Eczema — also called atopic dermatitis — is a chronic inflammatory skin condition that affects roughly 10% of adults and 20% of children in the U.S. At Fayetteville Dermatology, Dr. James Prezzano provides expert eczema care for patients across Central New York. Dr. Prezzano has co-authored peer-reviewed research on treatment-resistant atopic dermatitis and the use of newer biologic therapies, bringing a deep understanding of the condition to every appointment.
What Is Eczema?
Eczema is a long-term skin condition where the skin's protective barrier doesn't work the way it should. This causes the skin to lose moisture, become inflamed, and react more strongly to triggers like soap, detergents, allergens, stress, or weather changes. The most common form is atopic dermatitis — usually beginning in childhood and often appearing alongside asthma or allergies.
Eczema is not contagious. It is not caused by poor hygiene. It is influenced by genetics, immune system function, and environmental factors — and while there's no permanent cure, the right treatment plan can keep flares mild and infrequent for the majority of patients.
Signs and Symptoms
Eczema can look different depending on age, skin tone, and severity. The most common signs include:
- Dry, scaly skin that worsens in winter
- Intense itching, often worse at night
- Red or pink patches on lighter skin; purple, brown, or grayish patches on darker skin
- Cracked, weepy, or crusty areas during flares
- Thickened, leathery skin in chronically affected areas (lichenification)
- Common locations: behind the knees, inside the elbows, neck, hands, face, and scalp (in infants)
Severe or persistent eczema can disrupt sleep, focus, mood, and quality of life — and is often underestimated by people who haven't experienced it.
Common Eczema Triggers
Identifying and avoiding personal triggers is a core part of long-term eczema management. Common ones include:
- Harsh soaps, fragrances, and detergents
- Hot, long showers and dry winter air (a common issue in Central New York winters)
- Wool, synthetic fabrics, and rough textures
- Sweat and overheating
- Stress and lack of sleep
- Food allergies (in some children)
- Dust mites, pollen, pet dander
- Skin infections (often Staph aureus)
Treatment Options at Fayetteville Dermatology
There is no one-size-fits-all eczema plan. Dr. Prezzano will examine your skin, review your history, and build a treatment strategy matched to your severity, lifestyle, and previous response to therapy.
1. Skincare foundation. Every plan starts here: gentle, fragrance-free cleansers, daily thick moisturizers, and lukewarm (not hot) showers. We'll recommend specific products by name for your skin type.
2. Topical medications. For mild-to-moderate eczema:
- Topical corticosteroids — the gold standard for flares (used short-term and at the right strength for the right body part)
- Topical calcineurin inhibitors (tacrolimus, pimecrolimus) — useful on the face and other delicate areas
- Topical PDE-4 inhibitors (crisaborole) and JAK inhibitors (ruxolitinib) — newer non-steroid options
3. Phototherapy. Narrowband UVB light therapy can dramatically improve moderate-to-severe eczema for patients who haven't responded fully to topicals.
4. Systemic and biologic therapy. For moderate-to-severe eczema that hasn't responded to topicals or phototherapy, newer treatments have transformed outcomes:
- Dupilumab (Dupixent) — a biologic injection that blocks the immune signals driving eczema. Dr. Prezzano has co-authored published research on dupilumab for treatment-resistant atopic dermatitis.
- Tralokinumab, lebrikizumab — newer biologics for similar use cases
- Oral JAK inhibitors (upadacitinib, abrocitinib) — pill-form options
5. Trigger management & education. A treatment plan is only as good as the day-to-day routine. We'll spend time on what to avoid, when to escalate, and how to recognize a flare early.
Eczema in Children and Adults
We treat both. Pediatric eczema typically appears on the cheeks, scalp, and outer arms/legs in infants, then shifts to the inner elbows and behind the knees as children grow. Most kids see significant improvement by school age, though some carry it into adulthood.
Adult eczema often shows up on the hands (especially in healthcare workers, hairdressers, and food service workers), eyelids, neck, and face. Adult-onset eczema is also possible — even in patients with no childhood history.
For very young children, we always prioritize safe topicals and the most conservative effective approach, escalating only when needed.
Why See Dr. Prezzano for Eczema
Three things set Fayetteville Dermatology apart for eczema care:
- Research-backed expertise. Dr. Prezzano has co-authored peer-reviewed publications on treatment-resistant atopic dermatitis and the use of dupilumab — meaning he is intimately familiar with the patients who haven't responded to conventional treatment.
- All ages welcome. We see infants, children, teens, and adults. You don't have to bounce between providers as your child grows or your needs change.
- Quick access. Our average wait time for an appointment is less than one week — important when you're in the middle of a flare.
Dr. Prezzano is a Fellow of the American Academy of Dermatology (FAAD) and is board-certified in both Dermatology and Micrographic Dermatologic Surgery.
Eczema, Psoriasis, or Something Else?
Conditions like psoriasis and rosacea are commonly mistaken for eczema — and each needs different treatment. Confirming the diagnosis is part of every first visit, especially if what you've tried so far hasn't worked.
Frequently Asked Questions
No — although they look similar at a glance, they are different conditions with different causes and treatments. A dermatologist can usually distinguish them based on the location, appearance, and history of the rash. If you've been told you have one but treatment isn't working, getting a second look is worthwhile.
Yes. We see eczema patients of all ages, including infants. Pediatric dermatology is a regular part of our practice.
Yes. Office visits, prescription topicals, and phototherapy are covered by most major insurance plans. Biologic therapies (Dupixent, etc.) typically require prior authorization — our office will handle that paperwork for you and work with your insurance to get approval.
For moderate-to-severe eczema that hasn't responded to topicals, biologics like dupilumab have been transformative — many patients see dramatic improvement within weeks. They're not for everyone (cost, injection schedule, monitoring), but for the right patient, they can change quality of life entirely. We'll discuss whether you're a candidate.
Topical steroids are safe and effective when used correctly — at the right strength, on the right body area, for appropriate periods. Concerns about thinning skin and other side effects come from misuse (too strong, too long, on delicate areas). Dr. Prezzano will give you a specific plan including how often, how long, and when to step down.
Eczema is typically a long-term condition, but for many people — especially children — it improves significantly or becomes very mild over time. With the right treatment plan, most patients can keep flares brief and infrequent. The goal is excellent control, not "cure."
Schedule Your Mohs Consultation
If you've been diagnosed with a skin cancer — or your primary care provider or another dermatologist has recommended Mohs surgery — we typically have appointments available within the same week.
We accept most major insurance plans including Aetna, BCBS, Cigna, United Healthcare, and Medicare.
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