Eczema | All You Need to Know About Eczema

Eczema is a common disease that affects your skin. We often express this condition by dermatitis, as it causes skin inflammation. Eczema occurs in various types, including atopic dermatitis, allergic dermatitis, and irritant dermatitis. Atopic eczema is the most common one.

About 31.6 million persons in the United States have eczema. Eczema can affect children and adults. Eczema develops through the first weeks and months after birth. Eczema in young children presents with itching, swellings, and skin infections due to excessive scratching. They may recover early from the disease or continue to have it during adulthood.

Several types of eczema make your skin dry and itchy because it doesn’t retain much moisture. When your skin’s natural barrier weakens, your skin becomes less able to protect you against harmful irritants. Your immune system will overreact to these allergens and cause inflammation in your skin.

If your family has a history of the disease, you are more likely to be at risk. You are also at risk if one or both of your parents are asthmatic, have hay fever, or have any allergy. Any mutation in your genes that control the protein that maintains moist skin can lead to eczema. Some allergens can cause skin irritation, dryness, and inflammation, like pollen, pet hair, or food. Prolonged smoking and exposure to air pollutants, house dust mites, some types of soaps, shampoo, fabrics, wool, and some skin products raise the risk for the disease. Dry weather, heat, cold, and high humidity can cause sweating and make your skin dry, sensitive, and itchy. Food allergy, animal dander, and respiratory infections are principal causes of eczema.

Atopic dermatitis refers to an overactive immune reaction that involves asthma and fever. You can’t catch eczema from anyone because it isn’t contagious. Atopic dermatitis can affect your whole body. It affects the hands (especially fingers), the inner side of the elbows or backs of the knees, and the head.

The severity of eczema varies from one person to another. Mild symptoms have only dry and itchy skin. Sores, inflamed skin, and constant itching occur in severe cases. Lighter skin becomes red and darker skin becomes grey, which is difficult to see on darker skin. Scratching makes your skin bleed, and infections may happen.

Severe itching interferes with sleep resulting in interrupted sleep and late school level. You may notice a swelling in the lower part of your legs, especially during walking. If you have a blood flow problem like varicose veins, you may feel heaviness in your leg, and the skin over the varicose veins will be dry and itchy. If you get stasis dermatitis, open sores may develop on your lower legs and the tops of your feet. Patients with severe eczema need more intensive treatment to relieve their symptoms.

There are no specific laboratory tests for the diagnosis of eczema. Diagnosis of your condition depends on your symptoms and examination of your skin. Your doctor may need to do a patch test to find eczema triggers. A patch test can indicate allergens like skin allergies associated with contact dermatitis.

If you do not treat or control eczema in the early stage, it will lead to some complications, such as:

• • Sleep-related problems because it interferes with your sleep
  • Skin infections because repeated scratching in your skin lets it bleed and open to microbes that can cause skin infections
  • Hay fever and asthma, especially in children under the age of 12
  • Often, when you develop one type of eczema, you will be at risk of another.

The idea of treatment is to ease symptoms of eczema. Till now, no specific cure for eczema. The principal treatment of eczema includes:

Eczema treatment

The idea of treatment is to ease symptoms of eczema. Till now, no specific cure for eczema. The principal treatment of eczema includes:

• • Moisturize your skin several times all over the day.
  • Use antibiotics to treat skin infections.
  • Topical creams or systemic corticosteroids reduce inflammation, redness, and swelling.
  • Antihistaminics decrease scratching and severe itching during a flare-up
  • Use topical pimecrolimus or tacrolimus in sensitive sites that do not respond to moisturization.
  • Use special bandages that help your skin heal underneath.
  • Your doctor may offer more powerful treatments if you need them.

You should know how to deal with your condition and be aware of the following self-care:

• • Try to control scratching. Gently pinch your skin instead.
  • If your child has eczema, you should give him anti-scratch mittens to stop scratching his skin.
  • Cut your nails and clean them to minimize broking to the skin from unintentional scratching.
  • Avoid wearing fabrics that irritate your skin and use soft or cotton clothes.
  • Don’t stay a lot in hot weather.
  • Don’t use soaps or detergents that affect your skin.
  • Rid of house dust mites Because it is very irritative to your skin.

You should see your dietitian if you have a food allergy. If you are pregnant or breastfeeding, ask for medical advice before making any dietary changes. If you controlled the triggers, you could recover from the disease.

           Let’s discuss this topic in detail,

What is the prevalence of eczema?

