What is Eczema?
Eczema is an inflammation of the epidermis; broadly applied to a range of skin conditions that have the symptoms, such as redness, crusting, skin edema (swelling), itching and dryness, flaking, blistering, cracking, oozing, or bleeding. Usually, eczema is a chronic condition that accompanies with asthma or hay fever.
Although eczema can develop on any part of the body, the skin behind the knees and on the arms are most susceptible. Usually, even mild forms of eczema are extremely itchy. It is believed that eczema occurs due to a malfunction of the immune system of the body.
Atopic dermatitis is prevalent among infants and children, however, adults may also be affected. The major difference of eczema and psoriasis, although they look similar, is that eczema strikes the flexor aspects of the joints.
Symptoms of Eczema
The areas on which eczema appears most often include hands and feet, on the arms, behind the knees, and on the ankles, wrists, face, neck and upper chest. The eyelids are also sometimes affected, scratching which leads to redness and swelling around the eyes. Scratching and rubbing may also lead to patchy loss of eyebrows’ hair and eyelashes.
Eczema starts most often in childhood, between the ages 5 and 7 and may persist till adulthood. The rashes are extremely itchy and scratching increases the itch. To break the itch-scratch phenomenon may be quite challenging in most cases.
The most apparent symptoms of eczema include the following;
• Patches of red or brownish gray color
• Thickened, cracked or scaly skin
• Raw, sensitive skin from scratching
• Moderate to severe itching, especially at night
• Small, raised bumps, which may leak fluid and crust over when scratched
Diagnosis of Eczema
There is no specific laboratory test for diagnosing eczema. The diagnosis is made based on the examinations of the skin and looking at the symptoms. The medical history of the patient is also thoroughly checked by the doctor while making a diagnosis. The doctor may also ask several questions regarding the symptoms and signs of the disease. He may also inspect whether any of the patient’s family member has asthma, hay fever or other allergic diseases. The frequency of the appearance of rashes and inflammation, duration of the disease and the severity of the condition may also be brought into consideration.
Causes of Eczema
The exact causes of eczema are unknown. However, it is believed that the disease is caused by a combination of dry, irritated skin together with a malfunction in the body’s immune system. It has been found that although stress and other mental disorders aggravate the condition, they do not cause it.
It has also been found that eczema is common in families which the family members have asthma or hay fever. The relationship between the two diseases is unsure, but it is believed that these diseases are complimentary to each other. It is found that about 75% of the children who have atopic dermatitis develop asthma or hay fever later in their life.
Types of Eczema
Common forms of Eczema
1. Atopic dermatitis: This is the most common type of eczema which runs in families whose members have asthma and hay fever. The rashes in this type of eczema can be seen on head and scalp, neck, inside of elbows, behind knees, and buttocks.
2. Contact dermatitis: Contact dermatitis is divided into two types. The allergic contact dermatitis results from a reaction of an allergen, such as poison ivy or Nickel. The irritant type results from the reaction of a detergent. Contact dermatitis is treatable provided the offending substance is avoided and removed from the environment.
3. Xerotic eczema: It is actually a dry skin condition, being too severe, it turns into eczema. It attacks the limbs and trunk, most commonly. Unfavorable weather conditions may aggravate it.
4. Seborrheic dermatitis: This type of eczema is closely related to dandruff. Dry or greasy peeling of the scalp, eyebrows, and face, and sometimes trunk is sometimes noticed in this type of eczema.
Less common types
1. Neurodermatitis: It refers to a thick, itchy eczema patch that results from habitual scratching or rubbing. It is usually expressed as one spot. This type of eczema is curable through behavior modification and anti-inflammatory medication.
2. Dermatitis herpetiformis or Duhring’s Disease: It causes intensely itchy and typically symmetrical rash on arms, thighs, knees, and back. It is curable by maintaining a proper diet.
3. Venous eczema: This type of eczema results from an impaired circulation and is commonly found on the ankles of people aged over 50. Redness, scaling, darkening of the skin and itching are the common symptoms of this type.
4. Discoid eczema: This type of eczema is characterized by round spots of oozing or dry rash. It is usually found to occur with clear boundaries, often on lower legs.
5. Dyshidrosis: It is also known as dyshidrotic eczema, pompholyx and vesicular palmoplantar dermatitis or housewife’s eczema. It only occurs on palms, soles, and sides of fingers and toes. Vesicles, thickening and cracks are accompanied with it. The itching usually increases at night.
Treatment of Eczema
The treatment of atopic dermatitis is aimed to relieve the itching, bring down inflammations and prevent future attacks. Mild forms of the disease can be controlled by OTC creams and various lotions available to treat eczema.
Elimination of allergens doesn’t seem to control the condition, although the disease is related to allergies. Frequent shots of allergy are, on the contrary, found to worsen the condition.
Sometimes, medications are also prescribed to treat eczema. Prescription corticosteroid creams or ointments are common to ease scaling and relieve itch. Although many corticosteroids are available without prescriptions, it is advisable to consult the doctor before applying them.
For severe itches, prescription of oral antihistamines may be given. One of the common antihistamines, Diphenhydramine may make you very sleepy and hence can be used during bedtime. A mildly astringent wet dressing may also be prescribed if there are chances of infection.
Oral corticosteroids are also prescribed for short term to provide relief from inflammation and itching. The most common among these is prednisone. However, long term use is severely harmful and may result in other chronic illness.
Immunomodulators, such as tacrolimus (Protopic) and pimecrolimus (Elidel) are also prescribed in some cases. These medications affect the immune system and may be helpful in maintaining normal skin texture and reduce flares of atopic dermatitis.
Recently, Light therapy has also got popularity as a treatment option. In the process, the affected area is usually exposed to natural of artificial lights. The lights may include sunlight, ultraviolrt radiations and ultraviolet B. These may be applied alone or in combination, depending upon the severity and nature of the disease.
The treatment of infantile eczema includes avoiding skin irritations and extreme temperatures. It also uses bath oils, lotions, creams or ointments to lubricate the baby’s skin.
Living with Eczema
The first and formost requirement is to avoid scratching of the area affected by eczema. The use of soaps and detergents should also be limited so that the affected area may not get allergic. Use of mild wet dressings can also be used. The medications, if any should be followed regularly and a holistic approach should be taken that includes proper dietary and lifestyle habits. It should be remembered that the complications may be severe and taking proper care of the skin is necessary to avoid infections and sores.
Prevention of Eczema
Prevention of eczema requires following some simple lifestyle tips. The first is to avoid frequent bathing which dehydrates the skin. Choosing the right kind of soap and detergent is the next step. Deodorants and perfumes may be harmful for the skin affected with eczema, so it is better to avoid them. The affected area should also be adequately brushed and pat with a soft towel for drying. Moisturizers may also be helpful for the skin. However, while choosing the moisturizers the condition of the skin should also be considered.