Derived from a Greek word meaning “to erupt” or “boil over”, eczema refers to what is nowadays a commonplace skin condition. It is worth pointing out that eczema is not actually a specific medical condition, rather it is the symptoms of a range of underlying causes.
The terms dermatitis and eczema are often used interchangeably to describe an inflammation of the skin, which may have become sore, red, or weepy. Eczema can be acute, developing swiftly, or chronic, lasting for long periods of time. It is quite a common problem, affecting nearly 20% of the population at some point during their lives, but is not life threatening. Although the form of eczema most often referred to is atopic dermatitis various different types of eczema are recognized.
The most common symptoms include a red area or rash on the skin and very itchy skin which is also dry, cracked or flaky.
Different types of eczema
- Atopic eczema, sometimes called atopic dermatitis, is the most common form. It is caused by a mixture of genetic and environmental factors. Many children who suffer from this also suffer from asthma and hay fever or have a family history of these conditions.It is thought to affect between 10 and 20 percent of children. Luckily, many children affected grow out of the condition by the time they reach their teens, but some individuals will have lifelong outbreaks of the condition.In children, atopic eczema often starts with patches of dry, scaly skin. Infants under 12 months may be affected with a red skin rash on their cheeks. In both children and adults any part of the body can be affected. However children are more likely to have rashes in their joint areas such as elbows and knees, wrists or ankles. Adults with atopic eczema may be affected on their hands, nipples and eyelids.Scratching the skin will cause the body to produce more histamine, which will make the condition even worse. Scratching can also cause the skin to become infected. The condition can be really distressing and might interfere with sleep.Some people experience that stress can trigger a flare-up. Where that is the case, stress management may form an important part of the solution.
Other types of eczema include:
- Eczema craquelé which is most common, but not limited to elderly people and often appears as dry, cracked patches on the shins.
- Contact dermatitis, where the skin reacts to contact with irritants such as nickel, detergents or even over-exposure to water.
- Seborrheic dermatitis (known as Seborrhoeic dermatitis in the UK). The causes are mostly unknown, but it usually affects the head or scalp, for example in the form of dandruff, or cradle cap in a baby. Your health professional will be able to advise on the best treatment for cradle-cap. In mild cases of dandruff an anti-dandruff shampoo may be all that is needed to manage the condition. In more severe cases shampoos containing tar or salicylic acid may be needed.
- Discoid eczema (nummular eczema) can affect both children and adults. As the name suggests the flare-up appears as round, disc-shaped patches of inflamed skin. Sometimes these patches are itchy and sometimes they do not itch at all.
- Pompholyx eczema (dyshidrotic eczema) appears as deep blisters on the palms of the hands or the soles of the feet. The blisters may feel hot and/or itchy.
If you or your child breaks out in a rash, or appears sensitive to irritants such as soaps, extreme temperatures, detergents or wool, you should visit your doctor or allergist. For a diagnosis of atopic eczema, they are likely to ask about your family history, not just of eczema but of other conditions such as hay fever and asthma, as these conditions appear to be related. It is possible that a skin-prick test will be done to identify likely triggers.
If you suffer from eczema it is important to work out whether contact with particular substances causes or aggravates the condition, and if so to avoid contact with those. Some sufferers find that their condition improves if they cut down on bathing to encourage the natural oils in the skin to form a protective layer. Most sufferers prefer to avoid soap and to avoid wearing woollen clothes next to the skin. Some sufferers find that exposure to sunlight or light therapy improves their condition.
An emollient cream should be rubbed into the affected area regularly. Your medical practitioner may be able to recommend suitable emollients to help prevent the skin from drying out.
Your doctor might prescribe a short course of steroid cream or other anti-inflammatory cream. You can obtain low grade steroid creams from a pharmacist, but if symptoms persist it is a good idea to see your doctor. It is important not to exceed the stated dose. Some types of eczema may benefit from the use of anti-fungal creams.
In very severe cases your doctor may prescribe steroids in tablet form or other medication.