Eczema

Eczema, also known as dermatitis or atopic eczema, is a condition which causes inflammation of the skin, characterised by itching, redness and an outbreak of lesions. Some types of eczema skin disease can also cause blisters. It is a chronic condition and has a tendency to flare-up periodically. It is not a contagious disease; therefore it does not spread from one person to another. According to the National Centre for Biotechnology Information, eczema skin disease affects about 15% of children and 2% – 4% of adults.

Eczema is a skin condition wherein patches of skin become inflamed, itchy, cracked and rough causing blisters. According to the National Centre for Biotechnology Information, symptoms of eczema were detected in 2.7% of children (In the age group of 6-7 years). Symptoms of severe eczema were detected in 0.3% of adults and lifetime prevalence was 4.4% in the general population.

Types of Eczema

Atopic dermatitis: This is the most common type of eczema. It develops during the first year of birth in many cases and, hence, it is commonly known as infantile eczema. According to the National Center for Biotechnology Information, almost 90% of the patients with atopic dermatitis show symptoms before the age of five. These symptoms usually include reddish, dry or oozing, scaly eruptions at the bend of the elbows, back of the knees, neck, face, etc. The skin tends to be extremely dry and very itchy. Infants are unable to control the itching and, hence, it leads to excessive scratching that may result in secondary infections.

An allergic reaction to triggers such as foods or environmental allergens causes this type of eczema. “Atopic” describes an inherited tendency to develop dermatitis, asthma and hay fever; whereas “Dermatitis” means that the skin is red and itchy. Cases of atopic dermatitis are evident in case of a family history of allergy, asthma, hay fever, etc. It is often associated with other allergic and hypersensitive conditions like rhinitis.

Contact dermatitis: This type of eczema develops in localized regions where the skin comes in direct contact with an allergen (allergic contact dermatitis) or an irritant (irritant contact dermatitis). Extended period of contact usually triggers an eczematous reaction over allergens such as food and other environmental factors. However, limited exposure to allergens for a limited period of time can also trigger a rapid eczematous response.

Allergy caused by contact with nickel (a component of artificial jewellery) is one of the most common forms of contact dermatitis. Contact with chains, watches, rings, earrings or other items may also cause red and itchy rashes, which may further result in tiny blisters and peeling of the skin.

Seborrhoeic dermatitis (Dandruff): Seborrhoeic dermatitis is an eczema type that commonly affects the head, margins of the head and the area behind the ears. This type of eczema shows features of reddish rashes with yellowish, oily flakes. It is commonly seen in people with oily skin and scalp and varies depending on the season.

Exfoliative dermatitis: In this type of eczema, the patient experiences a large amount of scaling and flaking on the skin, covering almost the entire body.

Stasis dermatitis: This eczema type occurs in areas of the body with poor blood circulation; for e.g. the ankles. This type of eczema may develop into ulcers in the long run. It is mostly associated with circulatory disorders like varicose veins, among others.

Nummular dermatitis: Nummular eczema, also known as nummular dermatitis or discoid eczema is a chronic type of eczema that causes coin-shaped spots to develop on the skin. These eczema spots are often itchy and well-defined. This eczema type may result in the oozing of clear fluid or dry and crusty skin in many cases.

Neuro-dermatitis: It is an eczema type that develops due to emotional stress, wherein the patient feels intense skin itchiness, especially during resting or relaxing. This type of eczema usually limits itself to areas that are easily accessible to the individual such as lower legs, ankles, back and sides of the neck. It may also affect the wrists, forearms, and genitals.

Eczema Causes

Eczema causes redness, itchiness, dryness and inflammation of the skin and can occur at any age. It usually develops during infancy and continues into childhood. Several factors can act as reasons for eczema, however, the exact origin and mechanism of the condition is still not clear. Many factors, including genetics and environmental conditions, are responsible for triggering eczema or are reasons for eczema.

