Eczema, also known as Dermatitis or Atopic Dermatitis, is a skin disease that is characterized by the inflammation of the skin. It causes redness, itching, flaking, cracking and dryness of the skin. It may be an acute or a chronic condition and may prove to affect almost any part of the body [1]. Eczema is considered to be a fairly common skin condition throughout the world and it has a prevalence rate of about 3.5% globally. Atopic eczema is prevalent in about 10.7% children in USA, significantly higher than the global prevalence rate.

Conditions of eczema are found to be more common in infants and individuals infected with the disease may also be susceptible to various other allergies such as hay fever or asthma. However, eczema is not an allergic reaction itself.

While there are some cases of acute eczema, most of the cases prove to be chronic in nature. The rashes on the skin appear and subside periodically.

The causes of this skin disorder are unknown and as such, there is also no complete cure for the condition. In order to effectively manage eczema, the conditions of the disease and possible measures for prevention and management remedies should be known.

Eczema conditions may appear and disappear periodically. While it is not thought of to be a serious or a life threatening condition, eczema can prove to be quite irritating, especially due to excessive itching of the rashes of the skin. This may prevent individuals from conducting regular activities and may adversely affect daily routines such as that of sleeping. As such, it is important to observe care in order to successfully control the disorder.

Classification of Eczema

Eczema could be classified into various types depending on the following factors [2]:

  • Location: Eczema may be classified as per the location which it proves to manifest itself on the body. Hand eczema, face eczema and neck eczema are all fairly common types of eczema to affect individuals.
  • Appearance: Eczema may also be classified on the basis of the appearance of the rashes. For instance, discoid eczema is a type of eczema in which the rashes appear in the form of small red discs on the surface of the skin.
  • Occurrence period: Eczema may be classified as either acute or chronic depending on the period for which the condition lasts in an individual.
  • Underlying cause: Eczema may be classified to be either xerotic eczema or varicose eczema depending on the underlying reason which is found to cause the disorder.

Causes of Eczema

The exact cause of Eczema remains largely unknown and experts still debate on what could possibly be the exact reason behind the condition. Many experts however, agree that eczema may be caused by a combination of a number of internal as well as external factors which can be described as follows:

  • Genetics: Eczema is thought to be a hereditary disease that is passed on from one generation to another through the genes of an individual.
  • Auto-immunity: An immune system response to the body’s own cells may also lead to developing conditions of eczema. Bacterial infections may also lead to abnormal immunity that may cause eczema.
  • Lack of protective barriers in skin: It is believed that any defect in the natural skin barrier may lead to eczema. For instance, when the skin is naturally dry and lacks any moisturizing care, the risk of developing eczema is considered to be fairly high.
  • Conditions that lead to dryness of the skin: Dryness or loss of moisture from the skin may allow the allergic germs to enter in the body through skin. This may also prove to cause eczema in individuals.
  • Environmental conditions: Specific individuals may be subject to higher risk of encountering eczema triggered by environmental factors. For instance, dust mites may prove to trigger an allergic response in the body of an individual, leading to the development of eczema. Urbanization, exposure to polluting agents, and cold as well as dry climate, are all thought to be causes of eczema.

Symptoms of Eczema

While the signs and symptoms of eczema vary to a certain degree from one individual to another, eczema usually manifests itself in the form of rashes and inflammation on the surface of the skin [3]. The skin may also show certain signs such as itching, the appearance of reddish or brownish patches on the skin surface across different parts of the body, dryness of the skin, thickening and swelling of the inflammation and rashes and conditions may prove to affect almost any part of the body including the hands, the face, the neck and the legs. In children, these patches of redness may also be seen on the inner creases of the knees and elbows.

Itching during eczema leads to irritation, eliciting scratching by the individual that may further lead to bleeding or ooze of fluid as well. It may also prove to open up the sores and subsequently lead to the development of crusts on top of the area that may get infected all over again.Some of the factors which may prove to worsen the signs and symptoms of eczema include the following:

  • Taking long baths with hot water can cause excessive dryness of the skin
  • Scratching of the patches further damages the skin surface to a great extent
  • Infection of the inflammation by bacteria or viruses is quite common
  • Taking excessive stress is also detrimental and can prove to worsen conditions significantly
  • Sweating can lead to significant discomfort to the rashes
  • The rashes also prove to react to any sudden changes in humidity and heat levels
  • The use of cleaners such as detergents, soaps and cleaners can cause a lot of irritation to the skin surface
  • Wool as present in blankets, clothing and even carpets can prove to irritate the skin surface
  • Pollutants in the air including pollen, dust and smoke such as cigarette smoke can also cause irritation on the rashes
  • Some food types such as milk, eggs, soybeans, peanuts, wheat and fish can prove to cause irritation in infants and young children suffering from eczema

Precautions in case of Eczema

While Eczema is not a life threatening condition, it may prove to cause a lot of discomfort in individuals and may also be associated with some nasty complications [4]. The condition also does not have any definite cure and it is best to know as much about the methods of precaution to be observed if infected by the condition. Individuals are recommended need to consult a professional and licensed physician at the earliest in case:

  • There is a rash on the surface of the skin that is dry and itchy, with the individual having a history of eczema, hay fever or asthma in the family.
  • The treatment with hydrocortisone creams does not reduce inflammation or rashes on the skin.
  • There are blisters filled with pus, or the appearance of a yellowish brown crust over any existing patches of eczema. The possible cause of this is bacterial infection.
  • Contact with a person with viral infection such as genital herpes is made during an eczema flare. In such a case, the risk of contracting herpes simplex virus is significantly higher.
  • The inflammation and patches on the skin are accompanied with numerous small, painful and fluid-filled blisters. These may be signs of eczema herpeticum, a serious complication which needs to be provided with immediate care.

