Definition & Overview

Eczema, also known as dermatitis, is a skin condition characterized by inflammation or swelling, redness, and itchiness. Although not contagious, this skin problem poses major discomfort in the affected areas. It commonly occurs during early childhood and is common with babies and young children. During its onset, certain areas of the skin start to turn red, irritated, dry and scaly. Some cases of eczema lead to the formation of fluid-filled blisters, which eventually weep. Weeping is an indication that the eczema has progressed into an infection.

Causes of Eczema

Experts believe that eczema is the result of the body’s inability to repair damage on the skin barrier, making it susceptible to germs and bacteria. They claim that this inability to heal is caused by a mutation in the gene known as filaggrin. Two copies of the gene are needed for proper barrier repair. Those who have eczema only have one copy.

Dermatitis is also linked to an overactive response of the immune system to an irritant. The symptoms are the body’s response to the irritation, causing flare-ups and rashes. Eczema also commonly occurs in families with a history of asthma and allergies.

Although the exact cause has yet to be established, there are known risk factors that can trigger an eczema attack. These include:

  • Stress
  • Excessive heat and sweat
  • Cold or dry climate
  • Dry skin
  • Contact with rough or coarse materials and irritants like soap and synthetic fabrics
  • Colds or upper respiratory infection

Symptoms and Kinds of Eczema

Eczema typically affects the face, neck, elbows, wrists, groin, knees and the ankles. No matter where the affected area is, the major symptom is always itchiness. The itch may start even before the rash appears. The affected areas look dry, thick or scaly. The rashes are initially red, then turn into a brownish shade. Blisters may also occur when the rashes become infected. After weeping, the blisters turn into scab and peel.

Eczema is a general term for several types of dermatitis. Among common types are:

  • Atopic Dermatitis - Considered the most common yet most severe and chronic kind of eczema, this condition is characterized by dry and scaly skin. It almost always begins in childhood and typically affects the insides of the elbows, back of the knees, neck, and the face.

  • Hand Eczema - Dermatitis that affects only the hand.

  • Contact Dermatitis - This condition occurs when the skin is exposed to certain substances and irritants.

  • Seborrheic Dermatitis - A common condition that commonly occurs in the scalp, where the rashes look like dandruff accompanied by inflammation.

  • Dyshidrotic Eczema - A blister-causing type of dermatitis that affects the fingers, palms and soles of the feet.

  • Stasis Dermatitis - Also known as venuos dermatitis, it occurs due to problems with the veins of the lower legs.

  • Nummular Eczema - Also called discoid eczema, this type is characterized by well-defined coin-shaped spots on the skin.

Diagnosis and Treatment of Eczema

Eczema can be diagnosed by a pediatrician (for young children), dermatologist or a primary care provider / family doctor. There is usually no diagnostic or medical test that can accurately identify the condition. However, doctors can tell if it’s eczema just by looking at the symptoms (rashes) and asking you a few questions. Doctors may also perform allergy tests to pinpoint possible triggers or irritants that you have to avoid in the future.

Currently, there is no definite treatment available that can completely prevent eczema from occurring. However, it can be easily managed and controlled. The main goals of the treatment are to alleviate, relieve, and prevent the itching and avoid further infection. As eczema makes the skin dry, scaly and itchy, medication in the form of creams and lotions are usually recommended. Cold compress is also known to relieve itching.

Over-the-counter creams, such as ointments and creams containing hydrocortisone (1%) or corticosteroids are prescribed to decrease the inflammation. Non-steroidal topical calcineurin inhibitors (TCIs) are also known to effectively lessen inflammation. If the affected area becomes infected, antibiotics are recommended in the form of topical creams or oral medication. Antihistamines can also be recommended to lessen heavy itching.

For serious cases of dermatitis, tar treatments such as UV phototherapy and cyclosporine (an immunosuppresant) can be given. Moreover, psychodermatology, which is a novel field in dermatology that provides an alternative approach to treatment of skin diseases using psychological techniques of relaxation and hypnosis, may also be conducted.

Managing Eczema

If you happen to have eczema, it is for your best interest that you take very good care of your skin. It is important to keep it moisturized to keep it from drying. It is also important that you seek medical help to properly identify your trigger factors and avoid them altogether. Here are some additional tips to help you manage eczema and mitigate its effect in your daily life:

  • Avoid extremely hot baths or showers
  • Avoid any sudden or extreme changes in humidity or temperature
  • Try to reduce your stress
  • Always use hypoallergenic soap and shampoo and stay away from ordinary soaps with harsh ingredients
  • When toweling, gently tap your skin dry (don’t rub)
  • Avoid overheating or overcooling the skin, especially during winter or summer
  • Wear only smooth, soft materials (100% cotton) and avoid polyester, wool or acrylic-based clothing
  • Wear protective gloves when handling detergent or chemicals
  • Be wary of foods and allergens that can cause an outbreak
  • Avoid beauty products loaded with fragrance and scent
  • Be careful with the use of makeup, even hypoallergenic cosmetics can trigger eczema
  • Keep your creams and ointments ready as dermatitis can attack at any time.

Dermatitis is a condition that is not easy to live with, but it can be properly controlled and managed with the right care and caution.

References:

  • www.nationaleczema.org (2104) National Eczema Association “Eczema”
  • www.aad.ord (2014) American Academy of Dermatology “What is Eczema”
  • Berger TG (2012). Dermatologic disorders. In SJ McPhee, MA Papadakis, eds., 2012 Current Medical Diagnosis and Treatment, 51st ed., pp. 93–163. New York: McGraw-Hill.
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