Health Tips

Eczema

What is it all about?

Eczema is a condition that makes your skin red and itchy when it is inflammed. It's common in children but can occur at any age, for some of us, it may go away by adulthood. Eczema is a long lasting condition that tends to flare up periodically, hence it is commonly know as a recurring condition after the first break out.

There are many different types of eczema and the symptoms that come with it may vary from person to person. Therefore, later in the article, we will dive deeper to understand the specific causes and symptoms for each different type of eczema!

Eczema is related to a gene variation that affects the skin's ability to provide this protection that normally a person would have. This allows your skin to be more easily affected by environmental factors, irritants and allergens. Although the main reasoning behind eczema is due to the genes that causes an affected immune system, exposure to external trigerring factors can be controlled to miminise the impact onto the skin!

Although no cure has been found for eczema yet, healthy skin helps to retain moisture and protects you from bacteria, irritants and allergens. Treatments and self-care measures are extremely important to relieve itching and prevent new outbreaks. Let's look deeper into what we can do to prevent outbreaks at the end of the article!

Types of Ezcema

1. Atopic dermatitis

Atopic dermatitis is a form of eczema that represents a chronic, itchy inflammatory skin disease that is more commonly found in children but it can also affect adults. For some of them, it may go away by adulthood. It is often associated with elevated serum immunoglobulin (IgE) levels and a personal or family history of type I allergies, allergic rhinitis, and asthma.

Symptoms of atopic dermatitis includes:

• A rash that commonly forms: In the creases of your elbows or knees

• Area of skin affected may turn lighter, darker or thicker

• small bumps may appear and leak fluid if you scratch them

• Babies often get the rash on their scalp and cheeks

The cause of atopic dermatitis is usually due to a weakened immune system, therefore the natural barrier of the skin is more susceptible to irritable and allergens. Therefore a few factors that would lead to an atopic dermatitis includes:

• Genes/family history

• Weakened immune system

• External allergens/chemical triggers

• Dry skin

2. Contact dermatitis

Contact dermatitis is another form of eczema inflammation that is caused by allergies when there is a direct skin exposure. Patients with contact dermatitis will develop red and irritated skin when exposed to particular irritants that they are allergic to. A few common examples of irritants include latex, metal or strong chemical detergent.

Symptoms of contact dermatitis include:

• Itchy, red skin that may burn or sting

• Itchy bumps called hives may pop up on your skin

• Fluid-filled blisters can form that may ooze and crust over

Causes of contact dermatitis are more obvious as compared to other forms of eczema. The main cause would be direct exposure to irritants. Everyone reacts to certain substances differently so it is important to know what triggers your eczema! Here is a more comprehensive list of irritants that you might be allergic to:

• bleach

• jewelry

• latex

• nickel

• paint

• poison ivy and other poisonous plants

• skin care products, including makeup

• soaps and perfumes

• solvents

• tobacco smoke

3. Dyshidrotic eczema

Dyshidrotic eczema is an intensely itchy, chronic and recurrent skin eczema condition that is commonly associated with small blisters formation. Affected area of skin would usually be on the hands or feet. This form of eczema is more common in women than men!

Symptoms of dyshidrotic eczema include:

• Fluid-filled blisters on your fingers, toes, palms or soles of your feet

• Blisters may be itchy or painful

• Affected area around the blisters may crack, flake or thicken up

Dyshidrotic eczema can be caused by:

• Allergies

• Damp hands and feet

• Exposure to substances such as nickel, cobalt, or chromium salt

• Stress

4. Hand eczema

Hand eczema is a form of eczema that only affects your hands. The cause of this type of eczema is more commonly due to daily lifestyle. You may get inflamed with hand eczema if you are frequently exposed to strong chemicals like a hairdressing or cleaning related type of work.

Symptoms of hand eczema include:

• Red, itchy and dry hands

• Joints of fingers may crack or form blisters

As hand eczema is triggered by exposure to chemicals, people who fall in these fields of work may be prone to hand eczema:

• cleaning

• hairdressing

• healthcare

• laundry or dry cleaning

5. Neurodermatitis

Neurodermatitis is a form of eczema that is similar to atopic dermatitis. It is commonly associated with thick, scaly patches of skin that form when it flares up.

Symptoms of neurodermatitis includes:

• thick, scaly patches form on your arms, legs, back of your neck, scalp, bottoms of your feet, backs of your hands, or genitals

• these patches can be very itchy, especially when you’re relaxed or asleep

• if you scratch the patches, they can bleed and get infected

Neurodermatitis usually starts in people who have other types of eczema or psoriasis. Although the exact cause of neurodermatitis is unclear, many have suggested that stress may be a main factor.

6. Nummular eczema

Nummular eczema is a chronic, recurrent, inflammatory skin eczema characterized by multiple itchy, coin-shaped, inflamed lesions on any part of body.

Symptoms of nummular eczema includes:

• round, coin-shaped spots form on your skin

• the spots may itch or become scaly

Nummular eczema can be triggered by a reaction to an insect bite, or by an allergic reaction to metals or chemicals. Dry skin can also cause it. You’re more likely to get this form if you have another type of eczema, such as atopic dermatitis.

Stasis dermatitis

Stasis dermatitis is a common inflammtory skin condition that happens when fluid leaks out of weakened veins into your skin. This fluid causes swelling, redness, itching, and pain.

Symptoms of stasis dermatitis includes:

• the lower part of your legs may swell up, especially during the day when you’ve been walking

• your legs may ache or feel heavy

• you’ll likely also have varicose veins, which are thick, ropey damaged veins in your legs

• you may develop open sores on your lower legs and on the tops of your feet

How can I prevent another eczema outbreak?

1. Moisturize skin daily with rich, oil-based cream or ointment to form a protective barrier against the elements right after a shower.

2. Know your triggers and avoid them! E.g. strong detergent, latex, food allergies, makeup, chemicals or stress.

3. Apply steroid cream or ointment when inflammation flares up. Consult a doctor before using them.

4. Wear loose-fitting clothes made from soft fibers like cotton.

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References:

1. https://patient.info/skin-conditions/atopic-eczema

2. https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273

3. https://www.healthline.com/health/types-of-eczema

4. https://www.columbiaasia.com/malaysia/health-articles/how-ease-eczema-itch-dermatologist-way

Written by

Ms Jean Lau