Eczema is a condition in which the skin itches and turns red from time to time. It is common in children but adults can get it too. People with eczema often have allergies or asthma along with itchy, red skin. Eczema is not a single health condition but a recognizable pattern seen in a number of skin diseases. There are different types of eczema with varying causes but there are some commonalities between them.
Common symptoms of eczema
Itching: Itching can be intense. Most damage to the skin, when someone has eczema, is often due to scratching because of the itching.
Scaling: The surface of the skin can flake off giving skin a roughly scaly appearance.
Redness: The affected skin may bleed and appear blotchy
Fluid-filled blisters: They can ooze and form crusts.
Cracking: Severely affected skin may develop painfully deep cracks also called fissures.
Types of eczema
1. Atopic dermatitis
It’s the most common form of eczema usually starting in childhood and getting milder or going away completely by adulthood. Many people with atopic dermatitis also have asthma and hay fever which is why doctors refer to the three as the atopic triad.
Symptoms
- The rash often forms in the creases of elbows and knees.
- Skin in areas where the rash appears may turn lighter or darker or get thicker.
- Small bumps may appear and leak fluid when scratched.
- Skin can get infected when it’s scratched.
Causes
It happens when your skin which functions as the barrier against the elements is weakened compromising its ability to protect against irritants and allergens. It’s caused by a combination of factors including:
- Genes
- Dry skin
- An immune system problem
- Triggers in the environment
Treatment/Management
When it’s mild management may include:
- Avoiding known triggers
- Maintaining a regular bathing and moisturizing routine to protect and strengthen the skin barrier
- Getting high-quality sleep
- Eating a healthy diet
- Managing stress
2. Contact dermatitis
This is when the skin is red and irritated as a reaction to substances you may have touched. There are two types allergic contact dermatitis and irritant contact dermatitis.
Allergic contact dermatitis is a delayed reaction that appears as a rash a day or two after the skin is exposed to an allergen. It happens when the immune system reacts to an irritant like latex or metal. A common example is poison ivy. Other causes include fragrances and nickel.
Irritant contact dermatitis accounts for about 80% of all contact dermatitis and doesn’t involve an allergic reaction by the immune system. It happens when skin cells are damaged by exposure to irritating substances like solvents, detergents, soaps, bleach, makeup, hair dye, over-washing hands with hot water and soap, and wearing wool.
Symptoms
- The skin itches, turns red, burns, and stings.
- Itchy bumps called hives may pop up on the skin.
- Fluid-filled blisters can form that may ooze and crust over.
- Over time, the skin may thicken and feel scaly or leathery.
Treatment/Management
- Prescribe topical steroids to resolve itching and other contact dermatitis symptoms.
- Preventing future outbreaks by pinpointing and avoiding irritants, allergens and triggers.
3. Dyshidrotic eczema
It causes small blisters to form on your hands and feet. It’s more common in women than men.
Symptoms
- Intensely itchy blisters (sometimes fluid-filled) form on your fingers, toes, palms, and soles of your feet.
- Blisters may itch or hurt.
- Skin can scale, crack, and flake.
Causes
- No singular cause is known but it runs in families suggesting a genetic component.
- Allergies
- Damp hands and feet
- Exposure to substances like nickel, cobalt, or chromium salt
- Stress
Treatment/Management
Helpful steps include:
- Wash the affected skin with a mild cleanser and gently pat dry.
- Apply a heavy cream with ingredients like ceramides to help repair the skin barrier
- Remove rings and other jewellery when you wash your hands so water doesn’t linger on your skin.
- Wash and then moisturize hands or feet immediately after coming into contact with a potential trigger.
- Use stress management techniques.
- Keep fingernails short to help prevent scratching from breaking the skin.
4. Hand eczema
This refers to eczema that only affects the hands. One may get it if they work in a job like hairdressing or cleaning where they regularly use chemicals that irritate the skin.
Symptoms
- Hands get red, itchy, and dry
- May form cracks or blisters
Causes
Exposure to chemicals at work. Common among people in fields like cleaning, hairdressing, healthcare, and laundry or dry cleaning.
5. Neurodermatitis
Is similar to atopic dermatitis and causes thick, scaly patches to pop up on your skin.
Symptoms
- Thick, scaly patches form on the arms, legs, back of the neck, scalp, bottoms of feet, backs of the hands, or genitals.
- The patches can be very itchy, especially when one is relaxed or asleep.
- When scratched, the patches can bleed and get infected.
Causes
It usually starts in people who have other types of eczema. Doctors don’t know exactly what causes it but stress is a likely trigger.
Treatment/Management
- Most medication prescribed, usually topical is aimed at healing the skin and ending the itch-scratch cycle.
- Some oral medications like antihistamines can also help stop the urge to scratch.
- Some patients may benefit from counselling to help address anxiety and other emotional issues that may contribute to the itch-scratch cycle.
- Moisturizing daily, using cool compresses or taking baths, and wearing loose-fitting non-irritating clothes that can relieve itching.
- Keep fingernails short to minimize damage caused by scratching.
6. Nummular eczema
The word “nummular” means coin in Latin. This type of eczema causes round, coin-shaped spots to form on the skin.
Symptoms
- Round-coin shaped spots form on the skin.
- The spots may become scaly and the skin around them becomes inflamed.
- Itching and burning.
- Lesions that are oozing liquid or have crusted over.
Causes
- People with another type of eczema are more likely to get it.
- Reaction to an insect bite.
- Allergic reaction to metals or chemicals.
Treatment/Management
Prescribed topical antibiotics.
7. Stasis dermatitis
Happens when fluid leaks out of weakened veins into the skin causing swelling, redness, itching, and pain.
Symptoms
- The lower part of the legs may swell up, especially during the day after walking.
- Legs may ache or feel heavy.
- Potential varicose veins i.e. thick, ropey, damaged veins in the legs.
- The skin over the varicose veins is dry and itchy.
- May develop open sores on legs and tops of feet.
Causes
Blood flow problems in the lower legs.
Other risk factors include
- High blood pressure
- Obesity
- Multiple pregnancies
- History of blood clots in the legs
- Congestive heart failure
- Kidney failure
- Jobs that involve long hours of sitting or standing with little physical activity
Treatment/Management
Treatment can include:
- Compression stockings to reduce swelling.
- Elevating legs above the heart every two hours to reduce swelling.
- Avoiding foods high in salt.
- Supplemental vitamin C.
- Topical creams to apply to calm inflammation.
- Topical or oral antibiotic if the skin is affected.
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