Eczema and Dermatitis

Identification

Nearly one in ten people worldwide will develop eczema — a term that describes skin conditions characterized by irritated, inflamed, itchy patches. Eczema is also called dermatitis, and the two terms are often used interchangeably. There are many types of dermatitis. In some people, eczema causes the skin to appear very red with a rash that seems to bubble up; in others it can appear scaly and dry with less discoloration. Eczema often appears after an itch has been scratched, and therefore is commonly referred to as “the itch that rashes.”

“Anyone could develop eczema, regardless of age.”

Eczema can manifest differently with different people. It can present as erythematous rash together with a vesicle. From time to time for those chronic cases it may appear as a patch having a pale skin color. More commonly, it manifests after a person unceasingly scratches off their skin without realizing that they already have this condition. That’s why it is frequently referred to as “the itch with the rash.”

Where and When Eczema Occurs

Eczema can also appear anywhere on any body part. Anyone could develop eczema, regardless of age. These are some of the most common occurrences:
  • In infants, it is most commonly seen on the face, typically within the forehead, cheeks, neck and scalp. It can also be seen through the upper and lower extremities (arms and legs).
  • In children and adults, it is most commonly seen as a patch on:
    • skin folds of the neck area
    • face
    • torso
    • elbow creases
    • hands
    • fingers
    • popliteal (back of knee) area
    • feet

Prevention

What Causes Eczema?

The definite cause of eczema remains unknown. Dermatologists have not fully disclosed its exact cause, but some of its potential sources can be identified. Genetics: Having a family history of eczema will increase the probability of you having it. People having allergen caused lesions would likely tell you that some of their family members have asthma and other skin allergies. There are many variations of eczema. The most common cause is allergens. When an allergen comes in contact with the skin, it can trigger itchiness. If this continues it becomes an eczematous lesion.

Atopic dermatitis

The most common type of eczema that affects most of the infants in the United States is atopic eczema. About ten to twenty percent of very young people are affected by this type of condition. Atopic eczema has no definite time when it will erupt. However, this condition frequently sets off before five years of age.

Contact Dermatitis

When a specific substance comes in contact with the skin, and suddenly an inflammatory reaction occurs on or around where the contact happened, this is contact dermatitis. There are two main types of contact dermatitis:

Irritant Contact Dermatitis

If someone would suffer eczema after doing all the laundry, most likely the cause of the inflammatory reaction would be the soap that has irritated the skin. This is an example of irritant contact dermatitis. Irritant contact dermatitis results from touching a particular compound that causes a reaction after it has come in contact with the skin. For this type of dermatitis to occur, it would require a large amount of the allergens in order to create a rash.

Allergic Contact Dermatitis

Poison ivy is an excellent example of this type of eczema. Allergic contact dermatitis is much more complicated than irritant contact dermatitis. Even skin that has not come in contact with the allergen can also react, due to the body’s immune response.

How Eczema Happens

“When a person’s immune response gets compromised, eczema arises as a hyperactive inflammatory response…”

The epidermis is the superficial layer of skin. It serves as a primary barrier to the environment. The dermis, the layer under your epidermis, is made up of connective tissue that provides nourishment to our skin. When a person’s immune response gets compromised, eczema arises as a hyperactive inflammatory response of the epidermis and dermis.
The inflammatory reaction, likely from frequent scratching, creates a large elevated skin discoloration. When a person scratches the skin repeatedly, it may result in a secondary bacterial infection, creating fluid-filled areas around it. If the person continues to scratch off the area, pus may develop, burst and afterwards create a dry and scaly skin lesion. Although eczema has no morbid complication, secondary bacterial infections can still trouble any person suffering them.

“…[scratching] the skin repeatedly, may result in a secondary bacterial infection…”

Eczema’s signs and symptoms can be controlled by avoiding specific substances that may irritate the skin. The most effective way to prevent eczema from erupting is to avoid scratching off your skin. Most importantly avoid scratching the part of the skin that is being affected. This may create a bigger lesion from frequent scratching.

“Most importantly avoid scratching the part of the skin that is being affected.”

Cutting your nails on a regular basis can prevent subsequent infection via secondary bacterial infection. Repeated scraping of the skin by nails can spread bacteria. Take a warm shower, utilizing non irritating cleansers and applying moisturizers. This can soothe your skin and provide a pleasing comfort.

Treatment

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There is no single treatment for eczema. If you believe you have eczema, a dermatologist can aid you in finding the best option for you. Symptoms can often be reduced or prevented by avoiding specific triggers. The most effective measure you can take to clear an eczema flare-up is to avoid the urge to scratch the affected area, as this may worsens outbreaks. To avoid further irritation, keep your fingernails short and smooth, bathing in mild water, using cleansers, and moisturizing directly after bathing are also often effective in clearing symptoms. For severe cases where other treatments have failed, medications that affect the body’s immune response might be perscribed.

Chemical Peels

Salicylic acid is generally the best chemical peel for Eczema as it is a very strong keratolytic agent. It is able to remove plaques and rough spots very effectively, without being overly irritating to the underlying skin layer. Salicylic acid may be drying to the outer skin layer. In this case Skin Laboratory suggests using it in conjunction with Lactic acid. Proper use of Lactic acid can hydrate the skin. For this reason many customers alternate between Salicylic and Lactic peels weekly and find that this gives them the best results. By alternating the peels, you get good results without too much dryness.

Immunomodulators

Topical immunomodulators (TIMs) are another steroid free treatment. TIMs stop the immune cells from creating flare-ups (inflammation), restraining eczema.

Light Therapy & Laser

A less preferred option, a treatment combining psoralen (oral drug) with medical strength UVA (ultraviolet radiation). This is known as PUVA (Psoralen UltraVioletA). Lasers are not used to treat Eczema.

Treatment & Prevention Review

Though there are cases of eczema that can be managed simply, there are still cases that cannot be controlled by a simple medical treatment. Steroids which act on the body’s defense would most likely be recommended.
  • Don’t scratch:
      Most importantly, on the part of the skin that is being affected, don’t scratch as it may create a bigger lesion from frequent scratching.
  • Cut your nails regularly:
      Cutting your nail on a regular basis can prevent subsequent infection from secondary bacteria. Recurrent scraping of the skin via the nails spreads bacteria.
  • Take a warm shower:
      Taking a shower can soothe your skin and provide a pleasing comfort. To maximize this effect, use non-irritating cleansers and apply moisturizers.