Last updated date: 01-Jun-2023
Originally Written in English
What is the meaning of eczema? Eczema is a group of skin disorders normally associated with inflamed and itchy patches on the skin. It can also result in reddening of the skin in people with light skin tones and purple, brown, ashen, or grey skin in dark skin tones. This condition is more common among infants and young children but can also affect teenagers and adults.
Eczema is generally a chronic and long-lasting condition that often flares up occasionally. At times, it can be associated with hay fever and asthma. However, this condition may significantly improve over time. For some children, it can even clear entirely as they grow older.
Types of Eczema
Although eczema can be a chronic skin condition, it’s not contagious. This means that eczema cannot spread from one person to another.
The following are the types of eczema that can develop in both minors and adults;
- Atopic dermatitis
The most prevalent form of eczema is atopic dermatitis, also known as atopic eczema. The associated symptoms usually appear during childhood and might vary from moderate to chronic.
Atopic eczema is a genetic condition. Therefore, in a situation where one of the parents has atopic dermatitis, the child is likely to have it as well.
Food allergy is more common among minors with atopic dermatitis. There are also at risk of developing hay fever and asthma. However, there is a possibility for atopic eczema in kids to grow out.
Atopic dermatitis can result in dry skin patches that may turn itchy, swollen, and inflamed. These patches usually develop in the creases around the knees and the elbows, as well as on the neck, face, and wrists.
Mostly, scratching the patches can aggravate the inflammation and itchiness, causing the skin to seep transparent fluid. Repeated rubbing or scratching may cause thickening of the patch of skin over time and eczema with bumps.
Atopic dermatitis is characterized by flare-ups, in which eczema worsens for a certain period. These flare-ups are caused by a variety of factors, including:
- Certain irritants, including soaps, detergents, soaps, fragrances, and perfumes
- Dust mites
- Fabrics including synthetics and wool
- Food allergies
- Hormonal alterations, which often occur before menstruation or during pregnancy; commonly referred to as eczema pregnancy.
- Low humidity, cool weather, and intense temperature changes
- Saliva and animal fur
- Skin infections such as scabies
- Contact dermatitis
Some people tend to develop a negative skin reaction whenever they encounter particular substances or chemicals. Such a situation is referred to as contact dermatitis. Some of the common symptoms associated with contact dermatitis are;
- Itching, drying, and reddening of the skin, which is characterized by a burning sensation
- Formation of blisters
- Hives, a rash characterized by red and small bumps
In most cases, a child or adult with atopic dermatitis is at a higher risk of developing contact dermatitis. Contact dermatitis comprises two forms, including;
Irritant contact dermatitis:
This condition can occur due to repeated exposure to certain substances that cause skin irritation. These substances include;
- Fabric softeners
- Alkalis and acids
- Strong detergents
- Hair dyes
- Weed chemicals
- Certain shampoos
Most individuals who regularly come into contact with some of these substances have increased chances of developing contact dermatitis.
Allergic contact dermatitis:
Allergic contact dermatitis develops if the body's immune system negatively responds to a certain substance called an allergen. An allergen may not cause a reaction the first time a person comes into contact with it. But immediately, they become allergic; they will have it for the rest of their lives.
Some of the potential allergens are;
- Adhesives and glues
- Rubber and latex
- Certain drugs, including oral antibiotics and topical
- Dyes for fabrics and clothes
- Plants such as poison oak, poison ivy, and sumac
- Certain ingredients in cosmetics, creams, nail polishes, hair dyes, and other beauty products
- Metals like cobalt and nickel
- Discoid eczema
Discoid eczema, also known as nummular eczema, is distinguished by disc-shaped skin eczema patches that are red, itchy, broken, and swollen. These discs are most often found in the lower legs, forearms, and torso. At times the disc's core cleans up and leaves behind a ring of reddish skin.
Typically, discoid eczema can affect anyone and any age, even minors. At times, they can be confused to ringworms. Hence, it’s essential to consult a specialist who can tell if it’s a discoid eczema or ringworm.
