Eczema is a term for a group of medical conditions that cause the skin to become inflamed or irritated. It is not a single health condition but a recognizable reaction pattern seen in a number of skin diseases.
Eczema is very common. And in many cases, it’s also manageable.
It’s most common for babies and children to develop eczema on their face (especially the cheeks and chin), but it can appear anywhere on the body and symptoms may be different from one child to the next. More often than not, eczema goes away as a child grows older, though some children will continue to experience eczema into adulthood.
Adults can develop eczema, too, even if they never had it as a child.
Signs and Symptoms of Eczema
Almost always, your skin will itch before a rash appears in eczema.
Typically, eczema shows itself as:
Patches of chronically itchy, dry, thickened skin, usually on the hands, neck, face, and legs (but it can occur anywhere). In children, the inner creases of the knees and elbows are often involved.
If scratched, dry patches of skin and open sores with crusts may develop and may get infected.
The specific cause of eczema remains unknown, but it is believed to develop due to a combination of genetic and environmental factors.
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, mould, 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.
There are many different types of eczema:
Atopic dermatitis: This health condition has a genetic basis and is the most common type of eczema which is also called atopic eczema as with other forms of dermatitis. It is more prevalent in those with asthma and hay fever. Atopic dermatitis tends to begin early in life in those with a predisposition to inhalant allergies, but it probably does not have an allergic basis. Characteristically, rashes occur on the cheeks, neck, elbow and knee creases, and ankles.
Allergic contact dermatitis: This is a skin reaction following contact with a substance or allergen that the immune system recognizes as foreign.
Irritant dermatitis: This occurs when the skin is repeatedly exposed to excessive washing or toxic substances.
Dyshidrotic dermatitis: 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 dermatitis: This shows as circular patches of irritated skin that can be crusted, scaly, and itchy.
Seborrheic dermatitis: This forms oily, scaly, yellowish patches of skin, usually on the scalp and face.
Stasis dermatitis: This is a skin irritation of the lower leg usually related to circulatory problems.
Fungal infections: This can produce a pattern identical to many other types of eczema, but the fungus can be visualized with a scraping under the microscope or grown in culture.
Scabies: It's caused by an infestation by the human itch mite and may produce a rash very similar to other forms of eczema.
Lichen simplex chronicus: It produces thickened plaques of skin commonly found on the shins and neck.
Xerotic (dry skin) dermatitis: The skin will crack and ooze if dryness becomes excessive.
Though there are several distinct types of eczema, it is possible to have more than one type at a time.
Eczema caused by fungi and scabies can spread to other parts of the body or to others through skin-to-skin contact.
None of the other types of eczema are contagious.
An accurate diagnosis requires an examination of the entire skin surface and a careful health history. It is important for a doctor to rule out curable conditions caused by infectious organisms. Occasionally, a sample of skin (biopsy) may be sent for examination in a laboratory.
Most dermatologists specialize in the diagnosis and treatment of all forms of eczema.
Treatments for Eczema
There is no cure for eczema. Treatment for the condition aims to heal damaged skin and alleviate symptoms. Treatments include over-the-counter (OTC) remedies, prescription topical medications, phototherapy, immunosuppressants, and biologic drugs.
Doctors will suggest a plan of treatment based on an individual's age, symptoms, and current state of health.
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.
For some people, eczema goes away over time. For others, it remains a lifelong condition.
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
apply an anti-itch cream to the affected area such as a non-prescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve the itch and applying it no more than twice a day to the affected area, after moisturizing
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
reduce irritation by avoiding clothing that's rough, tight or scratchy and wear appropriate clothing in hot weather or during exercise to prevent excessive sweating
learning and avoiding individual eczema triggers
using a humidifier in dry or cold weather
rather than scratching when you itch, try pressing on the skin or cover the itchy area if you can't keep from scratching it and for children, it might help to trim their nails and have them wear gloves at night
Prognosis of Eczema
Most eczema comes and goes over time. Atopic dermatitis is usually worst in childhood and improves with age. Other forms of eczema may stay with you throughout your life, although you can take measures to reduce your symptoms.