All You Need to Know About Eczema

Rashes, itchiness, dry skin, scaly patches, blisters and skin infections are symptoms that characterise a group of inflammatory skin conditions known as eczema.

Types of Eczema

Types	Description
Atopic dermatitis (eczema)	Skin feels dry, itchy, inflamed. Can occur anytime in life but usually starts during childhood. Not contagious.
Contact dermatitis	An allergic reaction when the skin comes in contact with allergens that irritate it. Skin feels itchy, having rashes or blisters. Not contagious.
Seborrheic dermatitis	An inflammatory skin condition that is described as a papulosquamous appearance in regions abundant in sebaceous glands, especially the scalp, face, and body creases.
Dyshidrotic eczema	Small, extremely itchy blisters (pompholyx) on the hands or feet. These blisters can last for a period of three to four weeks before they disappear.
Neurodermatitis (lichen simplex chronicus)	Begins with an itch, but once scratched, it will lead to a rash. Most people will have one or two itchy patches, but in most cases, they require treatment.
Nummular eczema (discoid eczema)	Characterised as coin-shaped spots that can be itchy red or brown patches. In severe cases, oozing or crusting may occur. Dry skin, insect bites, or injury are triggers to this condition.
Stasis dermatitis (venous eczema)	Poor circulation in the lower legs (venous insufficiency) is the cause of this condition. Venous insufficiency is caused by the valves in leg veins that assist in pushing blood back to the heart weaken and leak fluid.

Risk Factors of Eczema

Genetics

Research found out that some people with eczema also have a mutation within the gene responsible for the production of filaggrin. Filaggrin is a protein responsible for maintaining a healthy protective barrier on the outermost layer of the skin.

Deficiency of this protein may lead to loss of moisture, thus making the person’s skin more susceptible to bacteria, viruses, and allergens entering the body. Lack of filaggrin causes the person to experience intense itchy skin, dry scaly patches of skin, blisters, skin infection, red spots or bumps, and other symptoms.

Immune system

Eczema is not under the classification of autoimmune disease as the immune system does not directly cause the disease. However, flare-ups caused by the immune system are a factor because they weaken the skin barrier, making the person more vulnerable to skin conditions.

Environmental triggers

Staying in intensely cold, damp, or hot swampy places may increase the risk of a person developing eczema. Itching, rashes, and other symptoms can be provoked by sweating that is caused by the warm weather, outdoor allergens, and increased exposure to sunlight.

Emotional triggers

Common triggers to eczema flare-ups are anxiety and stress, thus leading to an increase in anxiety and stress as well and this leads to a cycle of eczema flare-ups.

Eczema Symptoms

Infants and young children

Eczema among infants and young children is easily noticeable, as it usually appears on the face, elbows, and knees. Signs of eczema can be commonly identified by itchiness, dry, and scaly skin, along with redness and swelling. Small bumps are developed as well, and once scratched, it will lead to them being open and weeping.

Older children and adults

Eczema in older children and adults shows signs of it appearing on their hands and feet, arms, and back of the knees. Not all patches of dry skin are indicators of eczema, as the development of dry skin can be caused by the sun, air conditioning, and pool and salt water.

Triggers of Eczema Flares

Triggers of eczema flare-ups vary from person to person, these include:

Irritants: Soaps, detergents, shampoo, washing liquid, and bubble baths.
Environmental factors: Cold, dry weather, and humidity that may cause sweating.
Allergens: House dust mites, pet fur, pollen, and mould.
Food allergies: Cows’ milk, eggs, peanuts, soya, and wheat.
Specific materials worn against the skin: Wool and synthetic fabrics.
Stress.
Hormonal changes.
Skin infections.

Diagnosing Eczema

A person’s medical history, physical examination, and, occasionally, additional tests are needed to diagnosing eczema.

There are questions that your doctor may ask during the diagnosis:

Do your blood relatives have atopic dermatitis, asthma, or hay fever?
What symptoms are you (is your child) experiencing?
When did the symptoms start?
Which area of your (your child’s) skin does the atopic dermatitis appear?

These are some additional tests to help support the diagnosis or rule out other conditions:

Patch tests: To identify allergens.
Skin prick testing: To identify allergic reactions to specific substances immediately.
Blood tests: To measure the levels of IgE and eosinophils, as allergic conditions can increase their levels, including atopic dermatitis.
Skin biopsy: To confirm the diagnosis or exclude other skin disorders in rare cases.

Treatments for Eczema

Currently, there are no known cures for eczema, but there are treatments available to manage or reduce its symptoms. Consult a dermatologist to know the most effective treatment for you or your child’s condition.

Types	Description
Topical treatments	Topical corticosteroid: Applied on the skin to decrease inflammation within a few days. Emollients: Moisturising treatments applied on the skin to decrease water loss and to cover it with a protective film. Colloidal oatmeal: Possesses antioxidant and anti-inflammatories properties, which may provide the mechanisms for observed dermatological benefits. Calamine lotion: Primarily consists of calamine, zinc oxide, and glycerine. It has astringent, antipruritic, antiseptic, haemostatic, antibacterial, moisturising, and protective qualities beneficial to manage skin exudation, rashes, and itching. Coal tar: An antibacterial medication applied to the skin and scalp to treat itching, irritation, and dry patches (scaling and flaking). This medication is available in a variety of forms, such as cream, ointment, scalp, lotion, shampoo, or a liquid additive to your bath (emulsion additive). Wet wraps: In rare cases, your doctor may recommend the use of medicated bandages, clothing, or wet wraps to wear over parts of skin impacted by eczema. This method is used over emollients or with topical corticosteroids to stop scratching, allow the skin underneath to heal, and prevent it from drying out.
Oral medication	Oral corticosteroids: A short-term treatment against severe flare-ups to reduce inflammation. Oral immunosuppressants: To control moderate or severe eczema cases that are not reacting to other treatments. Antihistamines: This is used at night to help manage the itching. Biologic drugs: This medication is injected to help reduce inflammation for moderate to severe atopic dermatitis as it targets specific pathways in the immune system.
Relaxation techniques	Engage in light exercises like yoga or tai chi. Go outside for a stroll around the neighbourhood or park. Indulge in a relaxing and rejuvenating bath. Other self-care strategies that help you relax your mind and body.

Preventive Measures

Identify avoid exposure to triggers such as allergens.
Incorporate a daily bathing and moisturising regimen into your routine.
Implement a daily routine of bathing and moisturising.
Be consistent in taking medications prescribed by your doctor.

Make an Appointment at Gleneagles Hospitals

Consult a doctor if you notice your eczema has worsened or new symptoms are appearing. The team of expert dermatologists at Gleneagles Hospitals is available for consultation, ensuring the best care and support for patients.

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