What is eczema?
Although the term eczema is often used for atopic dermatitis, there are several other skin diseases that are eczemas as well. A partial list of eczemas includes: atopic dermatitis, nummular eczema (coin shape), dyshidrotic eczema, seborrheic dermatitis, irritant contact dermatitis, and allergic contact dermatitis. All types of eczema cause itching and redness and some will blister, weep or peel.
Atopic dermatitis often affects people who suffer from asthma and/or hay fever or have family members who do. The word 'atopic' was originally used to describe the allergic conditions asthma and hay fever.
Atopic dermatitis is not contagious. It almost always begins in childhood, usually during infancy. Its symptoms are dry, itchy, scaly skin, cracks behind the ears, and rashes on the cheeks, arms and legs. It alternately improves and worsens. During flare-ups, open weeping or crusted sores may develop from scratching or from infections.
Atopic dermatitis is a common disease, present worldwide, though it is more common in urban areas and developed countries. An estimated 10 percent of all people are at some time affected by atopic dermatitis (this may not apply in the tropics). It affects men and women of all races equally.
Trigger factors may be different in different people. Most eczema patients can get worse when they have a cold or infection. Some patients have worse problems in the winter, while others simply cannot stand the sweating during hot, humid summer weather. Common eczema triggers include following:
- Dry skin – wind, low humidity, cold temperature, excessive washing without use of moisturisers, and use of harsh, drying soaps can all cause dry skin and aggravate eczema.
- Irritants – these are any substances outside the body that can cause burning, redness, itching or dryness of the skin.
- Allergens – these are materials (such as pollen, pet dander, foods, or dust) that cause allergic responses and can worsen eczema.
- Stress – people with eczema often react to stress (frustration, anger, fear, embarrassment) by having red flushing and itching. Eczema itself, and its treatments, are also a source of stress. The challenge is to recognise stress and find stress reduction techniques that work for you.
- Heat and sweating – Most people with atopic dermatitis notice that when they get hot, they itch. They have a type of prickly heat that doesn't occur just in humid summertime but anytime they sweat.
- Infections – Bacterial ‘staph' infections are the most common, especially on arms and legs. Such infections might be suspected if areas are weeping or crusted or if small ‘pus-bumps' are seen. If some lesions look different, consult your doctor.
Researchers have found that some people with eczema have a genetic defect that causes a lack of filaggrin in the skin. Filaggrin is a type of protein that helps form the protective outer layer of our skin. This skin barrier protects the body from germs and other foreign substances. A lack of filaggrin dries out and weakens the skin barrier. This makes skin vulnerable to irritants such as soap and detergents. A weak skin barrier also makes it easier for allergens like pollen to enter the body. Scientists believe that this exposure may cause sensitivity to allergens and even certain foods.
The most important treatment for dry skin is to put water back into it. The goal of bathing and moisturising is to help heal the skin. The best way to hydrate your skin is to have a brief bath or shower and to moisturise immediately afterwards.
Use of an effective moisturizer several times every day hydrates your skin and improves its barrier function. Moisturiser should be applied to the hands every time they are washed or come in contact with water.
Once inflammation begins, see your doctor as soon as possible, as prompt treatment is needed.
NOTE: SCRATCHING OPEN A HEALING LESION MAY RESULT IN SCARRING AND CAN EXACERBATE THE RASH