Find in-depth all you want about eczema including causes, symptoms, diagnosis, treatments, and preventing flare-ups.
Eczema is an inflammation of the skin that tends to flare up from time to time. The severity of eczema ranges from mild to severe. The Bad news that there is no cure but treatment can control or ease symptoms. Moisturizers and steroid creams or ointments are the common treatments.
What’s Causing Eczema?
Eczema is caused because of the inability to repair damage to the skin barrier. This is due to a mutation in the gene called filaggrin which is important for formation of the skin barrier. Every cell in your skin has two copies of the filaggrin gene. But people who are susceptible to eczema have only one copy of this gene.
you need only one copy of the gene to form a normal skin barrier; however, two copies are important for skin barrier repair. If your skin is exposed to irritants and their skin barrier is affected, you with only one copy of the gene may find that their ability to repair the skin barrier is limited.
Once your skin barrier is disrupted, moisture leaves your skin and the skin will become dry and scaly. Moreover, environmental allergens can enter your skin and activate the immune system producing inflammation which makes your skin red and itchy.
If your family has a history of eczema or allergic conditions, you are more likely to get eczema.
In most cases, eczema is not caused by diet. If you feel a food is to blame, see your doctor for proper allergy testing and advice.
Eczema causes stress, and stress will increase the energy with which you scratch, stress does not in itself cause eczema.
What are the Symptoms of Eczema?
- Dryness of the skin.
- Some areas of the skin become red and inflamed, such as the front of the elbows and wrists, backs of knees and around the neck. However, any areas of skin may be affected. Commonly, the face is affected in babies with eczema.
- Itchiness of the skin. If you scratch, it will cause patches of skin to become thickened.
- The inflamed areas of skin can become blistered and weepy.
- The inflamed areas of skin can become infected.
Inflamed areas of skin tend to flare up from time to time and then settle down. The severity of flare-ups varies from time to time in the same person and from person to person.
- In mild cases, a flare-up cause just one or two small, mild patches of inflammation.
- In severe cases, the flare-ups will last several weeks or more covering many areas of skin.
- Many people with eczema are somewhere in between these extremes.
Types of Eczema
Why atopic eczema develops is something still unknown exactly in some people; however, research has shown that a combination of genetic and environmental factors plays a part.
In atopic conditions, your body’s immune system overreacts to things which would not normally do any harm, such as environmental factors that are all around us, such as irritants and allergens which make your skin inflamed and itchy. Dryness of your skin in atopic eczema is due to a defective skin barrier.
Atopic eczema in children
Atopic eczema is the most common form of eczema in children; however, it affects people of all ages. Most children with eczema find that their skin improves as they get older. In some children, the eczema will clear, but there is no way of telling in advance whether this will happen. As a general rule, children with eczema is more severe tend to retain the condition into adulthood. The eczema may improve significantly, but people who had atopic eczema as a child usually have ‘sensitive’ skin as adults.
How does atopic eczema look like?
Atopic eczema is a dry skin condition. It may make your skin red and sore called a ‘flare-up’. Your skin may calm down for a time, but tends to be dry and itchy. The chief characteristic of atopic eczema is itch. It can be almost unbearable making you want to scratch, especially at night, which interrupts sleep. Atopic eczema can cause developing large or small patches in any body area, which usually start on the face in babies affecting the skin creases, neck, back of the knees, inside of the elbows and the wrists
What are Triggers of Atopic Eczema?
Flare-ups are often the result of triggers. Triggers are not the same for everyone. Below are the most common triggers:
- Soap, detergents and perfume.
- Changes in temperature, humidity and sweating
- House-dust mite droppings
- Skin infection
- Tree/grass/weed pollens
- Animal dander (fur, hair) and saliva
- Synthetic clothing
Identifying what your triggers will help you to take control of your eczema. The bad news that what has provoked a flare-up is not always immediately apparent.
Itchiness of Atopic Eczema
As we mentioned, itch is the chief characteristic of atopic eczema which, sometimes, can be almost unbearable leading to sleep loss, frustration, stress and depression.
