What is Eczema?
One of the most challenging skin disorders to diagnose is Eczema. Derived from the Greek definition, “Eczema” translates to “inflammation” and “to boil out.” Eczema breakouts resemble a form of “boiling” on the skin. Itchy, angry, red patches, even blisters can develop in chronic cases. Scratching can inflame the rash and cause “weeping” of clear fluid. Over time, the affected patches of skin can thicken.
Eczema can appear differently on individuals, depending on the type of rash and where it appears on the body. Symptoms typically flare up for a period of time and then calm down before resurfacing.
Eczema is often used a catch-all term for a group of chronic, itchy skin rashes, some skin conditions can actually be interrelated and they can be difficult to pinpoint or diagnose without proper medical help.
Unfortunately, more than 30 million Americans have some form of eczema, and while the exact cause is not exactly clear, a combination of factors, such as genetics, environment, and immune system issues are thought to play a big role. Eczema is not a contagious condition. You can’t catch it from another person who has it.
Types of Eczema
Atopic Dermatitis: The most common form of eczema. Over 18 million American suffer from it. Dry, scaly, red, and itchy patches can appear on the face, scalp, hands or feet, inside the elbows, or behind the knees. In more severe cases, these patches crack and crust over, and they can become infected.
In many cases, atopic dermatitis can come, go and reappear. The rash goes into remission and can disappear for a time. It tends to occur in families with a history of this eczema, hay fever, or asthma. It can be a lifelong condition, although some children outgrow it or see symptom improvement as they age. Atopic dermatitis usually begins in childhood, usually within 6 months of a baby’s life.
Dyshidrotic Eczema: With this type of eczema, itchy, fluid-filled blisters develop under the skin on the hands or the feet, especially palms, soles, or sides of the fingers. Patches of flaky, red skin can develop. Over time, the affected skin can become thick and cracked. It may be aggravated by stress or frequent or long periods of contact with water. Working with certain metals like chromium, cobalt, or nickel—can trigger symptoms. It is more common in women, and there is a higher risk if you have had Atopic dermatitis (eczema) or allergic rhinitis (hay fever). It tends to occur in spring and summer and in warmer climates.
Nummular Eczema: Round or oval areas of itchy, inflamed sores that resemble the shape of a coin are the hallmark of this type of eczema, which is also called nummular dermatitis or discoid eczema. Clusters of tiny pimples form plaques, or patches, that become scaly. One or more areas of the skin, usually on the arms and legs, can be affected. It is more common in older males, but young women can get it, too. Nummular eczema tends to occur in people with dry skin, especially in winter. Like other types of eczema, symptoms can come and go. New patches may form where there was injury to the skin, such as an insect bite. Keeping skin moisturized can help prevent future flare-ups.
Signs and Symptoms of Eczema
The signs and symptoms of eczema can vary from one person to the next and include:
- Severe itching
- Red rash
- Dry, rough, scaly patches
- Painful skin cracking
How do you know a rash is eczema and not psoriasis or another skin condition? Eczema is usually accompanied by uncontrollable itching that worsens when you scratch it and can interfere with sleep. People can, in chronic cases scratch uncontrollably, sometimes until they bleed, yet itching persists, and the wound becomes vulnerable to infection.
Atopic Dermatitis: The most common type of eczema, usually strikes in childhood. Babies tend to develop a red rash on their cheeks and scalp that turns dry and scaly. The rash can bubble up, ooze, and crust over. In young children, other body sites may be affected, such as the inside folds of the elbows or knees, or the hands, wrists, or feet. Over time, these patches can lighten or darken, and they may become thick and bumpy and constantly itchy.
Dyshidrotic Eczema: Typically strikes the hands and feet. People with this type of eczema develop small, fluid-filled blisters that itch and burn. The blisters weep, crust over, and crack, exposing the skin to painful infection.
Nummular Eczema: Produces pimples or blisters that leak fluid and form crusty, coin-shaped patches on the legs, arms, hands, feet, or torso. It occurs more often in the winter months.
What Causes Eczema?
