Ways You Can Manage Your Eczema

Manage your eczema

What Is Eczema?

Eczema is an inflamed and itchy skin condition with many clinical patterns, occurring more commonly in children than adults.

Eczema is derived from the Greek word ekzein which means to effervesce.

It affects different parts of the body including eyelids, necks, arms, breasts, hands, ears and legs.

Eczema occurs in genetically predisposed people. It runs in families with history of hay fever, asthma, allergies and sensitive skin.

So, it is a form of hypersensitivity reaction, occurring first around the elbows and behind the knees, but can occur on any skin part when severe.

When eczema happens, the skin becomes crusty, red and itchy, and you are likely to scratch the affected skin parts all the time.

Eczema can get worse if you have a dry skin and are exposed to the extremes of temperature.

Studies have shown that if a child in his/her first year of life is exposed to dust, certain foods and animals, the child will be conferred immunity against eczema and allergies.

Eczema causes protein deficiency in outer skin layers therefore compromising the internal barrier function of the skin.

As a result, the skin starts leaking internal fluids leading to skin irritations.

These irritations may take the form of itchy blisters, patches of red skin with dry or wet yellow scabs, or cracked open red skin parts with yellow serous crusting.

What Are the Types of Eczema?

There are so many types of eczema, and many of them are common.

Each type of eczema has a different look on the skin from the other and occurs in a different part of the skin.

Here are the different types of eczema:

• Atopic dermatitis

Atopic dermatitis is a common skin condition, occurring particularly in children.

If you have atopic dermatitis, it shows that it runs in your family with one or more of your family members likely to have history of very sensitive skin, hay fever, allergies or asthma.

People often think of atopic dermatitis whenever the word eczema is mentioned.

Atopic dermatitis occurs often on the inner elbow part and the back of the knees but can occur on other parts of the skin when severe.

Atopic dermatitis causes skin itching, making the skin red with hard outer layer.

It makes you scratch your body and your skin may get infected. There is evidence that people with atopy may be carriers of Staph bacteria which cause impetigo.

Atopy is associated with dry skin which can trigger eczema.

Atopic dermatitis makes you hypersensitive to things touching your skin such as the ingredients in wool, laundry soap, moisturizers, and so on.

Therefore, you need hypoallergenic skin care, and daily moisturizing.

• Contact dermatitis

Allergic contact dermatitis is an allergic reaction to something the skin came in contact with.

It can be caused by perfumes, metal, essential oils, ivy, poison oak, hair dye, preservatives and many more.

Irritant contact dermatitis is triggered by contact with detergents, water and other chemicals, occurring commonly on the hands.

Contact dermatitis is most common in atopics but can happen to anyone.

If you have contact dermatitis, your skin will be red, itchy and may have blisters.

However, there is no allergen in the blister water, and therefore it is not contagious. Also, the rash is not going to spread.

• Dyshidrotic eczema

Dyshidrotic eczema occurs on the hands and feet, causing intense itching.

It appears as little dots on the palms, the sides of fingers or toes, and the soles.

Internal allergic reactions or seasonal allergies may play a role in its occurrence.

Dyshidrotic eczema makes your skin fragile. The eczema may get irritated and form painful cracks when you use your hands too much.

As a result, it may become debilitating and difficult for you to use your hand(s) to do house cleaning chores.

• Nummular dermatitis

Nummular dermatitis, also known as discoid dermatitis, is a chronic eczema manifesting as papular or papulo-vesicular coin-shaped patches.

It appears as dry, red, scaly and itchy patches on skin parts of the arms and lower legs susceptible to dryness.

Nummular dermatitis can happen on the trunk, occurring more with age and skin dryness. A minor injury is enough to start off the eczema.

You can prevent nummular eczema with good skin care. You have to use good moisturizers and avoid harsh soaps in order to improve your skin health.

Nummular dermatitis is not contagious but when it occurs in one spot of the skin, it appears to happen in other areas of the skin.

• Seborrheic dermatitis

Seborrheic dermatitis, also known as dandruff, appears on the scalp, eyebrows, behind the ears, and on the sides of the nose and mouth, secondary to toxic substances produced by yeasts.

It can also affect the chest and back skin. It comes with itchy, scaly rashes mainly on the scalp.

Owing to the running of sebum meaning of seborrhea from which the name of this eczema was derived, the early physicians thought that seborrheic dermatitis was due to excessive skin oil.