The triggers of discoid eczema, including those of other forms of eczema, are unknown. However, some of the potential risk factors and causes include:
- Skin dryness
- Skin damages or injuries, including friction and burns
- Insect stings and bites
- Insufficient blood supply
- Chilly weather
- Skin infections caused by bacteria
- Certain drugs
- Metal and formaldehyde sensitivity
- Atopic dermatitis
- Dyshidrotic eczema
Dyshidrotic eczema, also known as pompholyx eczema, is most common in adults under the age of 40. Dyshidrotic eczema on hands and feet are more common and comprises distinct symptoms such as persistent scratching and the formation of small blisters.
Dyshidroticeczema with blisters may enlarge and become watery in certain cases. They can also get infected; causing swelling and severe pain, and can even start to ooze pus. Blisters usually go away after a few weeks. After that, the skin tends to be dry and brittle, potentially resulting in sore skin fissures.
What causes or triggers dyshidrotic eczema is unknown. Its, however, more prevalent among individuals with the following conditions:
- Allergies (hay fever)
- Atopic dermatitis or a record of family history of the condition
- Skin fungus infections
Individuals who operate with some substances or keep their hands deep in water all day are even more likely to develop dyshidrotic eczema. Other potential causes are mental tension and temperature or weather variations.
Dyshidrotic eczema is thought to be a type of contact dermatitis. As such, individuals who have dyshidrotic eczema are occasionally prone to flare-ups.
- Varicose eczema
Varicose eczema can also be referred to as venous eczema, stasis eczema, or gravitational eczema. It is more popular among older people, especially those who have varicose veins.
Typically, the veins in the legs will diminish as they age and become less active. This may result in varicose veins as well as varicose eczema. Varicose eczema usually impairs the lower legs and can cause the following symptoms;
- Itchy and hot blisters or spots
- Dry and scaly skin
- Weeping eczema and crusty skin patches
- A broken skin
Since the skin around the lower leg can become brittle, you should stop scraping and picking at the blisters oreczema spots.
- Asteatotic eczema
Asteatotic eczema, also known as xerotic eczema and eczema craquelé, usually affects individuals above 60. This could be attributed to a person's skin getting drier as they age.
Asteatotic eczema mostly develops and affects the lower legs, although it may also affect other areas of the body.
Some of the symptoms involve;
- Cracking and drying of the skin with a distinctive appearance that has been described as "crazy paving."
- Cracks or grooves that appear red or pink
- Itching and aching
The causes of asteatotic eczema, like those of other forms of eczema, are unclear. However, the triggers may include the following;
- Cold, dry weather
- Detergents and other cleaning products
- Drying the skin with a rough towel
- Excessive skin washing or scrubbing
- Taking hot baths
Other types of eczema include;
- Xerotic eczema; also known aseczema xerosis
- Seborrheic dermatitis; rash or eczema on scalp, ears, face, and mid-chest in adults.
In certain circumstances, one may have more than one form of eczema on the body at the same time. Every type of eczema consists of its set of causes and medical treatment needs. As such, it's essential to see a medical provider who is trained to treat and manage eczema. Dermatologists, in particular, will assist you in determining the form or forms of eczema you have. They will also help address and prevent future eczema flare up.
Common Signs and Symptoms of Eczema
Eczema affects people differently and tends to vary in appearance. On the other hand, the flare-ups will not necessarily occur in the same place. But generally, eczema causes constant itchiness, regardless of the affected part of the skin. At times, itching can occur prior to the appearance of the rash. The skin can also appear red, broken, dry, or leathery.
The symptoms of eczema in toddlersand eczema in newborn include the formation of an itchy rash that can result in oozing and crusty conditions. This mostly occurs in the scalp and face but can also develop in the legs, arms, chest, and back.
In children and adolescents, the prevalent eczema symptoms include having a rash around the elbow bends, on the neck, behind the knees, or in the ankles and wrists. This rash can become dry and scaly.
The symptoms of eczema in adults include a rash that usually appears on the face or behind the knees, hands, feet, or wrists. The skin will also become extremely thick, dry, and scaly. With light skin people, the affected areas can first turn red and later brown. Eczema on black skin can impact the skin pigment, causing the affected part to become dark or light.
