Eczema: What is going on here?

This blog is a response to several emails in the “Comments” section of our website regarding Dr. Aron’s and others asserting that “All the red skin people have staphylococcus (staph) bacterial infections as the cause of their redness and that bathing in a bleach bath will solve all problems.”

The diagnosis of eczema varies in its manifestation and treatment modalities. Number 1: There is mild eczema especially in pediatric patients with the only manifestation being skin dryness and scaliness.

Care more for the individual patient than for the special features of the disease.

Sir William Osler

This form of eczema should be treated with lubrication, some sun exposure, and no steroids. Number 2: There is mild eczema or atopic dermatitis with itchy areas of rash often in the crooks of the elbows and backs of the knees. This type of eczema should be treated with a mid strength corticosteroid cream or ointment for a very short period of time, no more than a week. Sunshine is helpful and extra lubrication should be applied especially in winter or cold climates. Number 3:

There is Red Skin Syndrome seen in the eczema atopic dermatitis patients who have become addicted to steroids over time because of prolonged usage after worsening of the rash. Almost the entire skin surface turns red especially when steroids are not applied for a few days. These patients require the complete cessation of steroids and the treatments suggested in this website for cure.

By Dr Marvin Rapaport, MD|2021-10-19T03:16:57-07:00August 1st, 2015|What Is Eczema|Comments Off

About the Author: Dr Marvin Rapaport, MD

In 1978 I initiated and set up the contact and photo dermatitis clinic at UCLA. There was a need to evaluate a large group of patients who exhibited severe eczematoid rashes, especially on the face. Patients were referred from all over Southern California. All patients underwent a lengthy history and examination. Further evaluations included blood studies, allergy patch testing, special sunlight (photo) testing and skin biopsies. From the start it was apparent that most patients experienced a mild dermatitis on various parts of the body that progressively worsened. Their histories always included numerous doctor visits, multiple physicians, and therapy consisting of an increasing amount of corticosteroids. My testing failed to reveal any specific culprit chemicals, cosmetics, perfumes, workplace or recreational exposures. It became increasingly clear that the physician’s therapy, the corticosteroids, was invariably causing the problem. I wrote 7 scientific articles that were published in the most august peer-reviewed dermatologic journals and I gave many lectures at various dermatology meetings. To this day an unfortunate reluctance exists on the part of most physicians to accept this simple concept.