What is Eczema?
Eczema is a general term used to describe skin inflammation or “dermatitis.” Eczema is not contagious, but is believed to have a genetic component. It is therefore common for multiple members of the same family to have the condition. Research indicates that those with a family history of eczema or a family history of other allergic conditions, such as asthma or hay fever are more likely to present eczema. While eczema can affect people of any age, it is most common in infants. About 85% of people with eczema experienced its onset before the age of 5. Research shows that eczema is more common in females than males and effects people of all races.
There are several types of eczema and one can develop more than one type at the same time. Some of the most common types of eczema are Contact dermatitis, Dyshidrotic eczema, Nummular eczema, and Seborrheic dermatitis. (These different forms of eczema are discussed below under “What are some types forms Eczema?”)
What are the causes of Eczema?
The actual “cause” of eczema remains a mystery. Doctors and researches are continuously digging deeper into this condition to uncover the roots of the disease so that a cure can be developed. What is known about eczema is that some forms of the condition are triggered by substances that come in contact with the skin. Chemicals such as cosmetics, soaps and detergents, or even sweat and clothing, have been shown to trigger an eczema outbreak. Other events that have been shown to exacerbate eczema are changes in temperature, humidity, and high stress and anxiety.
What are signs and symptoms of Eczema?
Different types of eczema (discussed below)present with different symptoms. Dry skin, reddened skin that itches or burns are the most common signs of eczema. Each individual case of eczema has the capacity to present in a unique manner, but in the most general terms, eczema usually brings on dry and scaly skin with an intense itching sensation that may be followed by blisters and oozing lesions. Repeated scratching of affected areas can lead to thickening and crusting of the skin. These symptoms can be brief and last for only a few hours or days, or can be chronic and persist for months and years. In both children and adults, eczema has the capability of presenting anywhere on the body. However, it is more common to find eczema on the face, neck, and the insides of the elbows, knees, and ankles. In infants, it is not uncommon to find eczema presenting on the forehead, cheeks, and forearms as well.
What are some types of Eczema?
When dealing with a case of eczema, you may hear our doctors use an array of terms. As mentioned above, the word “eczema” is a broad term used to describe conditions of skin inflammation or “dermatitis.” Atopic Dermatitis is the most common form of eczema followed by Contact Dermatitis, Dyshidrotic Dermatitis, Hand Dermatitis, Neurodermatitis, Nummular Dermatitis, Occupational Dermatitis, Seborrheic Dermatitis, and Stasis Dermatitis.
Atopic dermatitis is a chronic skin disease that leads to eczema and is frequently described as “the itch that rashes.” It has been documented that a person’s quality of life can be affected due to the intense itching that atopic dermatitis brings on. When the disease presents in infancy, it is sometimes referred to as infantile eczema. Children are the most likely victims of this disease and often cannot sleep through the night due to the intense itch. This form of dermatitis has been shown to run down the family tree. A vast quantity of those presenting atopic dermatitis have a family history of the condition. Although it remains unclear as to what the cause of the condition is, dermatologists believe environmental factors such as mold, pollen, and pollutants play a role in triggering an episode of Atopic Dermatitis. Soaps, detergents, and perfumes are also believed to trigger the condition.
Contact Dermatitis or contact eczema is a localized reaction to an allergen. An allergen can be any object or substance a person came in contact with. From shampoo and jewelry to food and water, contact dermatitis brings along redness, itching, and burning in areas where the skin has come into contact with the allergen. Due to the vast number of substances with which individuals come in contact with on a daily basis, it can be difficult to determine the exact trigger for contact dermatitis. When the contact leads to irritated skin, the eczema is called irritant contact dermatitis. As with atopic dermatitismentioned above, it is very common to find that those with contact dermatitis have a family history of the condition.
This form of eczema occurs on the palms of the hands, sides of the fingers, and soles of the feet. Dyshidrotic dermtitis typically causes a burning or itching sensation along with a blistering rash. In our office one may hear a doctor refer to this condition by a different synonym such as hand eczema, pompholyx, vesicular eczema, and vesicular palmoplantar eczema.