About 9.6 million children under age 18 years in the United States have eczema. A third of them have moderate to severe conditions.

This disease in children has increased from 8% to 12% since 1997. In the United States, 16.5 million adults (7.3%) have dermatitis that initially began before age two years. 40% of them have moderate to severe conditions. Also, 10% of African Americans, 13% of Asian Americans, 13% of Native Americans, and 11% of white persons have the disease.

Children born outside the United States have a lower risk of the disease that increases after residing in the United States. Eczema affects both males and females equally. But some studies mentioned that atopic dermatitis is more common in adult females.

What about risk factors and causes of eczema?

We don’t know exactly the causes of eczema, but researchers think that a combination of genes and triggers has a role in getting the disease. You may be at risk of the disease if one or both of your parents have the disease. The interaction between the surrounding environment and your genes may contribute to eczema.

When an allergen outside or inside your body irritates your immune system, it results in inflammation on your skin surface. The deficiency of a protein called “filaggrin” that maintains moisture in your skin leads to itchy and dry skin.

Environmental irritants that cause allergic reactions and eczema include:

• • Prolonged exposure to dry air, extreme heat, or cold
  • Contact with some types of detergents as soap, shampoo, bubble bath, body wash, and cleansers
  • Cocamidopropyl betaine used in shampoo
  • Fabric softeners with chemical additives
  • Contact with wool or polyester in clothing and sheets
  • Natural liquids from fruit, vegetables, and meats
  • Candles and metals such as nickel, jewelry, or utensils
  • Microbes, such as Staphylococcus aureus, viruses, and certain fungi may also bring out the symptoms of eczema.
  • House disinfectants like formaldehyde and vaccines
  • Antibacterial baby wipes like isothiazolinone.
  • Paraphenylenediamine, which you can use in dyes and tattoos
  • Emotional stress is a cause, but the explanation is unknown yet.
  • Hormonal changes have a role in increasing eczema symptoms in pregnancy and the menstrual cycle.
  • Neurodermatitis starts in patients who have psoriasis. The mechanism is still unknown, but stress may be a trigger.
  • Nummular eczema is a type of eczema that causes round, coin-shaped spots on your skin. These spots may become scaly. This type of eczema occurs due to an allergic reaction to insect bites, meats, or chemicals.
  • If fluid leaks out of your weakened veins into your skin, it will cause swelling, redness, itching, and pain in your skin. This condition occurs if there is a problem with the blood flow in your legs, as in varicose veins. This condition is called stasis dermatitis.

What are the symptoms of eczema?

The symptoms of eczema differ according to the age and the severity of your condition. It also can vary by individual. Symptoms of eczema may not look the same on you as it happens on another patient or your baby. Diseased people will often orient when their symptoms worsen, followed by periods of symptoms relief.

Eczema is common in babies under the age of two years.

Infant symptoms include:

• • Scalp and cheeks rashes
  • Rashes bubble up, then fluid leaks
  • Severe itching interferes with sleep.

Childhood (above two years) symptoms include:

• • Rashes appear in the creases of elbows or knees.
  • Rashes appear on the neck, hands, ankles, and the crease between the buttocks and legs.
  • Bumpy rashes appear and become lighter or darker.

Symptoms disappear in 60% of children by adolescence.

Symptoms -in most cases- are mild. Eczema causes redness, itching, dryness, rashes, and irritation in your skin. The skin may appear greyish or brownish, which is harder to see in people of dark color. People may get dark or light skin patches in their skin even after recovery from the disease. These patches are hyperpigmentations and hypopigmentations.

Symptoms in adults include:

• • Rashes are more scaly than those in children
  • Rashes cover much of the body and appear in the creases of the elbows, the knees, or the neck.
  • Small blisters appear in short duration, but a thickening of the skin occurs after a long period.
  • Thickening of the skin leads to permanent itching.
  • Skin infections
  • Scratching and rubbing your skin irritates, inflames, and worsens the skin itching.

How can doctors diagnose your condition?

 

If you are experiencing symptoms of eczema, you should see your doctor if symptoms don’t improve on their own or if they interfere with your work and sleep. To help your doctor diagnose your condition and reach the trigger for you, you should answer the following questions:

1. 1. What do you eat and drink?
   2. What are skin products, chemicals, soaps, shampoo, cleansers, and detergents you use?
   3. What about your activities like taking a walk outside in the woods or swimming in a chlorinated pool?
   4. How long do you stay in the bath or shower, and what is the temperature of water you use?
   5. When do you are under stress?
   6. What makes your symptoms better or worse?

