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Dry, rough, and inflamed skin is a common issue faced by many. It might seem like a minor concern, however, it leads to physical discomfort, aesthetic problems, as well a loss of confidence and self-esteem. Eczema is a prevalent cause of dry, flaky, and irritated skin worldwide. This blog is a detailed guide about eczema, its mechanisms, types, treatment options, and prevention guidelines, so patients can find relief and are one step closer to achieving better skin health.
What is Eczema?
Eczema is a type of dermatitis. It is sometimes referred to as Atopic Dermatitis. It is a skin condition that leads to inflamed, dry, flaking, rough, and irritated skin. Eczema is more common in children, however, there is no set age limit for developing it. It can happen to anyone at any point in their lives. It has a chronic course, and flare-ups occur frequently. Individuals with eczema either have or are highly prone to developing other atopic conditions like food allergies, asthma, or hay fever.
Eczema occurs due to damage to the skin barrier, which allows moisture to evaporate and bacteria and other irritants to enter the body. This can happen due to a faulty gene that is responsible for the skin‘s integrity or due to the overgrowth of Staphylococcus aureus bacteria on the skin.
What are the Types of Eczema?
There are several types of eczema. The answer to what causes eczema lies in its classification.
Atopic Dermatitis
This is the most frequent type of eczema, commonly encountered in children. It typically presents as a triad along with asthma/hay fever, and allergies.
Contact Dermatitis
This type of eczema is triggered when an irritant or allergen is touched. Tends to occur due to substances like soap, detergents, fragrances, chemicals, and even certain paints. Contact dermatitis is a common cause of hand eczema.
Dyshidrotic Dermatitis
Dyshidrotic dermatitis is triggered due to stress, moisture, or physical contact with an irritant like detergents, or metals (nickel, cobalt). It is characterized by clusters of small blisters on the hands, sides of fingers, and feet that are itchy and inflamed. It is a frequent cause of eczema on the hands.
Discoid Dermatitis
Also known as nummular dermatitis, this type of eczema results in round or oval areas of irritated skin, hence the name discoid dermatitis. It may occur after a scratch or insect bite.
Seborrhoeic Dermatitis
This type of eczema causes inflamed, greasy flakes on the skin of the scalp, chest, and face. It is believed to occur from a combination of an overactive immune response and a fungal infection.
Eczema Herpeticum
Eczema herpeticum occurs when the Herpes Virus (HSV-1) gains entry into the body through dry and broken eczematous skin. It is a rare condition and is considered a medical emergency in people at extremes of age (infants, older individuals) and those with compromised immunity.
Baby Eczema
Baby eczema or infantile atopic dermatitis is frequently seen in infants. Symptoms include dry, rough, scaly, and itchy skin. The areas most frequently affected by baby eczema are the scalp, forehead, cheeks, torso, arms, and legs.
Hand Eczema or Irritant Hand Dermatitis
Usually occurs in people with chronically moist or wet hands exposed to harsh chemicals of soaps, detergents, and other cleaning materials.
Neurodermatitis
This type of eczema is triggered by stress and irritation. It is very itchy, and repeated trauma from itching leads to a leathery and thick appearance of the affected area. It is also called Lichen Simplex Chronicus.
Who Does Eczema Affect?
People at risk of developing eczema include those with:
Positive family history (Eczema, Hay fever, Asthma)
Susceptible age (more common in children)
Living in polluted environments (dust mites, pollen, fragrance)
Living in low humidity or fluctuating weather conditions
Have damage to the skin barrier
Suffer from stress, fatigue, and anxiety
Hormonal fluctuations (Pregnancy, Menopause, Menstruation)
How Common is Eczema?
Eczema is a fairly common skin condition that millions of people suffer from worldwide. According to the National Eczema Association, 10% to 20% of children and 2% to 10% of adults suffer from eczema all over the world. Atopic dermatitis is the most prevalent cause of eczema globally, while chronic hand eczema occurs in 14.5% of the population. Eczema is a debilitating skin condition and is more commonly encountered in childhood, with almost 80% of cases presenting before the age of 6 years. Itching is the most commonly reported and experienced symptom of eczema (atopic dermatitis).
What are the Symptoms of Eczema?
The symptoms of eczema are not related to one part of the body. It can occur anywhere, including hands, feet, eyes, scalp, etc. It starts before the age of 5 years in most patients, and carries into adulthood, although adult-onset dermatitis may also occur. Typical symptoms experienced in eczema include:
Dry, damaged, and cracked skin
Itching and flaking
Rash
Blisters and bumps
Swelling
Oozing clear fluid/crusting
Increased skin thickness (mechanical trauma due to itching)
Rough texture
Pigmentation around the eyes (Eye eczema)
Increased skin sensitivity
Secondary infections due to a damaged skin barrier
Eczema symptoms and its course are not the same in everyone. Some people are free of active disease for a long time after treatment while others frequently suffer from recurrences.
How is Eczema Diagnosed?
The first step for eczema diagnosis is to take a detailed history and perform a thorough physical examination to rule out any other cause for the symptoms. Along with relevant clinical findings, other tests to make a diagnosis of eczema include a patch test or allergy test, skin biopsy, and blood tests to exclude other causes.
Eczema treatment is not one size fits all. For effective management, the treatment is catered to individual patient needs and requirements. The treatment options include the use of gentle hand/body washes and moisturizing frequently. Eczema creams for topical application usually include corticosteroids and ingredients that will protect and maintain the skin barrier. For more severe or chronic cases, the dermatologist may prescribe oral medications like oral corticosteroids, antiallergics, immunosuppressants, or anti-inflammatory medications.