While the exact cause of eczema is unknown, scientists believe it’s a product of genetics and the environment. Eczema risk is greater in children whose parents had eczema or a condition like asthma or hay fever.
Usually the skin serves as a shield against toxins, bacteria, and allergens. With eczema, that protective barrier dries out and is easily breached by irritants in the environment. Exposure to household products such as soaps, detergents, or fragrances can be a trigger, as well as allergens like dust, pollen, or pet dander.
Typically, Eczema produces a red, itchy, scaly rash, but exact symptoms can differ from person to person. What eczema looks like may depend on the type of eczema. Eczema rash can affect different body parts, from the scalp to the toes. Some people may develop a patch or two of inflammation, while others have multiple lesions. Eczema symptoms can range from mild to severe.
Atopic dermatitis, the most common type of eczema, usually begins in infancy or childhood. The first sign of eczema in babies is often red cheeks. In children, eczema usually appears in the inner folds on the elbows and knees. Dyshidrotic eczema is more common in young adults. It produces fluid-filled blisters on the hands and feet. Older men are more likely to develop nummular eczema, which produces distinctive circular or oval patches of blistered, scaly rash.
Unfortunately, there’s no single test for diagnosing eczema. Your doctor or health care professional will conduct a physical exam. Some patients may be referred to a dermatologist or allergist. Doctors look for typical signs and symptoms of eczema, such as itching and rash.
The difficulty is often ruling out other conditions that cause irritating skin symptoms. Atopic Dermatitis, for example, may be confused with Seborrheic Dermatitis (a common condition that mainly affects the scalp), while nummular eczema may resemble ringworm (a contagious fungal infection).
Sometimes a skin patch test or allergy test may be required to confirm an eczema diagnosis by ruling out other conditions. Your doctor will ask you about your family history, known allergies, and medical history, as well.
Unfortunately, there’s no single magic bullet to get rid of eczema. But there are a number of treatments and strategies for relieving symptoms, reducing inflammation, and preventing flare-ups. These include ointments and creams that are applied to the skin, oral antibiotics or antihistamines, and an injectable medication.
Medications & Treatment
Medications to treat eczema include:
- Prescription or over-the-counter medicines
- Topical steroids such as hydrocortisone cream to relieve inflammation
- Drugs / Antibiotics to treat infections that may arise
- Antihistamines for itch control
- Prescription or over-the-counter moisturizers
Steroid ointments and creams have long been the go-to remedy to clear up eczema rash. Topical steroids come in different strengths, so if one doesn’t do the job, your doctor may switch you to something more potent. Topical products containing coal tar or antihistamines might be prescribed for itch relief.
Restoring moisture is crucial for preventing symptom flare-ups. Soaks and wet wraps can soothe pain and itching. Prescription and over-the-counter moisturizers can help repair dry skin and keep it hydrated.
Light therapy (also called phototherapy) using a special device that emits ultraviolet light is an option for clearing difficult-to-treat eczema and rashes that are dispersed across the body.
Antibiotics may be given to treat bacterial skin infections. Diluted bleach baths are sometimes used to treat baby eczema that results in frequent infections. Be sure to consult your doctor first for assistance.
Eczema and Proper Diet
In recent years, evidence has shown a healthy diet can improve many medical conditions, including eczema. Ask your doctor or health care professional for dietary assistance. It might significantly ease your symptoms.
Maintenance & Self-Care
Eczema requires a lot of self-care. You’ll need to recognize and avoid triggers, including allergens and other skin irritants. Keeping skin moisturized and avoiding temperature extremes – heat, which can make you sweat or low humidity, which can deplete the skin of moisture — may be important strategies for managing eczema.
There might be times when you might need to seek additional advice and follow-up care. Consult your doctor about making changes to your lifestyle or diet if symptoms, medical history, and diagnostic testing show issues or problems. Report any change in the severity of eczema symptoms. And if a prescribed treatment doesn’t seem to be working, don’t hesitate to contact your doctor about adjusting your medication.
Eczema can be a very serious problem for some people, and while it’s not life threatening per se, eczema untreated for worsened can expand into more serious issues like infections and viruses. Always be sure to notify your doctor of any issues you have.