If you have seborrheic dermatitis, your skin will be dry, flaky, red and itchy.

You can use anti-seborrhea medicines in soaps and shampoos to treat this condition. You can also use anti-yeast creams.

It is not exactly clear why seborrheic dermatitis happens. It is however believed that pityrosporum yeast plays some role.

Also known as malassezia folliculitis, pityrosporum folliculitis happens when yeast bacteria, occurring naturally on your skin, go under the skin, and into your hair follicles.

Pityrosporum folliculitis is found to co-exist with seborrheic dermatitis.

• Stasis dermatitis

Stasis dermatitis is a common condition resulting from poor vein circulation in the legs.

Impaired venous circulation over time damages the skin and breaks down in eczema.

Treating eczema with great success

Stasis dermatitis, like other types of eczema, causes redness, scaling and itching of the skin. Ulceration is a common complication of stasis dermatitis.

Stasis dermatitis that is left untreated can cause skin infections such as cellulitis.

If you have stasis dermatitis, elevate your legs to improve venous circulation.

Moisturize your skin to improve your skin health and wear support stockings to prevent leg edema.

Treat this condition early with cortisone creams to prevent infection.

• Asteatotic eczema

Asteatotic eczema, also known as xerotic eczema happens when the skin is abnormally dry, cracked and itchy.

It occurs mostly in the elderly and on the chest, arms, thighs and lower limbs, appearing as flaky and dry patches on the skin.

This condition gets more pronounced and worse in the winter months particularly in areas where indoor humidity is reduced with heating.

As such, there is symptomatic improvement in a warm and humid climate.

Risk factors for asteototic eczema include increased bathing frequency, types of cleansers and soaps used for bathing, diet, medications, and types of lubricants used.

These are controllable risk factors that your doctor will take into account when attending to you.

In controlling asteatotic eczema, you should minimize risk factors for dry skin through simple behavior changes.

Always have short showers with a mild soap. Avoid harsh skin cleaners that dry up the skin more.

Apply a petroleum-based emollient such as Vaseline within three minutes of bathing.

Use agents containing lactic acids and urea. Also, wear light non-restrictive clothing that does not irritate or cause itching.

Apply menthol lotion after oatmeal baths to reduce skin itching. Install and use the humidifier during the winter season.

• Id reaction

Id reaction or autoeczematization is a generalized eczematous dermatitis in response to a variety of stimuli including localized dermatosis, inflammatory and infectious skin conditions.

It is a polymorphous reaction, affecting hands and feet as pompholyx-like reactions or generalized popular eruptions.

Dermatophyte infections of the feet and stasis dermatitis are the most provoking conditions for id reaction.

However, no fungi are seen in the areas of eruptions that represent id reaction.

If you have id reaction, you will present with eruptions of small, erythematous papules and vesicles on your forearms and hands. Id reaction can also happen anywhere on the body.

To treat id reaction, your goal will be to adequately treat the underlying dermatitis or infection. This invariably leads to the resolution of id reaction.

Failure to treat the underlying causes adequately will result in the recurrence of id reaction.

You can use systemic or topical corticosteroids, wet compresses and systemic or topical antihistamines to treat eruptions from id reaction.

• Lichen simplex chronicus

Lichen simplex chronicus (LSC) is a localized neurodermatitis on a circumscribed skin area characterized by skin thickening resulting from repeated scratching, itching and rubbing of the skin.

LSC may happen on the normal skin of people having seborrheic dermatitis, psoriasis, atopic dermatitis, and contact dermatitis.

Resolving eczema

It may also occur in people with depression, anxiety disorder, nervousness and other emotional problems.

This problem is most common in children who are prone to non-stop scratching due to every insect bite or other itchy skin conditions.

It is also common in children with chronic repetitive movements. LSC complications include permanent skin color changes, bacterial skin infections and permanent scar.

So, LSC leads to scratching which causes more itching, and then more scratching and so on, a kind of vicious cycle.

It follows a continuous pattern starting with skin irritation from any source, followed by rubbing or scratching of the itchy area.

The skin begins to thicken with increased and persistent scratching.

The thickened skin further causes itching leading to more scratching, and more thickening of the skin. The affected skin parts may become leathery and brownish as a result.

To treat this condition, you can reduce itching with steroid cream on the affected areas.

