### Types of Eczema and How Doctors Determine Severity Eczema is a common skin condition that can vary in severity. Here are some common types of eczema and how doctors assess their severity: #### Types of Eczema 1. **Atopic Dermatitis**: The most common type, often starting in childhood. Symptoms include dry, itchy, and scaly skin, especially on the insides of the elbows, backs of the knees, and cheeks. Flare-ups can cause crusted sores. 2. **Dyshidrotic Eczema**: Causes itchy water blisters on the hands and feet, often with a burning sensation. Common in adults over 40, especially those with allergies or who frequently immerse their hands and feet in water. 3. **Nummular Eczema**: Characterized by coin-shaped spots on the skin. These can be dry and scaly or weeping and may be itchy. Commonly affects the lower legs, forearms, and trunk. #### Assessing Severity Doctors use tools like the Eczema Area and Severity Index (EASI) and the Severity Scoring of Atopic Dermatitis Index (SCORAD) to assess the severity of eczema. These tools evaluate the extent and intensity of symptoms across different body regions. EASI focuses on four body regions, while SCORAD also considers subjective effects like itchiness and sleeplessness. #### Treatment Options - **Topical Treatments**: Over-the-counter ointments or creams, such as corticosteroids. For mild to moderate eczema, crisaborole (Eucrisa) may be prescribed. Stronger creams like pimecrolimus (Elidel) or tacrolimus (Protopic) may also be used. - **Oral Prescription Drugs**: Antibiotics for infections, oral corticosteroids like prednisone for severe inflammation. - **Phototherapy**: Controlled exposure to natural sunlight or artificial ultraviolet light. This treatment increases the risk of skin cancer and early skin aging. - **New Drugs**: Dupilumab (Dupixent) for moderate to severe eczema, administered as a shot. If eczema affects your mental health or sleep, consider talking to a therapist or trying relaxation techniques.