Eczema is a a type of dermatitis. The terms "eczema" and "dermatitis" are a group of skin conditions that cause skin inflammation and dry, itchy patches of skin. It’s a common condition that isn’t contagious. Symptoms of eczema can flare up if you contact an irritant or an allergen. There are treatments available to help you manage symptoms, but there isn’t a cure.
What are the types of eczema?
Atopic dermatitis: The most common form of eczema is also a chronic one. "Sometimes it's worse, sometimes it's better, but it's always there". Usually starts in childhood. atients notice scaly patches, redness, inflammation, swollen skin, and sometimes open wounds, oozing, or crusting caused by scratching. Commonly affected areas include the elbows, knees, hands, feet, eyelids, and nipples. The treatment: Depending on the severity, we may prescribe a topical, oral, or injectable prescription.
Contact Dermatitis: There are two types of contact dermatitis: irritant and allergic.Irritant is the redness that occurs on the skin's outermost layer after something like, say, wearing a bandage. In allergic contact dermatitis, the rash manifests as an immune response. One common example is poison ivy. The treatment: identify the cause, whether it's an allergy to a dye in makeup, a preservative in wet wipes, or even the nickel in the button of your jeans. Since only the exposed areas are the ones affected, the location can determine what's causing it and then we go from there, prescribing an oral or topical steroid if necessary.
Dyshidrotic eczema: It usually crops up in the winter time on the hands and feet. You might develop red patches and pimple or blister-like bumps on your fingers and toes. The treatment: Will probably advise moisturizing regularly especially if you experience flare-ups in dry weather as well as using special topical creams.
Stasis Dermatitis: This one usually happens in the elderly on the lower legs. As your circulation diminishes with time, you get fluid build-up. The immune system then tries to correct the swelling, but an over-response may also cause a crusty rash on top of the inflamed areas. The treatment: May use topical creams, but we will also want to treat the underlying problem. Elevating the legs more frequently and wearing compression socks can also help with poor circulation.
Nummular eczema: Nummular means "coin-shaped" in Latin, so it makes sense that this type manifests as circular patches. The reaction usually occurs on the legs during the wintertime and it's more commonly seen in the elderly, but nummular eczema can affect anyone. The treatment: A topical cream can also help with this seasonal condition.
Seborrheic dermatitis: It isn't usually thought of as eczema, but scalp dandruff falls in this category. Besides your head, you might also find the greasy plaques and flakes on the eyebrows, nose, chest, or back. We believe that in these cases, a yeast that normally appears in the skin overgrows in gland-produced oils, causing the immune system to react. The treatment: We recommend an anti-yeast shampoo, like OTC options Head and Shoulders & Selsun Blue, or a prescription version.
It’s possible to have more than one type of eczema at the same time.
Who does eczema affect?
Eczema can affect anyone at any age. Symptoms usually appear during childhood and last into adulthood. You might be more at risk of having eczema if you have a family history or a diagnosis of:
Dermatitis
Allergies
Hay fever
Asthma
How common is eczema?
Eczema is common and affects more than 31 million Americans. Infants are prone to eczema, and 10% to 20% will have it. However, nearly half of all infants diagnosed with eczema outgrow the condition or have significant improvement as they get older.
Symptoms:
Dry skin
Itchy skin
Skin rash
Bumps on your skin
Thick, leathery patches of skin
Flaky, scaly or crusty skin
Swelling
Does eczema hurt?
Eczema doesn’t usually cause pain. If you scratch your skin, you could break the surface of your skin and create a sore, which could be painful. Some types of eczema, like contact dermatitis, cause a burning sensation and discomfort.
What does an eczema rash look like?
Eczema can look different on each person diagnosed with the condition. If you have a dark skin tone, an eczema rash can be purple, brown or gray. If you have a light skin tone, an eczema rash can look pink, red or purple.
