Skin disease: Eczema basic overview


What is eczema?

Eczema is a term for several different types of skin swelling. Eczema is also called dermatitis. It is not dangerous, but most types cause red, swollen and itchy skin. The most common type of eczema is called atopic dermatitis, which is an allergic reaction. Eczema is often very itchy and when you scratch it, the skin becomes red and inflamed. Eczema affects adults and children, but it is most common in babies. Atopic dermatitis is a chronic skin condition. “Atopic” describes an inherited tendency to develop dermatitis, asthma and hay fever. “Dermatitis” means that the skin is red and itchy.

Other types of eczema include:

  • Allergic contact eczema. The skin gets red, itchy, and weepy because it touches something that the immune system knows is foreign, like poison ivy.
  • Contact eczema. The skin has redness, itching, and burning in one spot because it has touched something allergy-causing, like an acid, cleaner, or other chemicals.
  • Dyshidrotic eczema. The skin on the palms of hands and soles of the feet is irritated and has clear, deep blisters that itch and burn.
  • Neurodermatitis. Scaly patches on the head, lower legs, wrists, or forearms are caused by a localized itch (such as an insect bite).
  • Nummular eczema. The skin has coin-shaped spots of irritation. The spots can be crusted, scaling, and very itchy.
  • Seborrheic eczema. This skin has yellowish, oily, scaly patches on the scalp, face, and sometimes other parts of the body.
  • Stasis dermatitis. The skin is irritated on the lower legs, most often from a blood flow problem.

Why should I be concerned?

About 1 out of every 10 kids develops eczema. Most kids who have eczema got it before they turned 5 years old, but you can get it when you’re older than 5.

What are the causes of eczema?

The cause of atopic dermatitis is not known. It is likely caused by both genetic (runs in the family) and environmental factors. People with atopic dermatitis may go on to develop hay fever and asthma.

Irritants and allergens can make atopic dermatitis worse.

Irritants are things that may cause the skin to be red and itchy or to burn. They include:

  • Wool or manmade fibers;
  • Soaps and cleaners;
  • Some perfumes and makeup;
  • Substances such as chlorine, mineral oil, or solvents;
  • Dust or sand;
  • Cigarette smoke.

Allergens are allergy-causing substances from foods, plants, animals, or the air. Common allergens are:

  • Eggs, peanuts, milk, fish, soy products, and wheat;
  • Dust mites;
  • Mold;
  • Pollen;
  • Dog or cat dander.

Stress, anger, and frustration can make atopic dermatitis worse, but they haven’t been shown to cause it. Skin infections, temperature, and climate can also lead to skin flares. Other things that can lead to flares are:

  • Not using enough lubricants after a bath;
  • Low humidity in winter;
  • Dry year-round climate;
  • Long or hot baths and showers;
  • Going from sweating to being chilled;
  • Bacterial infections.

Who is at risk of eczema?

(Uncontrollable risks i.e. family history, race, age, gender…

Controllable risks i.e. lifestyles, other diseases, emotional health…)

Children are more likely to develop this disorder if a parent has had it or another atopic disease like asthma or hay fever. If both parents have an atopic disease, the likelihood increases. Although some people outgrow skin symptoms, approximately half of children with atopic dermatitis go on to develop hay fever or asthma. Environmental factors can bring on symptoms of atopic dermatitis at any time in affected individuals.

What are the symptoms of eczema?

Atopic dermatitis and eczema may start out as dry, extremely itchy skin. The rash may become very red, swollen and sore. The more you scratch it, the worse it generally gets. A clear fluid may leak from the rash. Eventually, the rash will crust over and start to scale. Common places for the rash are in the elbow creases, behind the knees, on the cheeks, and on the buttocks.

When should I see a doctor?

