Eczema

Eczema most common symptoms include itchy, reddish, and dry skin caused by inflammation. Although adults can be affected, Eczema is prevalent in children. It is also named as “atopic dermatitis” or “atopic eczema” and is treated generally with steroid creams, oral medications and phototherapy.

What is Eczema?

Also known as Atopic dermatitis, Eczema simply refers to a common chronic, recurring skin disease identified by a repetitive itch which turns into a reddish rash due scratching. Atopic means a disease category which has a tendency to develop other allergic conditions, like hay fever and asthma. About 10% to 20% of infants and around 3% of adults in the U.S has been affected by this condition. Recent statistical data indicates 40% of the infants who develop this condition carry it until they are 10, while a lesser amount of people continue to have symptoms intermittently throughout life. 35% of infants with atopic dermatitis are prone to develop asthma later in life. Face, trunk and extremities are the mostly affected areas for Eczema and these patients have an increased tendency to expose to other skin bacterial and viral infections than others because of scratch thinning of the skin. Sticking to a proper treatment, Eczema often can be controlled, not cured.

What causes Eczema?

Eczema resembles an allergy condition although the exact cause is unknown. Skin irritation in Eczema, which is more apparent in children than adults, is not an allergic reaction. Ongoing research has shown that eczema is caused by a sequence of factors including:

Abnormal function of the immune system
Genetic factors
Environment-Unhygienic living atmosphere
Activities that may cause skin to be more sensitive-Stress, cleaning agents etc.
Defective ability of skin to act as a mechanical barrier for germs

What are the risk factors that trigger Eczema?

Adults with a family history of eczema, hay fever, allergies or asthma are more prone to be affected by this condition. Those in the health care profession have also been linked to having hand Eczema. Children living in urban areas, who are African-American, attend child care centers, or have attention-deficit hyperactivity disorder (ADHD) are also under the increased risk category.

Is Eczema contagious? Can I get it through someone else?

No. As patients with Eczema lack “Ceramides” in the outer part of the skin due to hereditary condition, there is no probability to spread this through physical contact. “Ceramides” are the main component of the stratum corneum, most exposed layer of the human skin. Together with saturated fatty acids and cholesterol, “Ceramides” create a water-impermeable, protective organ to prevent excessive water loss due to evaporation as well as a barrier against the entry of microorganisms. Due to the deficiency, patients cannot retain moisture on their skin, resulting in a dry skin and itching. Basically Eczema is a genetic condition with no infectious etiology and it cannot be spread from one person to another person.

What are the Treatments for Eczema?

Mainly treatments can be divided into three categories. Non drug treatments, medication based treatments, and phototherapy. In all these ways, maintaining a good skin care comes as the key component in controlling eczema. Modification of skin care routine and changing some lifestyle components may be all that is needed to treat mild eczema. Others with severe eczema need to take medications prescribed by a dermatologist to control their symptoms.

What are the non-drug treatments for Eczema?

Mild soap and moisturizer are a good place to start. It’s best to use ones that won’t dry your skin after a shower. Gentle soaps, known as “Syndets,” are available at pharmacies. Using a good moisturizer will help to retain and improve the skin’s natural moisture and should be applied right away after a bath. It’s recommended to use moisturizing agents at least once per day with a bath. In severe Eczema it is beneficial to take baths with a small amount of bleaching agent added to the water since it may help kill bacteria that live on the skin and reduce any prone to fungi infections.

Taking short, warm showers help to retain moisture for longer period and avoid scratching due to a dry skin. Taking very hot or long showers can dry out your skin and should be prohibited. It’s important to get rid of a stressful mentality by taking the proper steps to reduce stress, like adhering to a regular exercise schedule in spite of one’s busy schedule and set aside time to relax.

Attaching a humidifier in the rooms of Eczema patients is important as humidity drops, the skin becomes dryer, and the tendency to itch can increase. In some patients, it is helpful to use a humidifier in the room.

What are the medications available for Eczema patients?

Antihistamines - Oral antihistamines like Benadryl are available through pharmacies which may help alleviate symptoms. Drowsiness is a side effect of these antihistamines which may be of effective if nocturnal itching is a problem. Non-drowsy antihistamines are available in the market.

Hydrocortisone - Hydrocortisone cream or ointment may help mild eczema. For more severe eczema, prescription steroid cream may be needed.

Corticosteroids - Oral corticosteroids are the next alternative if other treatments fail. Follow your doctor’s advice while taking oral steroids to avoid many side effects.

Immunosuppressants - Drugs that suppress the immune system may also be another option. These medicines, such as azathioprine, cyclosporine or methotrexate, may be used by the dermatolodists when other treatments have failed.

Immunomodulators - These types of medicated creams like Elidel and Protopic can help to treat eczema by controlling inflammation and reducing the immune system reactions.

(FDA has issued its strongest “black box” warning on the packaging of Elidel and Protopic. Prescription of short-term use of Elidel and Protopic only after other eczema treatments have failed is recommended for these drugs while younger children are restricted to use these medications.)

Ultraviolet light therapy-Is it good or bad for a treatment option?

Eczema phototherapy refers to the use of ultraviolet light to treat the skin rash and itching of eczema. Hyperactive skin immune system cells that cause inflammation can be suppressed by exposing the skin to UV light. UV light therapy is extremely effective when other Eczema treatments do not work well, and if done properly they actually have fewer side effects than many of the prescription medications used for eczema. These side effects include, repetitive trips to the hospital over several weeks (as this is a gradual treatment), burning due to improper hyper exposure to UV light, headache, and nausea. Although there is no evidence that Eczema phototherapy causes skin cancer, prolonged exposure to UV light can increase the tendency to skin cancer.

How can Eczema blowups be prevented?

It’s better to be aware of factors that may easily prevent an outbreak of Eczema. Moisturizing frequently with a quick, moderately warm bath and avoiding contact with water for longer periods of time helps to avoid dry out of the skin. Also avoid sudden changes in temperature, humidity, excessive sweating, and overheating for the same reason. Following a stress free schedule with regular exercise, avoiding scratchy materials such as wool, keeping away with harsh soaps, and avoiding any food that may provoke Eczema symptoms can be useful in preventing Eczema flare ups in day to day life.