It is important to acknowledge that atopic eczema can affect whole family, not just the person with eczema. Actually, there is no known cure for atopic eczema. However, when it is well-managed, it is possible to limit its impact on day-to-day life.
What is the common treatment for atopic eczema?
The common treatment consists of three parts:
- Avoiding irritants to your skin and other triggers.
- Using moisturizers every day to help prevent inflammation developing.
- Taking Steroid creams and ointments when inflammation flares up.
Contact eczema or contact dermatitis occurs as a result of contact with irritants or allergens in the environment. Contact dermatitis is the most common type of work related skin disease. It is also known as occupational skin disease.
There are two types of contact dermatitis:
- Irritant Contact Dermatitis
It is a reaction to frequent contact with everyday things that irritate the skin, such as soap, detergents, bleach, cold wind and food.
Common areas for irritant contact dermatitis are the hands and face; however, the condition can affect other parts of the body. One who had atopic eczema as a child is at an increased risk of developing irritant contact dermatitis.
The symptoms of irritant contact dermatitis ranged from mild dryness and skin redness to the appearance of skin burns. It can be painful, red, fluid-filled and ulcerated.
Weak irritants are the commonest cause of irritant contact dermatitis, for example, diluted acids, diluted alkalis, solvents, soaps, detergents, metallic salts, cement, resins and cutting fluids.
Occupations at greatest risk of developing irritant contact dermatitis including: chefs, hairdressers, metal workers, nurses, cleaners and construction workers
- Irritant Hand Eczema (Hand dermatitis)
There many reasons why eczema occurs on the hands. Adults with a history of atopic eczema may find that in later life the condition reappears on their hands due to contact with irritants such as cleaning agents or white spirit.
Hand dermatitis is reaction that known as irritant contact eczema. It can occur in anyone who uses substances of this kind in their everyday life and those who have a history of atopic eczema.
- Allergic Contact Dermatitis
Allergic contact dermatitis is less common than irritant contact dermatitis. Minute quantities of apparently harmless substances can cause severe allergic contact dermatitis.
It is caused by an individual developing a specific allergy to a chemical. The repeated exposure to the chemical is required over a period of time for allergy to develop. Once this has happened, your body’s defense mechanisms learn to recognize the chemical. So, you will develop a reaction when the chemical contacts your skin again. The allergy is ‘remembered’ by your body for many years. In medical terms your body has become ‘sensitized’ to a chemical.
This reaction can be immediate or delayed depending on allergen in question. Most commonly seen on the hands, allergic contact dermatitis may cause your skin to become dry, red, split, cracked, weeping, fluid filled and intensely itchy, sore, painful and stinging.
Allergic Hand Eczema (Allergic Hand Dermatitis)
Allergic hand dermatitis occurs either on its own or against a background of atopic eczema. It makes the hands often scaly, dry and itchy and can be accompanied by blistering, soreness or splits in the skin. Below are common ‘sensitizers’ including:
- Nickel which found in many jewelry items, studs of jeans, zips and watch straps
- Perfumes which found in cosmetics and toiletries
- preservatives that found in cosmetics, toiletries, topical medicines such as creams, eye and ear drops.
If you suspect that you have allergic hand eczema, you need to see a dermatologist for possible patch testing.
Nickel sensitivity is very common, especially in women. Anyone can become allergic to nickel. However, more cases begin during the teenage years when girls start to wear cheap metal jewellery. It is possible to become allergic to nickel later on in life. For no reason, people who have been in contact with nickel for many years can suddenly become allergic to it.
Actually, we don’t know why some people become allergic to nickel while others don’t. However, those with certain jobs are commonly become sensitive to nickel. These job can include: hairdressing, nursing, catering, cash handling and those handling metals.
The rash can start in one place or in many places on the body at the same time. Normally, the rash appears wherever the nickel is in close contact with your skin, but it is possible for the rash to spread so that later on even areas that haven’t come into contact with the metal become red and itchy.
Once an allergic rash due to nickel develops on a particular part of the body, it is possible for the rash to spring up again on that area whenever the body comes into contact with nickel.
