Eczema

Eczema is recurring, itchy, long term inflammation of the skin. There is no cure to it, but it is usually manageable. Eczema usually begins in childhood, and can continue through adolescence into adulthood, although, the majority of people will outgrow the condition. The signs and symptoms of eczema vary from person to person. It can range from mild to where skin is dry, red, and itchy. The most severe occurs when the skin becomes broken, raw, and bleeding.

Eczema is often called the “itch that rashes” rather than the “rash that itches” because the itch will start long before the rash appears. The itch leads to a lot of scratching and that’s when the red, raw rash will appear.

Areas affected by eczema usually appear very dry, thick, or scaly. In fair skinned people, these areas will appear red and then turn brown. Whereas, in darker skinned people, the eczema can affect the pigmentation of your skin making the affected area lighter or darker.

The part of your skin that is affected will always be itchy. The rash is most commonly on the face, back of the knees, wrists, hands, or feet.

What to look for:

• Dry, sensitive skin
• Red, inflamed skin
• Very bad itching
• Dark coloured patches of skin
• Rough, leathery or scaly patches of skin (more chronic)
• Oozing or crusting
• Areas of swelling

The specific cause of eczema is still unknown. Children are more likely to develop eczema if a parent had it or another atopic disease (allergies and asthma).

Some potential causes to increase the chances of getting eczema would be:

Irritants – soaps, detergents, shampoos, disinfectants, juices from fresh fruits, meats or vegetables

Allergens – dust mites, pets, pollens, mold

Microbes – bacteria, viruses, certain fungi

Hot and cold temperatures – hot water, high and low humidity, perspiration from exercise

Foods – dairy products, eggs, nuts and seeds, soy products, wheat

Stress – not a cause of eczema but can make symptoms worse

Hormones – women can experience worsening of eczema symptoms at times when their hormone levels are changing, for example during pregnancy and at certain points in their menstrual cycle.

Eczema can occur at any age, but the risk is greater for infants and children. It is possible to develop eczema with or without a risk factor. Parents who suffer from allergic disorders, including eczema, asthma, and hay fever have a higher risk of having children with eczema. People who are also prone to allergies have a greater risk of developing eczema than those who do not have allergies. Some allergens that may be associated with eczema include plant pollen, animal dander, household dust mites, mold, and certain foods.

Atopic dermatitis (AD) is hereditary and the most common type of eczema. AD usually starts in infants and young children by itchy, inflamed skin, usually behind the knees, inside the elbows, and on the face, neck, and hands. AD typically begins in the first 6 months of the baby’s life. It is the most severe and long-lasting type of eczema. Often, AD disappears as a child grows older, although some children will continue to experience atopic dermatitis into adulthood.

Atopic dermatitis goes along with asthma and hay fever. People who have asthma and/or hay fever in the family are more likely to develop AD.

Contact dermatitis (CD) occurs when the skin comes in contact with a substance from the environment that you are allergic to. It may react by causing your skin to itch and become red. There are two types of contact dermatitis: allergic and irritant. An allergy occurs when the immune system reacts to a chemical. An irritant can be a strong soap or chemical.

Allergic contact dermatitis (ACD) occurs when the skin comes in contact with a new allergen. About 48 hours after contact with the allergen, the skin becomes inflamed. Poison ivy is the most common cause of ACD. Other common causes include metals, dyes, perfumes, and preservatives in cosmetics.

Irritant Contact Dermatitis is more common than ACD and is caused by repeated exposure to substances that chemically damage the skin. It can develop quickly when the skin touches an irritating chemical, is rubbed too hard, or comes in contact with heat. Examples of the irritants are harsh soaps, detergents, and cleaning products. These irritants remove oil and moisture from the outer layer of the skin, damaging the protective layer and triggering inflammation.

Dyshidrotic Eczema is a recurrence of multiple tiny, intensely itchy water blisters on the palms, side of the fingers, toes, palms, and soles of the feet. Stress, allergies, moist hands and feet, and contact with nickel, cobalt, or chromium salts may be triggers of dyshidrotic eczema.

There is no cure for dyshidrotic eczema, but it is manageable.

Nummular eczema are multiple, round plaques of eczema that are usually associated with dry skin and occur on the outer surfaces of the hands, arms, and legs. The spots can be very itchy or not itchy at all. They can also be very dry and scaly or can become wet and open.