When to Consult a Doctor;
Although eczema is mild at times, you should see a dermatologist if;
- The condition suddenly changes or aggravates
- You discover infections signs, including redness, fever, blisters, or warmth
- The prescribed eczema medication or treatment form is not effective
If you experience any sign or symptom that might indicate eczema, you should consult a dermatologist or healthcare provider. This is because it may be a sign of a new eczema allergy or other reactions. Hence, it's essential to determine the cause of the reaction.
Typically, there are no exact tests or procedures to diagnose various forms of eczema. However, dermatologists often request personal and family medical records for more analysis. They also inquire about recent reactions or exposures to possible irritants and allergens. It’s important to inform the doctor if you have asthma or hay fever.
The doctor can as well inquire about:
- Sleeping schedules
- Factors of tension or eczema stress
- Previous skin disease treatment
- Steroids use
At times, a physical assessment of the rash can enable the doctor to determine the form of eczema. A patch test, which includes pricking the skin using a needle containing possible irritants and allergens, can be performed. A patch examination can help identify whether or not the patient has contact dermatitis.
Treatment Options for Eczema
Depending on the type, the following forms of eczema cure and treatment procedures can help address the condition in both children and adults;
- Topical steroids
Topical steroids refer to the anti-inflammatory drugs that dermatologist usually recommends to address the skin's rash areas. Other than the dry regions, these medications are also useful around inflamed, red spots. Eczema steroids differ from other forms of steroids, including estrogen and testosterone.
Topical steroids are healthy and safe when used as directed by the doctor. A stronger or more potent topical steroid can improve the condition more effectively compared to a less strong topical steroid. Nevertheless, stronger steroids are associated with severe possible side effects, including skin thinning. Therefore, potent steroids cannot be applied on certain parts, such as the face, underarms, and groin. Eczema treatment over-the-counter topical steroids are usually less potent, unlike prescription steroids.
Steroid tablets or injections (shots) are stronger and more effective than topical steroids. As a result, they may have additional side effects such as bone disorders and weight gain. If possible, they should be avoided in general, especially in babies with eczema.
- Topical moisturizers
Normally, dry skin aggravates the rash and itchiness. Environmental factors like wind and low humidity might also dry out the skin. Hence, moisturizing the skin by hydrating or applying water is a vital part of eczema treatment. Once you are done soaking the skin in a shower or tub, gently pat it to remove excess water droplets. After that, put a moisturizer to the already damp skin right away to plug in the water and thereby enhance the dryness. Alternatively, doctors can recommend using eczema body wash to moisturize the skin.
It’s vital to understand that moisturizers aren’t steroids. Also, it’s essential to distinguish between steroids or other forms of anti-inflammatory eczema medicine from moisturizers. Your doctor can assist you in determining between them.
- Topical Anti-Inflammatory Drugs
In case topical steroids are ineffective, another form of the topical anti-inflammatory drug known as a topical immunomodulator can be considered. They are commonly used as the second resort when steroids fail to address eczema. Since they are not steroids, these drugs may be used to treat eczema on eyelids or other facial parts because they don’t cause skin thinning. They may, however, be associated with other possible side effects. Therefore, it’s crucial to discuss with the doctor before use.
- Wet wrap therapy
Wet wrap therapy is typically useful in treating an individual with serious and hard-to-manage eczema. The treatment involves soaking the skin in warm water for approximately 15 to 20 minutes before patting to dry. Topical treatments such as steroids or anti-inflammatory medications are then applied to the rash sections of the skin.
After that, the rash areas are covered with a wet dressing, which is either clothing or gauze. A dry wrap cloth, like an elastic bandage, sock, or pajamas, is then applied to the wet dressing. Wraps are normally used for 2-6 hours. Wet wrap treatment is used on a daily basis and should be done with the supervision of a doctor.
- Light therapy
This treatment option is recommended for patients who don’t improve with topical approaches or constantly flare up following treatment. The most basic light therapy method (also referred to as phototherapy) consists of skin exposure to a measured quantity of natural sunlight. Some types utilize artificial ultraviolet A (UVA) as well as narrow-band ultraviolet B (UVB). These forms can be used alone or in combination with other medications.
