Eczema - Treatment and Prevention

What Is Eczema?

Eczema, also known as atopic dermatitis, is a skin condition that causes the skin to become dry, red, itchy, and bumpy. It is one of many forms of dermatitis and is more common in children, but it can occur at any age. Eczema damages the skin barrier function, making the skin more sensitive and vulnerable to infection and dryness. However, eczema does not harm the body. Also, it does not mean that the skin is dirty or infected and is not contagious. Treatments can help manage the eczema symptoms. Unfortunately, to date, no cure has been found for eczema. But treatments and self-care measures can reduce itching and prevent new outbreaks.

How Is Eczema Classified?

Eczema can be broadly classified into:

Endogenous Eczema - The most prevalent in the population is atopic eczema, an itchy skin condition presenting since childhood along with or without a history of sneezing, allergic rhinitis, and asthma.

Exogenous Eczema - Among exogenous eczema, contact dermatitis is the most common type, whether it is allergic or irritant contact dermatitis.

What Are the Types of Eczema?

• Acute Eczema - Individuals with acute eczema can present with fluid-filled vesicles, blisters, erythematous papules, and itching. One significant history is the discharge of water and blood when the patient scratches the lesions.

• Subacute Eczema - In subacute forms, scaling starts to become more prominent.

• Chronic Eczema - In chronic cases, the thickness of the skin increases, causing the skin to become rough and dry.

What Causes Eczema?

The following factors cause eczema (atopic dermatitis):

• Immune System: The immune system overreacts to irritants or allergens if someone has eczema, resulting in skin inflammation.

• Genetics: People are more likely to have eczema if they have a history of dermatitis. In addition, a person is at a higher risk if there is a history of hay fever, asthma, or allergens like pollen, pet hair, or food products. Sometimes, there may be a change in the genes that control a protein that helps the body maintain healthy skin. Without normal protein levels, the skin cannot be completely healthy.

• Environment: Exposure to air pollutants, tobacco smoke, harsh soaps, fabrics such as wool, and certain skin products can irritate the skin. Low humidity can also lead to dry, red, and itchy skin. Heat and high humidity can cause profuse sweating, making the itching worse.

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• Stress: Emotional (depression, difficulty relaxing, anxiety, or use of illegal drugs to relax) and physical (nausea, dizziness, diarrhea, constipation, or insomnia) stress levels can cause or worsen eczema.

Who Is at More Risk for Eczema?

Eczema can happen at any age, but it usually begins in childhood. The primary risk factors for eczema include:

• Being female.

• African-American.

• Family history of eczema, hay fever, or asthma.

What Are the Signs and Symptoms of Eczema?

Eczema symptoms may vary from person to person and include:

• Dry skin.

• Itching, which may be intense, especially at night.

• Red to brownish-gray patches, especially on the hands, feet, ankles, and wrists.

• Crusting skin.

• Swelling.

• Hardened, cracked, and scaly skin.

• Tiny, raised bumps.

• Scaly, leathery patches of skin.

How Is Eczema Diagnosed?

No laboratory test is necessary to diagnose eczema. Instead, the healthcare provider probably makes a diagnosis simply by examining the skin and reviewing the medical history. However, when there is doubt, the provider may perform the following tests:

• An allergy skin test.

• Blood tests to look for causes of the rash that may be unrelated to dermatitis.

• A skin biopsy to differentiate one form of dermatitis from another.

How Is Eczema Treated?

Treatment of eczema can be difficult if the cause is something that cannot be controlled, such as genetics. First, try to figure out what triggers or worsens eczema, and then avoid it. The treatment aims to reduce itching and discomfort and prevent infection and additional flare-ups. However, no treatment can eliminate the symptoms of eczema 100 % of the time.

Consider the following treatment tips:

• Use a humidifier if dry air makes the skin dry.

• Seek help from a psychiatrist or a therapist for counseling for symptoms of poor emotional health.

• Moisturize the skin at least twice daily with suitable products, including bath oils, creams, ointments, or sprays.

• Use lukewarm water for a shower or bath instead of using hot water.

• Use gentle soaps and other skincare products free of fragrances and alcohol.

• Take over-the-counter antihistamines for intense itching.

• Apply over-the-counter cortisone creams and ointments to relieve the itching and redness.

• The healthcare provider may recommend steroid creams, pills, or shots. However, some adverse effects of these medications include weight gain, high blood pressure, and thinning of the skin. Some newer drugs, called topical immunomodulators, show progress in treating people unresponsive to other treatments.

• A biological drug called Dupilumab is FDA approved for treating moderate to severe eczema. These drugs block specific proteins from binding to receptors on the cells, easing or preventing inflammation by keeping the immune system from overreacting.

• Other medication options for eczema include:

  • Mycophenolate mofetil.

  • Phosphodiesterase inhibitors.

  • Azathioprine.

  • Methotrexate.

  • Ruxolitinib.

  • Upadacitinib.

• Phototherapy: The ultraviolet light (UV) waves in sunlight have been proven to help treat certain skin conditions, including eczema. Phototherapy utilizes ultraviolet light, often ultraviolet B (UVB), from special lamps.

What Is the Outlook or Prognosis for People With Eczema?

Most children with eczema outgrow the condition or experience significant improvement when they reach puberty. But unfortunately, others may continue to have some form of eczema. The condition can be well-managed for adults with good skin routine and treatment, although flare-up symptoms can happen throughout life.

Conclusion

Eczema is a common skin disorder that is not contagious. However, it can be uncomfortable and affect the quality of life. At its worst, it can keep a person from sleeping and make them feel self-conscious. See a healthcare provider as soon as you notice symptoms to get the treatment immediately. Prescribed treatments and self-care measures can alleviate itching and prevent new outbreaks.