What is eczema?

Also called dermatitis, eczema is an inflammatory skin response. It is chronic and has flare-ups and remissions. There are various types of eczema; some are caused by allergies or irritating chemicals, others by the result of other medical conditions such as varicose veins. In the early stages of eczema, the condition is characterised by dry, red and itchy skin. An acute attack may produce crusty scales or blisters. Eczema in children is often associated with asthma and hay fever. 

Different types of eczema

  • Atopic eczema – occurs in people who have an inherited predisposition to allergies such as allergic asthma, hay fever or food allergies. Babies between 2 months to 18 months may have eczema on the face, neck and groin. In older children, teenagers and adults, it affects mainly the skin on the hands and feet and in the folds of the elbows and knees.
  • Contact dermatitis – occurs after contact with a substance to which the patient has become allergic, such as the prolonged contact with mild irritants e.g. soap, detergent, bubble bath, sweat, saliva, urine (in nappy rash) or even water.
  • Allergic contact dermatitis – caused by an allergy to a specific metal or chemical, for example nickel and chemicals in perfumes, skin creams and lotions, cosmetics, shampoos, shoes and clothing. Contact with some animals, plants, flowers, herbs, fruits and vegetables may also cause a reaction in some people.
  • Hand eczema – a chronic eczema occurring only on the hands, is related to atopic eczema in allergic people, but can also be caused by repeated hand washing or exposure to strong detergents. It may also be caused by an allergy to latex rubber.
  • Asteatotic eczema – occurring mainly in the elderly, is caused by dry skin and dry conditions, for example when more time is spent in an indoors environment with low humidity during winter. This usually leads to fine cracks in the skin, starting on the legs.
  • Stasis dermatitis – the result of poor blood circulation in the lower legs. It affects people suffering from varicose veins or other conditions that cause poor blood circulation. It may lead to ulcers on the lower legs.
  • Seborrhoeic dermatitis – a scaly skin condition that occurs when the sebaceous glands produce too much oil (sebum). It is aggravated by stress.

What are the symptoms?

Generally the symptoms of eczema include patches of itching red, brown or normally coloured, raised skin, and tiny bumps or blisters that may ooze fluid. The itching may become very severe.

If untreated, the skin may become thick, scaly and dry, with areas of hair loss. In babies eczema is usually found on the face or groin, in children on the inside of the elbow or back of the knee and in adults on the hands, feet, ankles and groin.

The symptoms of eczema may clear up after a week or two or may persist for years, resulting in a chronic condition. Contact dermatitis, for example, may heal within a week after removing the irritant, whereas stasis dermatitis caused by varicose veins may persist for many years. The response to treatment may also vary from person to person.

Diagnosis

Your GP will take your personal and family history of allergies and enquire about your exposure to potential allergens. If an allergy is suspected, patch testing with various allergenic chemicals may be ordered to determine the source. Sometimes a skin scraping will be taken for microscopic analysis.  

Self-help tips

  • Prevent dry skin by using moisturising creams and ointments.
  • Prevent eczema flare-ups by avoiding exposure to extreme temperatures, dry air, harsh soaps and bubble baths.
  • Use cotton blankets and clothing and avoid wool and synthetic fabrics, which are more irritating.
  • Pat yourself dry after a shower or bath so that a thin layer of moisture remains on the skin.
  • Avoid contact with irritating chemicals, animals, plants, jewellery or any other substance that could trigger a skin allergy.
  • People with varicose veins should wear compression stockings and should elevate their legs as much as possible if they have to sit for long periods of time.
  • Prevent eczema in a baby by protecting the infant from potential allergens such as tobacco smoke, pet hair, mites and moulds.

Medication

Moisturising creams and ointments are essential. Steroid-based cortisone creams are used to help reduce itching, but not if the skin is broken or infected.

Antihistamine taken orally may be used to help control itching and to sedate the patient if the eczema is associated with an allergy.

In severe cases, a doctor may prescribe an oral corticosteroid. Always consult your GP or your pharmacist if you have any questions and before starting any treatment.

This information has been reproduced with kind permission of Zahra Publishing, publishers of Easy Health.