Apply ointments containing salicylic acid on thick skin patches. You can use lotions or soaps containing coal tar.

You may need dressings with or without medicated creams to cover, moisturize, and protect the affected skin parts.

Itching can also be controlled by oral antihistamines. Steroid injections can also reduce itching and irritation.

Take tranquilizers and antidepressants if your itching is due to an emotional problem.

You may require counselling to help you understand why you should stop scratching.

Also take time to learn more about stress management and behavior modification to help you overcome LSC challenge.

• Prurigo nodularis

Prurigo nodularis (PN) is an intense, itchy skin disease of unknown etiology characterized by itchy nodules, appearing on the arms and legs.

It causes intense itching leading to scratching which causes excoriated lesions.

Symptoms include presence of discrete, hyperpigmented and firm nodules mostly on the arms and legs, though they can appear on any body part. Also flat excoriated lesions with no crusted top may occur.

Repetitive and chronic picking, rubbing or scratching of the nodules may cause permanent skin changes such as hyperkeratosis, nodular lichenification, skin thickening and hyperpigmentation.

Excoriated lesions may appear scabbed, crusted or scaly. There may be lack of wound healing even after taking medications to relieve itching.

Diagnosis is made by your healthcare provider. It is based on the presence of itching and visual examination.

A skin biopsy may be done to rule out other skin conditions. A culture of a lesion may be required to rule out staphylococcus infection linked to atopic dermatitis.

Treatment of PN is hard. However, steroids, cryosurgery and UVB light are current therapies.

Antibiotics are used in the event of staphylococcus infection. Your doctor may want to use prednisolone to stop itching and scratching.

Talk to your healthcare provider for information on treatment options.

Happy managing eczema successfully

A Summary of Symptoms of Eczema?

Eczema occurs in different shapes, forms and places depending on your age.

In children aged 2 years and below, eczema occurs as peeling, red, crusted and itchy skin areas on the scalp, cheeks, behind the arms, hands, and the front of the legs.

Crusted yellow areas or blisters can also occur but the diaper area is spared.

Between the ages of 2 and 16, eczema occurs as less oozing and more thickened, red and itchy areas on the back of the legs, the front surfaces of the arms and the neck.

Eczema in this age group most typically breaks out on the front of the wrists, in the elbow creases, behind the knees and the front of the ankles.

In adults, eczema happens as localized thick, peeling and itchy patches on the face causing redness and itching of the eyelids, and on the elbow and knee creases.

Also, adults have eczema that is localized in bumps and small blisters with redness, occurring on the back of the hands, along the sides of the fingers, and on the feet.

Severity of eczema in adults will cause the blisters and bumps to become yellow crusting and oozing cracks. Bleeding may occur from severely inflamed open skin areas.

Generally, eczema may flare in times of stress, in your local season of allergy or when the air is colder and drier.

How Do You Know You Have Eczema?

Clinical Diagnosis:

If you have skin problems such as rashes on your neck, hands or feet, visit your doctor who will diagnose eczema if you have history of allergies, asthma, irritated itchy skin or other skin problems.

Clinically, your doctor will examine your arms, legs and torso at an office appointment, looking for skin changes that point to eczema.

Histological Diagnosis:

A skin biopsy and histology can be done to diagnose different types of eczema.

Atopic dermatitis will show chronicspongiosis, spongiotic or follicular patterns, while irritant contact dermatitis reveals epidermal cell necrosis, mild spongiosis and neutrophilic infilteration of the epidermis.

For allergic contact dermatitis, there is dermal inflammatory infiltrate, containing lymphocytes and mononuclear cells. It may also incite atypical T-cell infiltrates, simulating mycosis fungoides.

Nummular dermatitis will show spongiosis with exocytosis of inflammatory cells and acanthosis.

Scale-crust formation may appear above the thickened epidermis, and there may be dermal perivascular inflammatory infiltrate.

Stasis dermatitis reveals spongiosis with foci of scale crust and parakeratosis.

Dermal changes will show haemosiderin deposition, neovascularization and fibrosis formation. Ulceration indicates a complicated stasis dermatitis.

Acute, subacute or chronic spongiosis is indicative of seborrheic dermatitis. Spongiosis may have scale crust found over a hair follicle.

More chronic lesions from seborrheic dermatitis show less spongiosis, and more psoriasiformhyperplasia of the epidermis. There may be edema of the papillary dermis.

