens may be triggering your symptoms
• Patch testing to diagnose contact dermatitis if appropriate
• Blood tests when skin testing is not appropriate
• Breathing tests to evaluate asthma symptoms
• Imaging if needed to evaluate for sinus disease

After diagnosing your eczema, we tailor a treatment plan to manage your symptoms. We cover your plan in detail with you, explaining how to avoid or minimize exposure to factors that trigger your symptoms. We also may prescribe clinically proven medications, such as topical steroids, other topical medications, encourage the use of emollients, and in severe cases, biologic therapies are indicated.

Patch testing involves placement of a large number of chemical ingredients in personal care products. The patch is placed on the back and needs to remain in place for 48 hours. It can be removed at home or in the office. Then, 24 hours after removal, the skin is examined by a physician and the diagnosis of which chemicals could be causing the dermatitis is made.

About This Program

Expertise in Treating Regional Conditions

Our program is among the few in Boston with the resources to manage care for patients with allergies across the spectrum, from mild to severe. Our specialists are particularly skilled at diagnosing and treating allergic conditions associated with New England's unique climate, geography, plants, animals, personal care product exposures, and other factors that trigger symptoms.