Eczema
See also:
Hand
Dermatitis,
Atopic
Dermatitis
What is it?
Eczema is an inflammation of the skin that may cause
dryness, flaking, and itching. Dermatitis is a term that
means inflammation of the skin, and is often used
interchangeably with eczema.
Who gets it?
Eczema occurs in both children and adults, but usually
appears during infancy. Atopic dermatitis often affects
people with a family history of allergies. Those who are
genetically predisposed and then exposed to environmental
triggers may develop eczema. Many people who have eczema
also suffer from allergic rhinitis (hay fever) and asthma,
or have family members who do.
What causes it?
There are many causes of eczema, but the most common is
a general allergic over-sensitivity, called atopy. This
sort of eczema is known as atopic eczema, and it is linked
with asthma and hay fever. These conditions often run
together in a family. Another possible cause of eczema is
contact with substances that irritate the skin chemically,
called irritant contact dermatitis. This is caused by
direct contact between the skin and the substance, which
might be adetergent, soap, diesel or engine oil, strong
chemical, cleaner, etc. Eczema can also be caused by
contact with substances that the body has become allergic
to, called allergic contact dermatitis. This type commonly
involves nickel, poison ivy, cosmetics, and rubber
products. Infantile eczema often affects young babies, and
is caused by moisture from drool or inflammation of the
scalp (cradle cap). Varicose veins can lead to a form of
eczema affecting the lower legs, called stasis dermatitis.
This is also known as varicose or gravitational eczema.
What are the symptoms?
Whatever the cause, eczema leads to itching and
redness, and may make the skin dry and flaky. Sometimes
itchy blisters form. The surface of the skin may become
moist and crusty if these blisters burst, or when
scratching damages the skin. Atopic eczema is often worse
in the folds of the skin where the limbs bend. The itch is
intense, but scratching only makes the symptoms worse.
Eczema makes the skin more sensitive, so you may notice
that you are more irritated by cosmetics, soaps,
detergents, etc. Eczema in infants is most commonly seen
as a patch below the chin or cradle cap.
How is it diagnosed?
Eczema is usually diagnosed through a physical
examination. If in doubt, or your doctor feels that you
need further tests, you may be referred to a skin
specialist, called a dermatologist. Further tests may
include skin biopsy, in which a small sample of the
inflamed skin is removed for testing, or patch tests, in
which little patches of different substances are stuck to
your skin for a few days to see if you react to any of
them.
What is the treatment?
There is essentially no cure for atopic eczema because
it involves a sensitivity of the skin that will always
remain to some degree. There are, however, a number of
approaches that help to minimize symptoms. The primary
treatment is to keep the skin moisturized using creams,
ointments, and shower and bath oils that help to replenish
the skin's natural protective oils. Your doctor may also
prescribe a cream or ointment containing a steroid. These
are very effective at reducing inflammation and itch. Your
doctor will want you to use this sparingly, and only while
the eczema is bad. There are different strengths of
steroid applications, and the tendency is to use the
lowest strength that the skin requires at the time in
order to minimize the risk of possible side effects. Oral
antihistamines may also be helpful in reducing the itch.
Your doctor will prescribe antibiotics if the skin becomes
infected, which it is more likely to occur when the skin’s
normal protective surface has been damaged. If your skin
does not improve, additional treatments might include
bandages and wet wraps, and drugs to suppress the immune
system. Phototherapy, which is ultraviolet light treatment
(UVB and PUVA), can also be used to treat atopic eczema.
If you have irritant or allergic contact eczema, it is
wise to avoid the chemical that causes it, if possible.
Self-care tips
If you have eczema, follow your doctor's treatment
recommendations and avoid known irritants.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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