What is Eczema?
Eczema is the term used to describe a chronic skin disorder characterized by inflammation of the skin. Eczema results in irritation and itchiness, but scratching only prolongs the cycle. In most cases, the skin will begin to itch before a rash appears. Characteristic patches of dry, red, and itchy skin and can occur anywhere on the body and skin may develop scales or crusts over time. Affected areas are more likely to become infected with scratching. Eczema is more common in children than adults. In most cases, the condition appears before the age of five.
What causes eczema?
The cause of eczema is not clear. In most cases, eczema is associated with a condition known as atopic dermatitis. About 70 percent of individuals with eczema have a family history of “atopy,” which refers to the group of disorders that include asthma, hay fever (allergic rhinitis) and eczema. Up to 80% of children with eczema will later develop hay fever and asthma over time.
There are several genetic mutations that seem to occur frequently in individuals with eczema that are also associated with an increased risk of asthma and food allergy. Families with a significant history of atopy sometimes carry a mutation in one or more genes that needed to produce critical proteins in the skin structure, resulting in an impaired skin barrier. The body’s immune response is another factor implicated in development of eczema.
Some substances or exposures are considered “triggers” for eczema. These substances or exposures do not cause eczema, but they may cause a flare in someone who has the underlying condition..
Individuals with eczema seem to experience more frequent allergic reactions to dust mites, seasonal pollens, mold, or pet dander. Although eczema is not an allergic reaction, researchers have suggested that eczema is associated with an increased sensitivity to potential allergic reactions. Up to 80% of individuals with atopic dermatitis have sensitivity to specific foods, including dairy products, eggs, nuts, soy products, and wheat.
Other triggers in the environment include chemicals such as disinfectants, soaps, and detergents. Certain bacteria, fungi, and viruses may trigger a flare of eczema. Extreme temperatures and stress are triggers for eczema in some people.
Types of eczema
In addition to eczema associated with atopic dermatitis, eczema is associated with several other types of dermatitis. Neurodermatitis refers to eczema that develops in an area of skin irritation as a result of scratching. This can result in thickening or formation of deep wrinkles, although areas affected by neurodermatitis usually do not spread or increase in size. Seborrheic dermatitis refers to dandruff, which may be the result of an overgrowth of yeast that is normally found in balance on the scalp and other areas where hair grows. Stasis dermatitis is a type of eczema that develops in the lower extremities, particularly around the ankles, in people with poor veins and chronic swelling. Over time, theses areas may “weep” and develop crusts or a brown discoloration. Contact dermatitis refers to eczema that develops after contact with a strong skin irritant or after an allergic reaction to substances like poison ivy. Dyshidrotic dermatitis affects the hands and feet, initially as itching that gives way to blisters or scaly patches. Over time, deep and painful cracks may develop in the affected skin. Finally, coin-shaped red marks are associated with nummular eczema and affect men more frequently than women, usually after the age of 50. Although the cause of nummular dermatitis is not known, the risk is increased with exposures to chemicals like formaldehyde.
Treatment of Eczema
Eczema is a chronic skin condition in many patients, but treatment can minimize the occurrence of flares. Steroids, including oral medications and topical creams and ointments, are commonly used to treat patients who have eczema. Protecting the skin from exposure to irritant substances or allergens is also important when trying to control this condition. Patients should be careful to further irritation and possible infection by resisting the urge to scratch the affected areas. Some patients may require treatment with ultraviolet light. If you have eczema, consider a consultation with a dermatologist. Call us today for an appointment at one of our convenient locations.