Call your doctor if you or your child has atopic dermatitis and:

  • Itching makes you or your child irritable.
  • Itching is interfering with daily activities or with sleep.
  • There are crusting or oozing sores, severe scratch marks, widespread rash, severe discoloration of the skin, or a fever that is accompanied by a rash.
  • Painful cracks form on the hands or fingers.
  • Atopic dermatitis on the hands interferes with daily school, work, or home activities.
  • Signs of bacterial infection develop. These include:
    • Increased pain, swelling, redness, tenderness, or heat.
    • Red streaks extending from the area.
    • A discharge of pus.
    • A fever of 100.4°F (38°C) or higher with no other cause.

How is eczema diagnosed?

Diagnosis is based on the symptoms. Each person has his or her own mix of symptoms that can change over time. Doctors will ask for a medical history to:

  • Learn about your symptoms;
  • Know when symptoms occur;
  • Rule out other diseases;
  • Look for causes of symptoms.

Doctors also may ask about:

  • Other family members with allergies;
  • Whether you have conditions such as hay fever or asthma;
  • Whether you have been around something that might bother the skin;
  • Sleep problems;
  • Foods that may lead to skin flares;
  • Treatments you have had for other skin problems;
  • Use of steroids or medicine.

What are other medical tests can help diagnosis?

There isn’t a certain test that can be used to check for this disease. But you may be tested for allergies by a dermatologist (skin doctor) or allergist (allergy doctor).

What are the treatments for eczema?

Atopic dermatitis treatment goals are to heal the skin and prevent flares. Your doctor will help you:

  • Develop a good skin care routine;
  • Avoid things that lead to flares;
  • Treat symptoms when they occur.

You and your family members should watch for changes in the skin to find out what treatments help the most.

Medications for atopic dermatitis include:

  • Skin creams or ointments that control swelling and lower allergic reactions;
  • Corticosteroids;
  • Antibiotics to treat infections caused by bacteria;
  • Antihistamines that make people sleepy to help stop nighttime scratching;
  • Drugs that suppress the immune system.

Other treatments include:

  • Light therapy;
  • A mix of light therapy and a drug called psoralen;
  • Skin care that helps heal the skin and keep it healhy;
  • Protection from allergens.

What are the complications may happen?

(Long-term complications to other body parts in brief)

The skin of people with atopic dermatitis lacks infection-fighting proteins, making them susceptible to skin infections caused by bacteria and viruses. Fungal infections also are common in people with atopic dermatitis.

  • Bacterial Infections: A major health risk associated with atopic dermatitis is skin colonization or infection by bacteria such as Staphylococcus aureus.
  • Viral Infections: People with atopic dermatitis are highly vulnerable to certain viral infections of the skin. For example, if infected with herpes simplex virus, they can develop a severe skin condition called atopic dermatitis with eczema herpeticum.
  • Bullying: Schoolchildren may experience teasing or bullying if they have atopic eczema. Any kind of bullying can be traumatic and difficult for a child to deal with.
  • Problems sleeping: Sleep-related problems are common among people with eczema. A lack of sleep may affect mood and behavior. It may also make it more difficult to concentrate at school or work.
  • Self-confidence: Atopic eczema can affect the self-confidence of both adults and children. Children may find it particularly difficult to deal with their condition, which may lead to them having a poor self-image.

How can I manage my eczema?

To help reduce itching and soothe inflamed skin, try these self-care measures:

  • Take an oral allergy or anti-itch medication.
  • Take a bleach bath.
  • Apply an anti-itch cream or calamine lotion to the affected area.
  • Moisturize your skin at least twice a day.
  • Avoid scratching.
  • Apply cool, wet compresses.
  • Take a warm bath. Sprinkle the bath water with baking soda, uncooked oatmeal or colloidal oatmeal — a finely ground oatmeal that is made for the bathtub (Aveeno, others). Soak for 10 to 15 minutes, then pat dry and apply medicated lotions, moisturizers or both (use the medicated form first).
  • Choose mild soaps without dyes or perfumes. Be sure to rinse the soap completely off your body.
  • Use a humidifier. Hot, dry indoor air can parch sensitive skin and worsen itching and flaking.
  • Wear cool, smooth-textured cotton clothing.
  • Treat stress and anxiety.

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