Long-term light therapy, though successful, has negative side effects. They can include premature aging of the skin and a high possibility of developing skin cancer. Due to this, phototherapy is less widely recommended, especially when addressing eczema in children. Also, it should not be given to infants with eczema. Discuss the benefits and drawbacks of light therapy with the doctor.
Antihistamines taken orally or in pill form do not relieve the itchiness caused by eczema. Besides, it’s not caused by histamine. Sometimes, sedative antihistamines help promote the required sleep during the night.
Nonetheless, there are several possible side effects, such as daytime sleepiness or sedation, increased dryness, and urinating problems. If possible, you should avoid using topical antihistamines because they cause allergic reactions and aggravate the rash.
Newborn eczema treatment;
Eczema treatment for babies or newborns can include the following;
- Refraining from exposure to severe temperatures
- Identifying the skin irritants and avoiding them
- Lubrication of the child’s skin using eczema lotion, cream, bath oils, and eczema ointment
- Putting on eczema gloves to keep the affected hand cool during extreme temperatures
Consult the child's doctor in case these interventions do not alleviate the rash or if the rash seems to be contaminated. To control the eczema rash or cure an infection, the baby might require prescription drugs. Alternatively, the doctor might prescribe an antihistamine (oral) or eczema honey to relieve itchiness and induce drowsiness. This could be beneficial for overnight scratching and irritation.
If necessary, the doctor might prescribe a stipulated eczema dietto help manage the condition and prevent flare ups.
Complications Associated With Eczema
Some of the possible complications of eczema in both children and adults include;
Severe itchy and scaly skin: Neurodermatitis, also known as lichen simplex chronicus, is a skin disease that begins with an itchy patch of skin. Scratching the spot makes the condition worse by triggering more itchiness. You can eventually scratch merely out of tendency. The blemished skin can become discolored, dense, and leathery as a result of this condition. In the end, this could result in visible eczema scars.
Asthma and hay fever: Sometimes, eczema tends to precede these disorders. At the age of 13, more than 50 percent of children who have atopic dermatitis experience hay fever and asthma.
Infections of the skin: Generally, eczema is itchy and scratching the cracked skin repeatedly will result in open sores and more breaks. This raises the risk of bacterial and viral infection, like eczema herpeticum which associated with a herpes simplex virus.
Sleeping problems: As a result of the constant itching and scratching cycle, one is likely to experience sleeping difficulties or poor quality sleep.
Eczema and Atopic Dermatitis:
Generally, eczema definition is a non-specific term for various skin inflammation and disorders (dermatitis). Eczema dermatitis is thus classified into many types, including allergic, irritant, and nummular eczema and contact. Hence it could be difficult to differentiate eczema vs dermatitis.
Atopy refers to a medical diagnosis that encompasses three related disorders that often coexist in the same person. They include atopic dermatitis, asthma, and inhalant allergies. These three elements do not have to be found in the same individual at the same time.
Eczema vs. Psoriasis:
Distinguishing eczema versus psoriasis may be difficult. This is because they are both skin conditions associated with similar signs and symptoms. However, a professional dermatologist may be able to differentiate them.
Eczema and psoriasis can feel a bit different. Eczema triggers severe itching that can worsen. This results in intense scratching, making the skin bleed. On the other hand, psoriasis can also be itchy; however, the skin can burn or sting.
Eczema and hives:
Eczema and hives are major forms of skin allergies associated with symptoms that can develop beneath or on the skin. However, the distinguishing aspect of eczema vs hives is that hives result in red, itchy, swollen pumps on the skin, which vary in size. On the other hand, eczema is an allergy condition. Hence, the skin turns red, becomes itchy, and develops an allergic rash.
Eczema is an autoimmune disease that results in itchy, inflamed, and cracked patches on the skin. Depending on the type and severity of the disease, blisters can sometimes develop. The most common form of eczema that dermatologists often diagnose is atopic dermatitis or atopic eczema. Fortunately, eczema is not contagious.
The signs and symptoms of eczema vary from one person to another. While some are mild, others tend to be chronic and irritating. As such, it’s essential to consult a medical provider if you suspect or notice eczema-related symptoms.