Complications of Eczema

Some of the complications that are commonly associated with eczema include:

  • Eczema sometimes precedes the onset of asthma or hay fever
  • Eczema may lead to neurodermatitis, a chronic condition in which the skin surface becomes discolored, thick and scaly due to excessive itching and scratching
  • Frequently scratching he skin can rupture the surface, making the sufferer prone to a number of skin infections
  • There may be a number of eye complications that can be associated with eczema if the rashes occur around the eyes and it may further lead to conjunctivitis or blepharitis
  • Workers who are subject to using a lot of harsh chemicals such as those found in disinfectants and detergents can cause an irritating form of dermatitis to develop on the skin surface of the hands
  • Sufferers of eczema may also face allergic reactions to some drugs including corticosteroids which are used to treat dermatitis
  • The quality of sleep can be greatly reduced due to repeated itching and scratching of the skin
  • When a child suffers from eczema, certain studies have demonstrated a link between ADHD and eczema, especially if the child is losing out on sleep

Treatment of Eczema

Eczema, unfortunately, has no definite cure and managing the condition and treatment of the signs and symptoms of the disease are the only ways of controlling eczema.

Some of the widely agreed upon necessary treatment measures available for treating eczema include:

  • Application of corticosteroids: These creams or ointments should be applied to the rashes immediately after a bath under your doctor’s prescription and direction.
  • Use of anti-histamines: Anti-histamines such as hydroxyzine are highly recommended in order to reduce the itching of the rashes.
  • Immunomodulators such as pimecrolimus and tacrolimus are newer drugs to have come out that can help reduce itching in case of a severe rash. These drugs modulate the immune system and prevent the exaggerated response of the body to an allergen. However, these drugs should only be taken under doctor’s prescription.
  • Using moisturizers: It is always recommended to keep the skin highly moisturized during eczema. It helps reduce the sensitivity and itchiness that can be felt on the ashes.

Prevention of Eczema

As there is no definitive cure to the condition of eczema, it is best to prevent the occurrence of the disease. Eczema can be avoided by following a number of preventive measures which may include:

  • Avoiding contact with irritants such as detergents, dust, pollen and chemical solvents among others.
  • Avoiding the use of antibacterial or deodorant soaps which can greatly dry up the skin. It is always advised to use mild and gentle soaps.
  • Avoiding taking up too much stress.
  • Wearing gloves and covering exposed parts of the body while going out in the sun.
  • Using moisturizers and other lubricants to avoid dryness of the skin. For best results, it is recommended to do this at least twice a day. Individuals with extremely dry skin may also resort to using baby oil in order to keep the skin moist for longer.
  • Wearing light cotton clothes rather than heavy synthetic fabrics which prove to be milder on the skin.
  • Using mild soaps and more preferably soaps with glycerin or moisturizers.
  • Avoiding contact with people with viral infections such as herpes simplex.
  • Individual sufferers of eczema may have different triggers for their symptoms. These triggers must be identified and avoided as far as possible.
  • Avoiding taking long baths and avoiding the contact of the rashes with hot water.
  • Drying the skin thoroughly after taking baths with a soft towel, followed by the use of a thick skin moisturizer such as eucerin, nutraderm or cetaphil is quite helpful in preventing bouts of eczema.
  • It is best to seek professional medical attention at the earliest in case you suspect that your skin may be infected and if you are also suffering from a fever [5]. Eczema can cause you a lot of discomfort during your daily activities such as sleeping and dryness, itching and pain of the skin. If you feel that the condition is proving to affect your vision or if you have already tried methods of self-care but failed, then professional medical consultation should be taken. While eczema may not prove to be very serious, it has some nasty complications associated with it and as such, it is best to diagnose the disease early and to adopt treatment measures as early as possible in order to shorten the course of the condition.

References


[1] Management of Patients with Atopic Dermatitis: The Role of Emollient Therapy, M. Catherine Mack Correa, Judith Nebus; PMC3449106- 2012 Sep 13- DOI: 1155/2012/836931, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3449106/


[2] Anthocyanins from bilberry (Vacciniummyrtillus L.) alleviate pruritus in a mouse model of chronic allergic contact dermatitis,KatsunoriYamaura, Maki Shimada, and Koichi Ueno; 3(3): 173–177.- 2011 Jul-Sep-DOI: 4103/0974-8490.85002, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193617/


[3] Clinical Validation of a New Triplex Real-Time Polymerase Chain Reaction Assay for the Detection and Discrimination of Herpes simplex Virus Types 1 and 2, HeideReil, ArianeBartlime, Jana Drerup, Thomas Grewing;10(4): 361–367.;- 2008 Jul-DOI: 2353/jmoldx.2008.070104, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2438206/


[4] Analysis of circulating γδ+ T cells in children affected by IgE-associated and non-IgE-associated allergic atopic eczema/dermatitis syndrome,C Cairo, E Arabito, F Landi, A Casati, E Brunett; 141(1): 116–121-2005 Jul-DOI: 1111/j.1365-2249.2005.02813.x, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1809419/


[5] Inhibition of NK cell activity by IL-17 allows vaccinia virus to induce severe skin lesions in a mouse model of eczema vaccinatum,Yuko Kawakami1, Yoshiaki Tomimori1, Kenji Yumoto; 206 (6): 1219-8 June-doi: 10.1084/jem.20082835, http://jem.rupress.org/content/206/6/1219.short