What is eczema?
The most common form of eczema, atopic dermatitis, causes patches of your skin to be itchy and inflamed. Atopic dermatitis is a long-lasting (chronic) condition that tends to flare up periodically. People who suffer from asthma, allergic rhinitis, or have relatives who have atopic dermatitis, are at a higher risk of having the skin condition. Eczema is not contagious.
What are some of the symptoms?
Symptoms of eczema include:
- Dark patches
- Dry skin
- Inflamed red scaly rashes
- Itching, which may be severe, especially at night
- Itchy, hard skin bumps
- Raw and weepy broken skin from scratching
- Thickened, cracked skin
Other types of eczema
When most people refer to eczema, they usually mean atopic dermatitis as it is the most common and chronic type of eczema. The following are other common types of eczema which may match your particular symptoms:
Contact dermatitis
This skin condition occurs when your skin comes into contact with irritants or allergic substances, leading to itchy red rashes or even blisters. The inflammation usually goes away following treatment and when the offending substance is removed.
Discoid/Nummular dermatitis
This type of eczema causes round red patches on the skin and usually affects your legs. It can be mistaken as fungal infection.
Dyshidrotic dermatitis
Dyshidrotic dermatitis affects your hands fingers and feet. It causes itchy blisters or scaly and painful skin patches.
Seborrheic dermatitis
Seborrheic dermatitis causes itchy, red, scaly rashes over oily skin areas of your scalp, eyebrows, eyelids, the sides of your nose, and behind your ears.
What causes eczema?
The cause of eczema is not fully understood but is believed to be a combination of dysfunctional skin barrier and an overactive immune system which may respond aggressively when exposed to irritants. Eczema triggers include:
- animal dander
- any infections eg. common colds, upper respiratory tract infections
- insect bites
- certain foods that may aggravate eczema in some patients
- chemicals found in cleaners and detergents that dry out the skin
- contact allergy eg. nickel, hair dye
- rough scratchy material, like wool
- stress
- sweating
- synthetic fabrics
- temperature changes, especially to heat
Living with eczema
Some children grow out of eczema. For other people it is a lifelong condition that has to be managed. Here are some steps you can take to better manage your eczema:
1. General measures
- When bathing, use a mild soap or soap substitute that won't dry your skin, and afterwards apply a good moisturiser.
- Keep your skin moisturised throughout the day. Apply moisturiser daily and regularly to repair the skin barrier.
- Avoid taking very hot or very long showers as this can dry out your skin.
- Manage your stress. Get regular exercise, and set aside time to relax.
2. Control the itch and scratch
- Antihistamines can help control the itch, examples include cetirizine, loratadine, levocetirizine, desloratadine, fexofenadine etc.
3. Treat skin inflammation with topical steroid creams
- Different potency steroid creams can be used to treat eczema skin inflammation, depending on extent and area of rashes.
- Your doctor can explain proper use of creams and monitor for side effects.
- There are also non-steroid creams to treat skin inflammation, generally used for sensitive areas on the face and eyelids.
4. Treatment for flare-ups
- If you have a bad flare, you may require intensive topical treatment (wet wraps) or a course of oral steroids.
- Oral medications may be required to treat any skin infections or infected eczema.
5. Treatment for difficult-to-control eczema
- If flare-ups are recurrent or eczema is difficult to control, you may need to escalate treatment.
- Your doctor may prescribe medication to control the immune system (eg. ciclosporin, azathioprine, new biologic injection dupilumab).
- Phototherapy may be another option.
6. Allergy tests (prick, patch test)
- Allergy tests may be required for certain types of eczema and to identify potential substances which your skin may be allergic to.
7. Maintenance treatment
- Avoid triggers
- Moisturise regularly
- Regular antiseptic soap wash for active rashes
- Your doctor will explain to you how to use maintenance topical creams.
When do you see a doctor?
See a doctor if you:
- are so uncomfortable that the condition is affecting sleep and daily activities
- continue to experience symptoms despite trying home remedies
- have a fever or generally unwell together with the rash
- have persistent or worsening skin rashes, especially with wet weepy wounds developing on the skin
If you currently suffer from eczema, don't be disheartened. Seek help early and begin taking steps to manage the condition.
Article reviewed by Dr Tay Liang Kiat, dermatologist at Parkway East Hospital
Reference
Eczema (Atopic Dermatitis) Treatment. Retrieved 11/06/2019 from https://www.webmd.com/skin-problems-and-treatments/eczema/understanding-eczema-treatment#1
Eczema: Symptoms, Causes, and Treatment. Retrieved 11/06/2019 from https://www.healthline.com/health/eczema
Atopic dermatitis (eczema). Retrieved 11/06/2019 from https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273
13 Severe Eczema Triggers and How to Avoid Them. Retrieved 11/06/2019 from https://www.healthline.com/health/severe-eczema/triggers-how-to-avoid
What Are the 7 Different Types of Eczema? Retrieved 11/06/2019 from https://www.healthline.com/health/types-of-eczema