Eczema

9 May

Eczema, symtoms, causes and treatments

The term "eczema" is derived from the Greek word "ekzema," which means "to boil over" or "to effervesce." The name is quite fitting because eczema is a skin condition characterized by red, inflamed, and itchy skin, often accompanied by the appearance of blisters, oozing, or "boiling over" of the skin's surface.

Eczema, also known as atopic dermatitis, is a chronic and non-contagious skin disorder that can affect people of all ages. It is often associated with a dysfunctional immune response and is believed to have genetic and environmental factors as contributing causes. Eczema can lead to dry, itchy, and inflamed patches of skin that can vary in severity from mild to severe.

The name "eczema" has been used for centuries to describe this skin condition, and it reflects the characteristic symptoms of the disorder. While the term "atopic dermatitis" is commonly used in the medical field to describe a specific form of eczema, the broader term "eczema" is often used to refer to various types of dermatitis and skin inflammation, making it a more general term for skin disorders with similar characteristics.

Common symptoms of eczema include:

Itchy Skin: Pruritus (itching) is a hallmark symptom of eczema. The itching can range from mild to severe and can be especially intense at night, leading to sleep disturbances.
Redness and Inflammation: Eczema often causes red or pink patches of inflamed skin, which may become warm to the touch.
Dry or Scaly Skin: The affected skin may appear dry and scaly, especially in between flare-ups.
Rash: Eczema can cause the development of a rash, which may consist of small, raised bumps that may ooze and then crust over.
Swelling: The affected skin may become swollen or puffy, especially during flare-ups.
Cracking and Peeling: Eczema can lead to skin that becomes cracked and peeling, particularly in areas that flex, such as the elbows and knees.
Thickened Skin: Over time, the constant scratching and irritation of eczema can cause the skin to become thickened or lichenified.
Blisters: Some individuals with eczema may develop blisters that ooze and crust over. This is more common in the later stages of a flare-up.
Changes in Skin Color: The affected skin may become lighter or darker in color than the surrounding skin.
Sensitive Skin: Eczema-prone skin is often more sensitive to irritants and allergens, which can trigger or exacerbate symptoms.
Pain or Discomfort: In some cases, eczema can cause pain or a burning sensation, especially if the skin is severely inflamed.

Eczema can occur in various parts of the body and may affect different areas in different individuals. Common areas for eczema to appear include the face, neck, arms, hands, elbows, knees, and the back of the legs. It can also affect the scalp and genital area.

Causes

Eczema, also known as atopic dermatitis, is a complex and multifactorial condition with no single known cause. It is believed to result from a combination of genetic, environmental, immunological, and lifestyle factors. Common factors that are thought to contribute to the development and exacerbation of eczema include:

Genetics: Eczema tends to run in families. If one or both parents have eczema or a history of atopic conditions like asthma and hay fever, their children may be at a higher risk of developing eczema.
Abnormal Immune Response: Individuals with eczema often have an overactive immune response to triggers that are normally harmless. This heightened immune response can lead to inflammation and skin symptoms.
Skin Barrier Dysfunction: Eczema-prone individuals may have a defective skin barrier, which allows irritants, allergens, and microbes to penetrate the skin more easily. This can lead to inflammation and itching.
Environmental Factors: Eczema symptoms can be triggered or exacerbated by exposure to environmental factors, such as:

Allergens: Substances like pollen, dust mites, pet dander, and mold can act as allergens and trigger eczema symptoms.
Irritants: Substances like soaps, detergents, fragrances, and certain chemicals can irritate the skin and worsen eczema.
Temperature and Humidity: Changes in temperature and humidity can impact the skin's moisture balance and trigger flare-ups.

Food Allergies: Some individuals with eczema may have allergies to certain foods, and consumption of these foods can exacerbate their eczema symptoms. Common allergenic foods include milk, eggs, nuts, and shellfish.
Stress: Stress and emotional factors can play a role in triggering or worsening eczema symptoms in some individuals. High stress levels can lead to a release of inflammatory chemicals in the body.
Microbes: Certain bacteria, viruses, and fungi can colonize the skin and trigger or exacerbate eczema symptoms.
Hormonal Changes: Hormonal fluctuations, particularly in women, can influence eczema symptoms. For example, some women may experience worsening eczema during their menstrual cycle.
Scratching: Persistent scratching can damage the skin and lead to further inflammation, known as the "itch-scratch" cycle.
Contact Allergens: Exposure to substances that an individual is allergic to (contact allergens) can trigger eczema, especially in the form of allergic contact dermatitis.

The exact cause of eczema is not fully understood, and its development can vary from person to person. Eczema is considered a chronic condition, and while there is no cure, it can often be managed through a combination of lifestyle modifications, skin care, and medical treatments.

Treatment

The treatment of eczema, also known as atopic dermatitis, typically involves a combination of strategies aimed at reducing inflammation, relieving symptoms, preventing flare-ups, and improving the quality of life. Treatment approaches can vary depending on the severity of the condition and the individual's specific needs. Here are common treatment options for eczema:

Moisturizers (Emollients): Regularly applying moisturizers helps keep the skin hydrated and prevents dryness, which is a common trigger for eczema. Opt for fragrance-free and hypoallergenic moisturizers.
Topical Corticosteroids: These are anti-inflammatory creams or ointments that can help reduce redness, itching, and inflammation during eczema flare-ups. They come in various strengths, and the choice depends on the severity of the symptoms and the area of the body affected.
Topical Calcineurin Inhibitors: These non-steroidal creams or ointments, such as tacrolimus (Protopic) and pimecrolimus (Elidel), are used to reduce inflammation and are sometimes recommended when corticosteroids are not suitable or effective.
Antihistamines: Over-the-counter or prescription antihistamines can help relieve itching and improve sleep quality if itching is keeping you awake at night.
Wet Wrap Therapy: Wet wrap therapy involves applying a moisturizer or medication to the skin, followed by wrapping the area with wet bandages or clothing. It can be particularly helpful in severe cases and under the guidance of a healthcare provider.
Oral Medications: In some severe cases, oral corticosteroids or other systemic medications may be prescribed to control inflammation. These are typically reserved for short-term use due to potential side effects.
Biologic Medications: These newer medications, such as dupilumab (Dupixent), are sometimes prescribed for moderate to severe eczema when other treatments are ineffective. They work by targeting specific immune system responses involved in eczema.
Phototherapy (Light Therapy): This involves exposing the skin to controlled amounts of natural or artificial ultraviolet (UV) light under medical supervision. It can be helpful for some individuals with moderate to severe eczema.
Identifying and Avoiding Triggers: It's essential to identify and avoid triggers that worsen eczema symptoms, such as specific foods, allergens, irritants, or stressful situations.
Allergy Management: For individuals with eczema related to allergies, allergy management, including allergen avoidance and allergy shots (immunotherapy), may be recommended.
Stress Management: Reducing stress through relaxation techniques, such as meditation and mindfulness, can help prevent or alleviate eczema flare-ups.
Wearing Comfortable Clothing: Wearing loose-fitting, breathable clothing made from natural fabrics like cotton can help prevent irritation and overheating.
Proper Skincare: Use mild, fragrance-free soaps and avoid hot water during baths or showers. Pat your skin dry instead of rubbing, and apply moisturizer immediately after.

It's essential to work closely with a dermatologist or healthcare provider to develop an individualized treatment plan for eczema. Treatment may need to be adjusted over time based on your response and any changes in your condition. The goal of treatment is to manage symptoms effectively, reduce inflammation, and improve the quality of life while minimizing side effects and potential complications.