What is Eczema?
Eczema, which is also termed as “atopic dermatitis, ” is a chronic skin disease marked by redness, inflammation, itching, weeping, minute papules and vesicles, oozing and crusting, and later by scaling and pigmentation of the skin.
Symptoms of eczema
Symptoms of eczema vary person to person. You may have some or all symptoms of eczema. Symptoms may be mild to moderate or may be severe which need medical care. Common symptoms are as follows:
1. Red, inflamed skin
2. Intense itching
3. Dry and sensitive skin
4. Constant rash on skin
5. Formation of scales on inflamed skin areas.
6. Oozing, weeping and crusting on skin
7. Rough, dark leathery patches on skin
Types of Eczema
1. Atopic Dermatitis
This is the most common type of eczema. It may affect you if you have asthma or hay fever or family history of eczema. If you have skin defect that allows moisture to go out and germs to enter into the skin, you are more likely to get this type of eczema. It usually begins in infants but may affect adults also. It commonly affects the face, hands, feet, elbows or knees. Too much itching or scratching the affected area may worsen the condition. Irritants like soap, clothes, chemicals, dust mites or other allergens may trigger the symptoms.
2. Allergic contact eczema (dermatitis)
Allergic contact eczema is a reaction when skin comes in contact with any foreign substance. You are allergic to these foreign objects and whenever you come in contact with these materials you get skin inflammation. These substances may not affect others but only you. Some of the allergens are dust mites, pets, pollens, dandruff, molds, poison ivy, nickel, or Balsam of Peru.
3. Irritant contact eczema
Irritant contact eczema is a reaction when skin comes in contact with certain materials that can cause skin inflammation. These substances are called irritants, and they cause burning, itching and redness of the skin. Some irritants are detergents, fumes, solvents, industrial chemicals, tobacco smoke, fabrics, dyes, skin care products, industrial chemicals, bleach, acidic foods, astringents, fragrances and others.
4. Dyshidrotic eczema
In this type of eczema irritation occurs on palms, soles and sides of fingers and toes, characterized by blisters. These blisters may be reddish bumps, thickened and scaly that are very itchy. It gets worse at night and warm weather.
In this type of eczema, scaly patches of skin are found on the head, forearms, wrists and lower legs that are caused by localized itching. Too much scratching or itching of the same area over time causes neurodermatitis. It may happen due to an insect bite.
6. Nummular eczema
In this type of eczema round shaped plaques of scaling skin are found on the lower legs. It is common in older individuals. This kind of eczema usually occurs on legs, back of the hands, forearms, lower back, and hips. Exact cause is not clear but factors such as cold, dry air, chemicals such as formaldehyde, exposure to metals such as nickel may cause nummular eczema.
7. Seborrheic eczema
In this type of eczema oily, greasy, scaly yellowish patches of skin are usually found on the scalp, eyebrows and face and sometimes trunk. In infants, it causes a thick, yellow, crusty scalp rash called cradle cap. It occurs due to lack of biotin and is often curable. Older children and adults may also develop this condition on their scalp which is very much similar to dandruff in appearance but is more itchy and inflamed. The cause of seborrheic dermatitis may be due to an abnormal inflammatory response to a yeast called “Malassezia” typically found on the skin.
8. Stasis dermatitis
In this type of eczema, skin irritation occurs on lower legs. It is usually related to circulatory problems. So, it is also called venous stasis dermatitis as it arises when there is a problem with the veins. Abnormal blood flow allows pressure to develop in varicose veins which result in fluid leaking out of the veins and into the skin. Thus, it causes swelling, scaling, redness, itching or pain.
9. Hand eczema
It is the common type of eczema which affect the palms and hands. It may be caused by internal factors like genetic make-up or external factors like irritants or allergens. It is common among people who are involved in jobs such as cleaning, healthcare, catering, hairdressing, and mechanical work. It causes skin inflammation of hands. The symptoms are redness, itching, pain, dryness, cracks and even blisters on hands.
10. Xerotic eczema
Xerotic eczema occurs when the skin is very dry. It can be caused when your body is dehydrated, or your skin is not moisturized properly on a regular basis. People living in cold and dry regions throughout the year are more prone to this type of skin condition as compared to those living in normal or temperate climate. Here are 5 home remedies for dry skin work.