For asteatotic eczema, there is mild subacute spongiotic dermatitis with compact and irregular stratum corneum.

Id reaction shows localized dermatosis or spongioticreaction pattern. Dermal oedema and lymphocytic infiltrate may be seen.

For Lichen simplex chronicus, hypergranulosis, parakeratosis and hyperkeratosis will be reported.

There may be elongated and irregular thickening of epidermal ridges. Papillary dermal fibrosis is characteristic of LSC.

Prurigo nodularis appears histologically as increased acanthosis with dilated follicles. There may be mild spongiosis and parakeratosis.

In prurigo nodularis, skin excoriation may lead to eroded lesions while secondary changes may mimic a squamous cell carcinoma.

Dermal changes due to prurigo nodularis include fibrosis of the papillary dermis, perivascular inflammatory infiltrate and vascular hyperplasia.

Dyshidrosis reveals thickness of the stratum corneum with no follicular structures. Acute dyshidrosis is characterized by bullae or intraepidermal spongiotic vesicles.

It is important to avoid confusing eczema histology with similar histopathologic features of other dermatoses such as pityriasis rosea, the annular erythemas, gianotti crosti syndrome and miliaria.

To this end, diagnosis of eczema should depend on clinic-pathologic correlations.

Enjoying healthy skin after treating eczema

Important Tips on Treating Your Eczema

Always take good care of your skin by applying proper skin care techniques. Bath with warm water, instead of hot water.

Use non-soap skin cleansers in place of soaps and body washes.

The cleansers should be used sparingly on the armpits and groin.

You can take antihistamine such as loratidine, cetirizine, Diphenhydramine and fexofenadine.

They will help you reduce itching and scratching resulting from eczema outbreaks, giving your skin a chance to health.

Eczema can be controlled when you apply unscented, hydrating skin moisturizers three times daily.

The above techniques work, but if they did not work for you, your healthcare provider will recommend topical corticosteroids.

The following medications can be prescribed by your healthcare provider for eczema:

For thickened skin, your healthcare provider may prescribe betamethasone, triamcinolone or clobetasol topical creams

For facial eczema, a topical corticosteroid such as desonide may be prescribed.

For resistant eczema, your healthcare provider may introduce topical calcineurin inhibitors.

This can be applied in place of or together with hydrocortisone cream.

With an improved eczema, your healthcare provider will taper down the medications to minimally effective doses and intervals.

Important Healthy Habits to Control Your Eczema

• Do not use hot water

Stay away from hot water. Use warm water instead. Do not wash your hands too often or submerge them in water as doing so will cause your skin to dry up.

• Always keep your body moist

Apply body oil or unscented lotion to your body after bathing, hand washing, and in dry or winter times.

Doing so will keep your skin from getting cracked or dried out.

• Do not use too much soap to clean your body

Soaps dry out the skin and will worsen your eczema. Use soap to clean your hands, underarms and groin.

Use soaps sparingly on other body parts.

The hands, underarms and groin are the most important body parts that require cleaning with soap.

• Use fragrance-free detergents

Choose natural laundry detergent that has no dyes and fragrance.

Do not use fabric softener and use bleach sparingly.

• Protect your home from allergy

Are you allergic to things like pet dander, cold, animal furs dust or wheat?

If the answer is yes, then you need to keep your home and diet free from these triggers.

Your eczema will be under control when you avoid or minimize exposure to the triggers.

• Protect your hands

Always wear rubber gloves when you want to wash dishes.

Also, wear cottons lined rubber gloves when using cleaning products that irritate the skin.

Good skin care = Healthy skin

Conclusion

Eczema is not curable but can be controlled by embracing healthy skin-care practices.

There is need to visit your healthcare provider to examine your skin regularly, review your care plan, and adjust medications if necessary.

If you have severe eczema that is associated with allergies, treating the underlying allergies will help your eczema.

You will benefit from the services of a dermatologist who may help you with calcineurin inhibitor- cyclosporine or photo therapy.

If you have good knowledge of eczema and follow the principles of good skin care, you can successfully manage your eczema.

Eczema occurs early in life, starting before the age of 5 in 85% of the people with the condition. About 60% of people with eczema had it start before one year of age.

It is important to note that though eczema has no cure, it can be managed well with proper skin care and use of topical ointments.

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