Seborrhoeic dermatitis in adults
Adult seborrhoeic dermatitis usually starts on the scalp as dandruff which can progress to redness, irritation and increased scaling. The eczema may spread onto the face and neck as the scalp becomes inflamed.
Seborrhoeic dermatitis can be particularly bad behind the ears. Larger and greasy scales stick to your skin and surrounding hair making the area look thickly crusted. The ear folds and canal cab also be affected causing irritation inside the ear, which is called ear eczema.
Seborrhoeic dermatitis usually occurs only on the scalp and face; however, it can extend to the centers of the chest and back. Other areas which can also be affected are the armpits, under the breasts, groin and between the buttocks and genitals.
What’s causing Seborrhoeic dermatitis?
The cause of seborrhoeic eczema is not clear; however, it is thought to be an inflammatory reaction related to an overgrowth of normal skin flora, species of malassezia yeasts. Seborrhoeic dermatitis cannot be cured because once a person is sensitized, malassezia on the skin will cause a reaction. However, with treatment, the condition can be controlled in most cases so that the skin and scalp are comfortable.
Infantile Seborrhoeic Dermatitis
Infantile seborrhoeic dermatitis (seborrhoeic eczema) is a common skin condition in infants under the age of one year. It appears suddenly between two weeks and six months after birth. Commonly, it affects the scalp when it is commonly called cradle cap. However, the face, ears, neck, flexural folds and nappy area may also be affected.
How Does Infantile Seborrhoeic Dermatitis Look Like?
Thick, yellow, waxy scales develop on the scalp that stick to the hair and are difficult to remove. In the nappy area, the baby’s bottom looks red, inflamed and flaky. There are small, white skin scales that tend to rub off easily giving the skin a shiny appearance. The redness can extend into the baby’s skin folds at the tops of the legs, around the genitals and between the buttocks. Then, it can spread quite rapidly and widely.
On other areas of the body, as the face, flexures and trunk, there are small, dry, salmon-pink patches that join up to cover larger areas.
What’s Causing Infantile Seborrhoeic Dermatitis?
The exact cause of infantile seborrhoeic dermatitis is not known. However, it is believed to be linked to developing sebaceous glands. Infantile sebhorroeic dermatitis is not contagious and is not a serious condition. It is not often itchy and looks far worse than it is. Therefore, your baby should feed, play and sleep as usual, without any problems. Commonly, it will resolve within weeks to a few months. For those infants for whom the condition does not resolve on its own, there are some simple treatment measures.
Cradle cap is a skin condition in which young infant has a thick, scurfy scalp. It usually occurs around birth or in the first couple of months of his life and is not seen again after the first year. It starts with the scalp becoming thickly coated with greasy yellowish scales which stick to the head making it look crusted. The eyebrows can be scaly and the forehead, temples, neck fold and behind the ears can also be affected. Cradle cap looks unsightly; however, it is not itchy and causes no discomfort to your baby.
It is also known as nummular dermatitis. Discoid eczema is usually seen in adults with dry skin. However, it can affect teenagers and young children. It is very distinct with ‘coin shaped’ discs of eczema the size of a fifty pence piece which start off slightly bumpy, usually on the lower legs, trunk or forearms. Within a few days, the patches begin to ooze, and can become very itchy, crusted and infected. Then, the surface becomes scaly and the center of the discs clear leaving the skin dry and flaky.
What’s Causing Discoid Eczema?
Like most types of eczema, the exact cause is unknown. However, dry skin is the most common feature seen in people with this condition. The use of soaps and detergents, and previous experience of atopic eczema can play a part.
It is also known as dyshidrotic eczema. Blistering is the key characteristic of this form of eczema that is restricted to the hands and feet. Pompholyx eczema is a type of eczema which is restricted to the hands and feet. In most cases, it involves the development of intensely itchy watery blisters affecting the sides of the fingers, the palms of the hands and the soles of feet. It can occur at any age; however, it is most common before the age of 40 years.
