Health Tips

ECZEMA: The itch that stays?

Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It's common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) condition that tends to flare periodically. It may be accompanied by asthma or hay fever.

Types of eczema

• Allergic contact dermatitis: This is a skin reaction following contact with a substance or allergen that the immune system recognizes as foreign.
• Dyshidrotic eczema: This is an irritation of the skin on the palms of the hands and the soles of the feet. It is characterized by blisters.
• Neurodermatitis: This forms scaly patches of skin on the head, forearms, wrists, and lower legs. It is caused by a localized itch, such as an insect bite.
• Nummular eczema: These show as circular patches of irritated skin that can be crusted, scaly, and itchy.
• Stasis dermatitis: This is a skin irritation of the lower leg usually related to circulatory problems.

Symptoms of eczema

Atopic dermatitis (eczema) signs and symptoms vary widely from person to person and include:

• Dry skin
• Itching, which may be severe, especially at night
• Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp
• Small, raised bumps, which may leak fluid and crust over when scratched
• Thickened, cracked, scaly skin
• Raw, sensitive, swollen skin from scratching

Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.

Causes of eczema

The specific cause of eczema remains unknown, but it is believed to develop due to a combination of genetic and environmental factors. Eczema is not contagious. Children are more likely to develop eczema if a parent has had the condition or another atopic disease. If both parents have an atopic disease, the risk is even greater.

Environmental factors are also known to bring out the symptoms of eczema, such as:

• Irritants: These include soaps, detergents, shampoos, disinfectants, juices from fresh fruits, meats, or vegetables.
• Allergens: Dust mites, pets, pollens, mold, and dandruff can lead to eczema.
• Microbes: These include bacteria such as Staphylococcus aureus, viruses, and certain fungi.
• Hot and cold temperatures: Very hot or cold weather, high and low humidity, and perspiration from exercise can bring out eczema.
• Foods: Dairy products, eggs, nuts and seeds, soy products, and wheat can cause eczema flare-ups.
• Stress: This is not a direct cause of eczema but can make symptoms worse.
• Hormones: Women can experience increased eczema symptoms at times when their hormone levels are changing, for example during pregnancy and at certain points in the menstrual cycle.

Complications of eczema

• Asthma and hay fever. Eczema sometimes precedes these conditions. More than half of young children with atopic dermatitis develop asthma and hay fever by age 13.
• Chronic itchy, scaly skin. A skin condition called neurodermatitis (lichen simplex chronicus) starts with a patch of itchy skin. You scratch the area, which makes it even itchier. Eventually, you may scratch simply out of habit. This condition can cause the affected skin to become discolored, thick and leathery.
• Skin infections. Repeated scratching that breaks the skin can cause open sores and cracks. These increase the risk of infection from bacteria and viruses, including the herpes simplex virus.
• Irritant hand dermatitis. This especially affects people whose work requires that their hands are often wet and exposed to harsh soaps, detergents and disinfectants.
• Allergic contact dermatitis. This condition is common in people with atopic dermatitis.
• Sleep problems. The itch-scratch cycle can cause poor sleep quality.

Treatment

There is no cure for eczema. Treatment for the condition aims to heal the affected skin and prevent flare-ups of symptoms. Doctors will suggest a plan of treatment based on an individual's age, symptoms, and current state of health. For some people, eczema goes away over time. For others, it remains a lifelong condition.

Home care

There are numerous things that people with eczema can do to support skin health and alleviate symptoms, such as:

• Taking lukewarm baths
• Applying moisturizer within 3 minutes of bathing to "lock in" moisture
• Moisturizing every day
• Wearing cotton and soft fabrics, and avoiding rough, scratchy fibers and tight-fitting clothing
• Using a mild soap or a non-soap cleanser when washing
• Air drying or gently patting skin dry with a towel, rather than rubbing the skin dry after bathing
• Where possible, avoiding rapid changes of temperature and activities that make you sweat
• Learning and avoiding individual eczema triggers
• Using a humidifier in dry or cold weather
• Keeping fingernails short to prevent scratching from breaking the skin

Medications

There are several medications that doctors can prescribe to treat the symptoms of eczema, including:

• Topical corticosteroid creams and ointments:

These are a type of anti-inflammatory medication and should relieve the main symptoms of eczema, such as skin inflammation and itchiness. They are applied directly to the skin. If you want to buy topical corticosteroid creams and ointments, then there is an excellent selection online with thousands of customer reviews.

• Systemic corticosteroids:

If topical treatments are not effective, systemic corticosteroids can be prescribed. These are either injected or taken by mouth, and they are only used for short periods of time.

• Antibiotics:

These are prescribed if eczema occurs alongside a bacterial skin infection.

• Antiviral and antifungal medications:

These can treat fungal and viral infections that occur.

• Antihistamines:

These reduce the risk of nighttime scratching as they can cause drowsiness.

• Topical calcineurin inhibitors:

This is a type of drug that suppresses the activities of the immune system. It decreases inflammation and helps prevent flare-ups.

• Barrier repair moisturizers:

These reduce water loss and work to repair the skin.

• Phototherapy:

This involves exposure to ultraviolet A or B waves, alone or combined. The skin will be monitored carefully. This method is normally used to treat moderate dermatitis.

Even though the condition itself is not yet curable, there should be a particular treatment plan to suit each person with different symptoms. Even after an area of skin has healed, it is important to keep looking after it, as it may easily become irritated again.

Download our DOC2US app from Google Play Store or Apple Store and chat with a doctor now.

References:

1. 7 Types of Eczema: Symptoms, Causes, and Pictures. Healthline. Published January 12, 2017. Accessed December 12, 2019. https://www.healthline.com/health/types-of-eczema
2. Eczema: Symptoms, treatment, causes, and types. Published July 16, 2021. Accessed December 12, 2019. https://www.medicalnewstoday.com/articles/14417
3. Atopic dermatitis (eczema) - Symptoms and causes - Mayo Clinic. Accessed December 12, 2019. https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273

Image sources:

1.https://www.dermmd.com/2019/02/15/a-brief-introduction-to-eczema-types/

2.https://eczemaliving.com/atopic-dermatitis-eczema-infographic/

3.https://www.pinterest.com/pin/709528116273979947/

4.https://www.perdanauniversity.edu.my/the-basics-of-managing-your-childs-eczema/

Written by

Dr. Veronica Thomas Caroline