You should see your doctor as soon as possible if you notice that your skin has become infected. Your doctor will ask you to notice connections between your activities and your eczema flare-ups. An allergy specialist may do a patch test to know the type of the allergen.

This test applies small amounts of irritating substances to your skin patches. The specialist lets the patches on your skin for about half an hour to see if you react. This test helps your doctor to find triggers for your eczema. So, you can avoid these triggers to improve your symptoms.

A biopsy may be needed to confirm your diagnosis.

You should be aware of the complication of eczema to keep your skin. How much do you know about this?

Patients with dermatitis may develop physical and psychological problems. Approximately 55% of adults with moderate to severe dermatitis had improper disease control. When eczema makes your skin cracked and broken, bacterial skin infections may occur. This risk increases after scratching the skin or inappropriate treatment.

Signs of bacterial infections include:

• • Fluid leaks from your skin.
  • Crusts and small white spots appear on your skin surface.
  • Skin becomes swollen and sore.
  • Feeling unwell and hot.

Symptoms may rapidly worsen with no improvement despite regular treatment.

Inflamed skin may also become infected with the herpes simplex virus. This viral infection causes cold sores and may lead to a severe condition called eczema herpeticum which include:

• • Painful eczema
  • Fluid-filled blisters that break and leave small open sores on your skin

Preschool children with eczema may have psychological problems, such as hyperactivity, than other children. They need and depend on their parents more than other children.

Teasing or bullying may be noticeable in schoolchildren with eczema.

Your high levels of stress can worsen the condition. So, you should treat the cause well.

Also, patients may suffer from sleep-related problems. Interference with sleep may affect mood and behavior and make it more difficult to concentrate at school or work.

Your child may need a rest from school. It may also affect his ability to keep up with his study. Eczema may affect the self-confidence of adults and children. Having a poor self-image may affect their ability to develop social skills.

Management of eczema

After diagnosing your case, your doctor will start the management. Eczema often comes and goes without treatment (self-limiting). Symptoms in many children may improve when they grow up. There is no unique cure for eczema, just management of your symptoms will occur.

Management may include a combination of lifestyle modification as well as medications.

Here are some self-care tips that can help you keep your skin healthy and decrease symptoms:

• • Take warm baths and avoid high hot showers or bathwater.
  • Use moisturizer or creams that contain ceramides daily after bathing to keep your skin smooth.
  • Wear cotton and soft fabrics.
  • You can use a humidifier in cold weather to prevent the dryness of your skin.
  • Use a cold compress with natural remedies, such as an apple cider vinegar bath, aloe vera, and coconut oil.
  • Use a mild soap with low pH or a non-soap cleanser when washing.
  • Take your precautions to prevent a flare-up of eczema in winter.
  • Air drying (or kindly drying) your skin with a towel is better than rubbing your body after bathing.
  • Avoid sweating where possible and keep away from rapid temperature changes.
  • Ask about eczema triggers to avoid them.
  • Cutting your fingernails, pinching, and patting your skin is better than scratching or breaking your skin.
  • Don’t sit on the grass, plastic chairs, or rough carpet with bare legs.
  • Acupuncture may help you relieve the itching pain.

Your doctor may prescribe some medical treatment to control your symptoms. Medical treatment includes:

• • You can apply topical corticosteroids to your skin to relieve eczema because steroids are anti-inflammatory medications that can reduce itching, swelling, and redness. Your doctor may need to prescribe aggressive medications to some people.
  • If topical creams are not enough, you may need oral medications like systemic steroids and immunosuppressants. The use of these medications is only for short periods till symptoms disappear.
  • Antibiotics treat skin infections.
  • Antihistaminics treat scratching at night, so they act as drowsiness.
  • Usage of topical calcineurin inhibitors inhibits the activities of the immune system, so it decreases inflammation and eczema flares.
  • Your doctor might prescribe barrier repair moisturizers to reduce water loss and help skin repair.
  • Phototherapy may be beneficial to treat moderate dermatitis by exposure to ultraviolet A or ultraviolet B waves. Your doctor will monitor your skin through this time.
  • Your doctor may limit your immune response by injecting biological drugs which block proteins in your immune system.

This illness may be recurrent, so follow-up is necessary after your skin has healed.

       Finally, live healthily and keep your skin soft and smooth.