Eczema is not contagious but has a significant impact on skin. The affected skin may be more vulnerable to infections such as warts, cold sores and athlete’s foot. Eczema or atopic dermatitis is evident in case of a family history of allergy, asthma, hay fever, etc. It is often associated with other allergic and hypersensitive conditions like rhinitis.

Some of the causes of eczema include the following:

• Environmental allergens such as house dust, sand, pollen, smoke, moulds, animal dander, etc., are eczema causes.
• Dietary allergens such as milk and milk products, fish, soy, eggs, peanuts, etc., can worsen the eczema resulting in flare-ups. Other foods such as sugar, refined carbohydrates, gluten and red meats are also triggers or eczema causes.
• Contact with irritant substances such as soaps, cleaning products, detergents, cosmetics, perfumes, certain forms of clothing, rubber, jewellery, watches, metals such as nickel, etc. are important eczema causes.
• Genetic factors are an important cause in the development of eczema. Patients with eczema have commonly reported a family history of allergies, asthma, hay fever or other forms of allergic diseases. According to a research conducted by the National Centre for Biotechnology Information, the risk of childhood eczema is two to three times higher in children with a maternal or paternal history, irrespective of parent sex or body region affected.
• Eczema is caused by psychological stress in several patients; however, its correlation with triggering an altered immune response still remains unclear. The body releases a hormone called cortisol when under stress which increases inflammation throughout the body. This can lead to skin inflammation and can be a cause of eczema flare-up.
• A major eczema cause is the alteration in temperature and humidity. Heavy perspiration can lead to itchy skin that can be a trigger or reason for eczema.
• Dry climate and cold temperatures can be causes of eczema, as prolonged exposure to dry air can reduce the skin’s natural moisture. Excessive dryness often leads to itching, which then results in inflammation.
• Abnormal blood circulation, especially in the legs further causes stasis dermatitis and is a major reason for eczema.
• There are several factors that trigger certain forms of dermatitis, such as seborrhoeic dermatitis, atopic dermatitis, etc. These triggers or eczema causes may include materials like polyester or wool that may result in itchiness and redness.

Eczema Symptoms

Eczema is a skin condition that makes your skin inflamed, red and itchy. It is most seen in infants, but it can occur in people of any age.

Eczema symptoms depend on the age of the person as well as on the type of eczema the person is suffering from. Therefore, eczema signs and symptoms vary from person to person.

The eczema symptoms common to most forms of eczema are as follows:

• Dry, itchy skin
• Redness, heating-up and swelling on the affected area
• Skin eruptions, usually multiple small ones
• Occasional oozing of thin, watery fluid from the eruptions
• Chronic scratching, which may lead to thickening of skin in the affected area
• Darkening of skin in long standing cases
• Crust formation
• Flaking

Skin lesions are a common eczema symptom. They may take the form of rashes, bumps, cysts, blisters, pus-filled sacs, swelling, discolorations, hardening or any other change in or on your skin. People may experience lesions on any part of the body, but these signs of eczema are generally seen in the areas mentioned below:

• Knees, elbows, ankles (especially on the inner sides)
• Arms and legs
• Face and neck
• Folds of the skin

Eczema Symptoms in Infants

The following eczema symptoms are usually seen in children less than 2 years of age:

• Rashes on the cheeks and scalp
• Rashes that tend to bubble-up before leaking fluid
• Rashes that can cause excessive itching, which may pose difficulties in sleeping

Eczema Symptoms in Children

The following eczema symptoms are generally observed in children aged 2 and above:

• Rashes that appear on the wrists, neck, ankles and the crease between the legs and buttocks
• Rashes that appear behind the creases of elbows or knees
• Bumpy rashes
• Rashes that can grow darker or lighter
• Skin thickening, also known as lichenification, which can later develop into a permanent itch

Eczema Symptoms in Adults

The following eczema symptoms are commonly seen in adults:

• Extremely dry skin on the affected areas
• Rashes that are scalier than the ones seen in children
• Rashes that generally appear in the creases of the knees, elbows or the nape
• Rashes that cover most of the body
• Rashes that are permanently itchy
• Skin infections