Causes of Eczema
Although the peculiar cause of eczema is unknown, but some researches show that it may develop due to hereditary and some environmental factors.
1. Genetical cause – You are more likely to develop eczema if one of your parents or both the parents have it.
2. Environmental factors – Some environmental factors cause the symptoms of eczema. These can be irritants or allergens or microbes or temperature or foods or stress.
Irritants – Some chemical substances like soaps, detergents, shampoos, disinfectants can be harsh to the skin and causes rashes.
Allergens like dust mites, pets, pollens, dandruff or mold can cause skin inflammation.
Microbes like bacteria such as Staphylococcus aureus, viruses and certain fungi can also cause skin inflammation.
Temperature – Hot temperature, high humidity give a favorable condition for microbes to grow which causes eczema. Cold temperature can also cause skin rashes.
Foods – Certain food products may be allergic to some people and causes skin inflammation. These foods are like dairy products, eggs, soy products, wheat, nuts, and seeds.
Stress – Stress is actually not a cause of eczema but can make the symptoms worse.
Treatment of Eczema
Eczema is a chronic disease, and there is no cure for this. However, treatment of eczema is to control its symptoms by reducing inflammation and itching. Mild to moderate inflammation can be treated with moisturizers and steroid creams. For severe eczema, creams based on topical preparation and calcineurin inhibitors are used for treatment.
Phototherapy is also effective in treating eczema.
1. Corticosteroids – Topical steroids that are available in the form of cream, lotion or ointments reduce skin inflammation efficiently. It is very effective especially when eczema flares up. It gives relief from itching, irritation, and soreness, allowing the skin to heal and recover. Your doctor may prescribe oral corticosteroids that can effectively cure eczema.
2. Immunosuppressants – Immunosuppressants are the drugs that reduce skin inflammation by suppressing the immune system. These drugs are recommended for a short period. Some examples of immunosuppressants are cyclosporine, azathioprine, or methotrexate that may be used when other treatments have failed.
3. Hydrocortisone – For mild eczema hydrocortisone cream or ointment can help reduce the inflammation. Hydrocortisone is chemically similar to a hormone cortisol, which is made by our body every day. It can be used without prescription but for severe eczema, prescribed hydrocortisone is advised.
4. Antihistamines – Your doctor may prescribe oral antihistamines such as Benadryl may help relieve the symptoms of eczema. It may cause drowsiness. So it is better to take the medicine at night before retiring to bed.
5. Immunomodulators – Immunomodulators help in the treatment of the disease by inducing, enhancing, or suppressing an immune response. Some examples are Elidel and Protopic.
6. Moisturizers – Moisturizing your skin on a regular basis with a good moisturizer help reducing inflammation by improving skin hydration and barrier function of the skin. You should apply moisturizer every day after taking bath. Some of the prescription based moisturizers are Hylatopic Plus, Mimyx, and Epiceram.
Ultraviolet light therapy
For severe eczema, your doctor may suggest you for light therapy if other medications don’t work.
1. UVB light therapy that is narrowband ultraviolet B light of wavelength 280 nm to 315 nm is the common type of phototherapy for treating eczema. Your skin is exposed to UVB light which is emitted by a special machine. This portion of natural sunlight is very useful in treating skin disease. Artificial method of providing UVB light therapy is very beneficial in reducing skin inflammation and scaling.
2. PUVA light therapy – In this type of light therapy, your skin is exposed to UVB light of wavelength 315 nm to 400 nm. It effectively reduces itchiness and swelling.
Your doctor may prescribe topical antibiotics which fight against bacterial infections which can make the condition worse. Some of the antibiotics which are used in treating eczema are Mupirocin (e.g. Bactroban) or fusidic acid (e.g. Fucidin ointment). Topical treatment such as mild hydrocortisone combined with Fucidin help in reducing inflammation as well as bacterial infection. Treating of bacterial infection helps in eczema management.
Your doctor may also prescribe oral antibiotics for the severe skin infection.
How to prevent Eczema from occurring and growing
1. You should regularly moisturize your skin after taking bath.
2. You should wear cotton or soft fabrics and avoid tight and rough fibers.
3. Take bath with lukewarm water using mild soap and cleanser.
4. You should use a soft towel for drying your body.
5. You should avoid allergens that trigger the condition.
6. You should avoid scratching and rubbing the affected area.
7. Keep your nails short to avoid infection and scratching.