As mentioned above, there are several different and unique types of eczema. Hand eczema or hand dermatitis does not refer to one specific type of eczema, but rather is a broad and general name given to conditions of eczema that develop on the hands. The reason hand eczema is given specific attention by medical professionals is because hand eczema is often the result of one’s occupation. The allergy a person has may be directly related to their specific occupation.
Neurodermatitis, as its name implies, stems from a condition in the body’s nervous system. This form of dermatitis arises when nerve endings in the skin become irritated, triggering a severe itch-scratch-itch cycle. Patients with this condition report that endless scratching does little to relieve the itching sensation of the condition. Common causes of nerve irritation include an insect bite and emotional stress. Women are more likely to develop Neurodermatitis than men. The condition generally will present itself between the ages of 25 and 50 and can result in thickened and leathery skin.
Nummular Dermatitis is a common form of dermatitis that develops after the skin experiences trauma (skin injury such as a burn, abrasion, or insect bite). That being the case, the most common areas that develop nummular dermatitis are arms, knees, legs, and buttocks. The hallmark of this condition are unique coin-shaped (nummular) or oval lesions and patches of irritated and itchy skin.
Occupational dermatitis is not limited to one specific form of eczema. Rather, it is any type of eczema caused by a person’s workplace or occupation. This distinct classification came about because occupational dermatitis has unique causes and many people develop eczema on the job.
Seborrheic dermatitis generally presents on the scalp as oily and waxy patches. It is not uncommon for this form of dermatitis to spread to the face, cheeks, and shoulders. Seborrheic dermatitis does not necessarily have the “itching sensation” that come along with other forms of eczema. As mentioned previously, seborrheic dermatitis has a tendency to flare up when exposed to triggers such as cold temperatures and dry weather. Our doctors may use synonyms such as Cradle Cap (occurs in infants aged 0 to 6 months), Dandruff, and Seborrhea when referring to this condition.
Stasis dermatitis occurs almost exclusively in middle aged people. As one ages, circulation in the lower extremities such as the legs begins to slow. Diminished blood flow to the lower extremities can lead to a fluid build up. This ultimately leads to swelling that affects the skin by causing an itchy rash with painful sores and skin discoloration. To effectively treat this form of dermatitis, our doctors will not only take into account the trauma to the skin, but will focus on correcting the circulation problem thereby diminishing the swelling which will ultimately terminate the skin condition.
What are common treatments for Eczema?
The first goal of an eczema treatment plan would be to prevent itching and reduce inflammation thereby minimizing the worsening of the condition. Treatment may involve changes in one’s lifestyle (to avoid allergens) and/or medication.
Avoiding products that may trigger an episode of eczema is the key to treating an existing condition and preventing a future episode. Keeping the skin well hydrated and moist is an important aspect in treating eczema. This can be accomplished by using oil based moisturizing creams. To treat inflammation, a dermatologist may prescribe a corticosteroid that helps reduce inflammation in the skin. Use of prescribed creams depends on the severity of the condition. A well-trained and qualified dermatologist will be advising you on the concentration of the cream and how often it should be applied. In severe cases, oral antihistamines may be prescribed. Phototherapy or light therapy is another form of treatment that is sometimes employed to treat people with eczema.
Can Eczema be prevented?
As mentioned above, it is not completely clear as to what the cause of eczema is but there are certain measures that can be taken to prevent an outbreak or a reoccurring episode. Exercising good skin hygiene is a first step in both preventing and treating eczema. Keeping the skin moist is an excellent preventative measure. Bathing or showering with a mild soap and shampoo that does not dry the skin out, and applying a moisturizer after bathing and showering will help prevent an episode of dermatitis. Those that have experienced an episode of dermatitis should limit or avoid contact with known irritants like soaps, perfumes, detergents, and jewelry. Instead of itching and irritating the skin, one should use a cold compress to control the uncomfortable sensation and should visit a dermatologist to determine a treatment plan.
Dr. Suzanne Friedler for HealthiNation
The “Love Your Skin” show, hosted by Advanced Dermatology’s outstanding dermatologists, discusses various aspects of medical conditions of the hair, nails, and skin, and also covers cosmetic, laser dermatology and plastic surgery techniques and how they can better your skin’s health and appearance.
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