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Dermatology
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Eczema
Eczema, or
dermatitis, is a
group of skin
conditions which can
affect all age
groups. In the
United Kingdom, up
to one fifth of all
children of school
age have eczema,
along with about one
in twelve of the
adult population.
The severity of the
disease can vary. In
mild forms the skin
is dry, hot and
itchy, whilst in
more severe forms
the skin can become
broken, raw and
bleeding. Although
it can sometimes
look unpleasant,
eczema is not
contagious. With
treatment the
inflammation of
eczema can be
reduced, though the
skin will always be
sensitive to
flare-ups and need
extra care.
Causes
The causes of eczema
are many and varied,
and depend on the
particular type of
eczema that a person
has. Atopic eczema
is thought to be a
hereditary
condition, being
genetically linked.
It is proposed that
people with atopic
eczema are sensitive
to allergens in the
environment which
are harmless to
others. In atopy
there is an
excessive reaction
by the immune system
producing inflamed,
irritated and sore
skin. Associated
atopic conditions
include asthma and
hay
fever. Other
types of eczema are
caused by irritants
such as chemicals
and detergents,
allergens such as
nickel, and yeast
growths. In later
years eczema can be
caused by a blood
circulatory problems
in the legs. The
causes of certain
types of eczema
remain to be
explained, though
links with
environmental
factors and stress
are being explored.
Types of Eczema
Atopic
eczema
Atopic eczema
is the
commonest form
of eczema and
is closely
linked with
asthma and hay
fever.
It can affect
both children
and adults,
usually running
in families.
One of the most
common symptoms
of atopic
eczema is its
itchiness which
can be almost
unbearable.
Other symptoms
include overall
dryness of the
skin, redness
and
inflammation.
Constant
scratching can
also cause the
skin to split,
leaving it
prone to
infection. In
infected eczema
the skin may
crack and weep
(‘wet’ eczema).
Treatments
include
emollients to
maintain skin
hydration and
steroids to
reduce
inflammation.
Allergic
contact
dermatitis
Develops when
the body’s
immune system
reacts against
a substance in
contact with
the skin. The
allergic
reaction often
develops over a
period of time
through
repeated
contact with
the substance.
For example, an
allergic
reaction may
occur to
nickel, which
is often found
in earrings,
belt buckles
and jeans
buttons.
Reactions can
also occur
after contact
with other
substances such
as perfumes and
rubber. In
order to
prevent
repeated
reactions it is
best to prevent
contact with
anything that
you know causes
a rash.
Irritant
contact
dermatitis
This is a type
of eczema
caused by
frequent
contact with
everyday
substances,
such as
detergents and
chemicals,
which are
irritating to
the skin. It
most commonly
occurs on the
hands of adults
and can be
prevented by
avoiding the
irritants and
keeping the
skin
moisturized.
Infantile
sebhorrheic
eczema
A common
condition
affecting
babies under
one year old,
the exact cause
of which is
unknown. Also
referred to as
cradle cap, it
usually starts
on the scalp or
the nappy area
and quickly
spreads.
Although this
type of eczema
looks
unpleasant, it
is not sore or
itchy and does
not cause the
baby to feel
uncomfortable
or unwell.
Normally this
type of eczema
will clear in
just a few
months, though
the use of
moisturizing
creams and bath
oils can help
to speed this
along.
Adult
sebhorrheic
eczema
Characteristically
affects adults
between the
ages of 20 and
40. It is
usually seen on
the scalp as
mild dandruff,
but can spread
to the face,
ears and chest.
The skin
becomes red,
inflamed and
starts to
flake. The
condition is
believed to be
caused by a
yeast growth.
If the
condition
becomes
infected,
treatment with
an anti-fungal
cream may be
necessary.
Varicose
eczema
Varicose eczema
affects the
lower legs of
those in their
middle to late
years, being
caused by poor
circulation.
Commonly the
skin around the
ankles is
affected,
becoming
speckled, itchy
and inflamed.
Treatment is
with emollients
and steroid
creams. If left
untreated, the
skin can break
down, resulting
in an ulcer.
Discoid
eczema
Is usually
found in adults
and appears
suddenly as a
few coin shaped
areas of red
skin, normally
on the trunk or
lower legs.
They become
itchy and can
weep fluid.
Usually discoid
eczema is
treated with
emollients (and
steroid creams
if necessary).
While eczema cannot be cured,
most cases can be controlled by making
lifestyle modifications to prevent flare-ups
and using medication as prescribed
This approach tends to
prevent inflammation and itching and keeps eczema from
getting worse. Dermatologists recommend that treatment be
sought at the onset of signs and symptoms. When therapy
begins early, it often reduces severity and duration.
Effective treatment requires a
correct diagnosis; however, it is not always easy to
distinguish one type of eczema from another or from similar
skin conditions. Dermatologists have the medical training
and experience needed to determine if eczema is present —
and if present, which type.
The primary goal of treatment is to relieve discomfort by
controlling the signs and symptoms. Since eczema is usually
dry and itchy, most treatment plans involve applying
lotions, creams, or ointments to keep the skin as moist as
possible. The treatment plan also may require lifestyle
modifications and using medication as directed.
Ned Long IV, MD
/ Plastic Surgery
Renee
Long, MD / Dermatology
427 W. 20th Street, Suite 300
Houston,
Texas 78705
Phone:
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