The cause of nummular eczema is unknown, and it doesn’t run in families. It can be triggered by an insect bite, a reaction to inflammation elsewhere on the body and by dry skin in the winter.

Seborrheic eczema is a yellowish brown, greasy, scaly patches on the scalp, eyebrows, nose, and chest. Seborrheic dermatitis appears on the body where there are a lot of oil producing glands like the upper back, nose, and scalp. People of any age can develop seborrheic dermatitis including infants.

Seborrheic eczema can be triggered by stress, hormonal changes or illness, harsh detergents, solvents, chemicals and soaps, and by cold and dry weather.

Stasis dermatitis is a chronic eczema on the inner area of the lower legs, and it is associated with varicose veins. This causes pressure to build up as the blood tries to flow through the distorted veins up to the heart. This then leads to swelling with the rash on the legs.

Dry Skin – when your skin gets too dry, it can easily become brittle, scaly, rough, or tight, which can lead to an eczema flare up.

Irritants – these are everyday products and even natural substances that can cause your skin to burn and itch, or become dry and red. An irritant can be something that you would use on your body or in your home in everyday life. For example, hand and dish soap, laundry detergent, shampoo, bubble bath and body wash, or surface cleaners and disinfectants.

Stress – some people’s symptoms get worse when they’re feeling stressed. Whereas others may become more stressed just knowing that they have eczema, which can cause a flare up.

Research into new treatment for mild to severe eczema is very active at present. New non-steroidal topicals are being tested for mild disease as well as oral injectable therapies for moderate to severe disease. The future of safer, effective treatments appears to be promising.

Most patients with eczema require a combination of treatments.

Eczema is very visible, since it is very common on the hands and face. It is therefore visible to many people who know nothing about this skin condition. The more you know about your condition, the better you will be about answering questions and help educate people who know nothing about eczema.

Eczema is a chronic disease, which means that it can be managed, but not cured, if you establish a routine that works for you and stick to it.

You should be aware of your eczema triggers. Many things can trigger a flare up of eczema, from scented products to dust mites. The important thing to do is to learn what your triggers are and then try to avoid them. Moisturizing your dry and itchy skin is one of the best ways to help keep your eczema under control. Use your moisturizer often, especially after washing and bathing. Don’t scratch your eczema patches, when you scratch it can damage your skin and lead to an infection, watch your stress levels when it comes to living with eczema. Stress can cause a flare up of your eczema and it will lead to more stress.

Bleach Baths

Bleach baths are used to help manage eczema. Adding bleach to your bath water will help control the skin bacteria.

How to make a bleach bath:

• Add 60 to 120ml (¼ to ½ cup) of regular household bleach (406^ sodium hypochlorite) to a full bathtub of warm water.
• Mix the bleach and water well
• Bathe in the solution for 5-10 minutes. Do not submerge your head.
• Rinse the skin well with warm water, and then pat the skin with a soft towel, and MOISTURIZE

These bleach baths should be taken 2-3 times a week.

There are many moisturizers available including creams, lotions, and balms. Some are better than others. This should be discussed with your dermatologist. The bottom line is the best moisturizer is one that you would use regularly.

Hand eczema, also known as hand dermatitis, is a common condition that affects about 1 in every 20 people. Genetics and contact allergens play a large role in triggering hand eczema. It can start in childhood but is very common in adults. It often affects people who work in cleaning, catering, hairdressing, healthcare, and mechanical jobs where they come in contact with chemicals and other irritants and wash their hands frequently.

Hand eczema is not contagious, you cannot “catch” it from another person and spread it.

Treatments

Moisturizers play an important role in treating hand dermatitis. Moisturizers help repair the damaged skin and keep the moisture inside the skin making it soft again.

Soap substitutes are important if you have hand eczema, this is because they clean skin without damaging it.

Steroid creams and ointments are important if you have hand eczema. They help relieve symptoms and calm down inflamed skin. You will typically receive a stronger strength steroid as mild steroids do not work on thick skin.

Steroid tablets may also be given to you for a few weeks after a severe flare up of hand eczema.

Alitretinoin (Toctino) is a vitamin A derivative oral drug that is prescribed for severe chronic hand dermatitis. This drug can be life changing, but precautions must be taken due to potential side effects.