Dry skin
Itchy skin
Skin rash
Bumps on your skin
Thick, leathery patches of skin
Flaky, scaly or crusty skin
Swelling
Where do symptoms of eczema appear on my body?
Hands
Neck
Elbows
Ankles
Knees
Feet
Face, especially cheeks
In and around ears
Lips
Nipples
Breasts
Folds of skin near your vagina (vulva)
Penis
What causes eczema?
Your immune system: If you have eczema, your immune system overreacts to small irritants or allergens (triggers) in your environment. When you contact a trigger, your immune system assumes that these small irritants are foreign invaders, like bacteria or viruses, that can harm your body. As a result, the triggers activate your body’s natural defense system. Your immune system’s defense is to create inflammation. Inflammation causes symptoms of eczema on your skin.
Your genes: You’re more likely to have eczema if there’s a history of eczema or dermatitis in your family. You’re also at a higher risk if there’s a history of asthma, hay fever and/or allergies. Common allergies include pollen, pet hair or foods that trigger an allergic reaction. You could also have a genetic mutation that causes your skin’s barrier function to not work as it should.
Your environment: There’s a lot in your environment that can irritate your skin. Some examples include exposure to smoke, air pollutants, harsh soaps, fabrics such as wool, and some skin care products. Low humidity (dry air) can cause your skin to become dry and itchy. Heat and high humidity can cause sweating and that can make your itchiness even worse.
Emotional triggers: Your mental health could affect the health of your skin, which can cause a flare-up of eczema symptoms. If you have high levels of stress, anxiety or depression, you may have more frequent flare-ups of eczema symptoms.
Is eczema an autoimmune disease?
While eczema can cause your immune system to overreact, it isn’t classified as an autoimmune condition. Research is ongoing to learn more about how eczema interacts with your immune system.
Prevention:
Moisturize your skin regularly or when your skin becomes dry. Seal in moisture after a bath or shower by immediately applying moisturizer to your skin.
Take short baths or showers with warm, not hot, water.
Stay hydrated and drink at least eight glasses of water each day. Water helps keep your skin moist.
Wear loose clothes made of cotton and other natural materials. Wash new clothing before wearing it. Avoid wool or synthetic fibers.
Manage your stress and emotional triggers. See a psychiatrist for medication and a therapist for counseling if you’re experiencing symptoms of poor mental/emotional health.
Use a humidifier if dry air makes your skin dry.
Avoid irritants and allergens.
When should I see my healthcare provider?
You experience symptoms of eczema.
Your symptoms get worse after treatment.
Your symptoms don’t go away a few weeks after treatment.
You get an infection, have a fever or experience severe pain.
Questions and Answers About Atopic Dermatitis
Q. Since this condition is associated with allergies, can certain foods be the cause?
A. Rarely (perhaps 10%). Although some foods may provoke atopic dermatitis, especially in infants and young children with asthma, eliminating those foods is rarely a cure. You should eliminate any foods that cause immediate severe reactions or welts.
Q. Are environmental causes important and should they be eliminated?
A. Rarely. The elimination of contact or airborne substances does not bring lasting relief. Occasionally, dust and dust-catching objects like feather pillows, down comforters, kapok pillows and mattresses, cat and dog dander, carpeting, drapes, some toys, wool, and other rough fabrics, can worsen atopic dermatitis.
Q. Are skin tests, like those given for hay fever or asthma, of any value in finding the causes?
A. Sometimes, but not as a rule. A positive test means allergy only about 20% of the time. If negative, the test is good evidence against allergy.
Q. Are shots (immunotherapy injections) such as those given for hay fever and other allergies useful?
A. Not usually. They may even make the skin condition worse in some patients.
Q. What should be done to treat this condition?
A. We will provide advice on avoiding irritating factors in creams and lotions; rough, scratchy, or tight clothing; and woolens. Rapid changes of temperature and any activity that causes sweating can aggravate atopic dermatitis. Proper bathing, moisturizing, and dealing with emotional upsets which may make the condition worse should be discussed.