The skin will be very itchy with a burning sensation of heat and prickling in the palms and soles. It is followed by a sudden crop of small blisters which turn into bigger weepy blisters and can become infected, causing redness, pain, swelling and pustules. There is subsequent peeling as the skin dries out, and then the skin can become red and dry with painful cracks. Pompholyx eczema can also affect the nail folds and skin around the nails causing swelling.
What causing Pompholyx Eczema?
Basically, the exact cause of pompholyx eczema is still not known. However, it is thought that factors such as emotional tension, sensitivity to metal compounds, heat and sweating can develop this condition. 50% percent of people with pompholyx have atopic eczema, or a family history of atopic eczema. Pompholyx eczema can coexist with fungal infections.
The hands and feet are areas of the body that are also prone to contact dermatitis. This can take one of two forms irritant contact dermatitis or allergic contact dermatitis. The reaction could be the result of contact with potential irritants causing irritant contact dermatitis. Or it could be an allergic reaction to a substance that is not commonly regarded as an irritant causing allergic contact dermatitis. If you identify a pattern, which suggests that your hand and foot eczema can be a contact eczema. You need to tell your healthcare professional as allergy patch testing may be appropriate.
It is also known as “eczema cracquelée”. Asteatotic eczema always affects people over the age of 60.
The cause is not known. However, asteatotic eczema can be linked to a decrease in the oils on the skin surface, low humidity, over cleansing of the skin, hot baths, scrubbing the skin and vigourous towel drying. Pre-existing dryness and roughness of the skin can also be linked to this type of eczema.
Initially, asteatotic eczema appears on the shins with a ‘crazy paving’ appearance. Fissures can also appear which look pink and red, but tend to affect the superficial layers of the skin. Other areas that can be affected are upper arms, thighs and lower back. It can cause a great deal of discomfort that include soreness and itching.
It is also known as gravitational or stasis eczema. This type of eczema is common in later life, particularly in women. However, it can occur from the teenage years onwards.
If you have poor circulation, have varicose veins, have had a blood clot in your legs, have had phlebitis or cellulitis in the past or are overweight you are at risk of developing varicose eczema.
The pressure of the blood in the veins is greater in the lower legs than anywhere else in the body when you stand up because humans walk upright.
In active adults, the return of blood to the heart through the leg veins is good because muscle activity will help to push blood along. However, as we get older and less active, the blood moves less well up our veins and collect in the lower legs.
If the leg vein walls are weak, they cannot withstand high pressure in them and varicose veins develop. If someone in your family has varicose veins, the chances for you of developing them are higher. If you spend a lot of time standing up or sitting with your legs in one position, the tendency to develop varicose veins is greater. If you are overweight or pregnant, your chances are increased even further. Other conditions, such as a blood clot in the leg vein that can occur during a period of inactivity, or inflammation of the vein wall can weaken the leg veins and damage the valves which direct the flow of blood through them. Cellulitis can weaken the veins and lymph vessels causing the venous system to function less efficiently. All these conditions make the leg veins less able to contain the pressure of blood in them, causing problems, sometimes years later.
If the vein walls are weakened and the blood moves sluggishly up the leg veins, fluid can pool in the lower legs and ooze through the vein walls into the surrounding space causing the ankles to swell. Then, fluid can leak through the very small vessels, causing red‐brown speckled spots to appear on the skin which becomes hot and itchy and tiny blisters can also appear. Over time, if left untreated, your skin can develop eczema, with red, itchy spots, dryness and flaking. The skin can change in color and become weepy with some skin crusting.
When the eczema settles, your skin may later crack if it becomes over‐dry, or break down if scratched or picked. Generally, the skin on the lower leg becomes fragile.
What causing a varicose ulcer?
A leg ulcer is a small hole in the skin that can deepen and widen and become very sore. It can easily be infected and can be difficult to heal especially in those with poor circulation. The skin that affected by varicose eczema is thin and unhealthy and can easily break down. The area should be treated to help the skin heal quickly.
If left untreated, the small hole can deepen and widen more and more, and the resulting wound is called a ‘varicose ulcer’. Sometimes events can occur the other way around, varicose eczema can develop for the first time around an existing ulcer or wound on the lower leg. However, treatment remains the same.