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Eczema is a condition that affects the skin. Another name for eczema is dermatitis. Dermatitis is inflammation of the skin. There are many types of dermatitis. Atopic dermatitis is the most common form of eczema. Atopic Atopic refers to a tendency to develop allergy conditions. Seborrheic eczema (seborrheic dermatitis) is another form of eczema, which causes skin inflammation with no known cause. Eczema is most common in babies and children, but can occur at any age. As many as 20% of children and 1-2% of adults have Eczema.

Symptoms of Eczema

Eczema symptoms can vary from person to person but some of the most common symptoms include the following:

  • Intense Itching - this is usually the first symptom to appear and can be so intense that it interferes with sleep.
  • Rash - the rash is dry, flaky and patchy on top of reddened, inflamed skin. It usually appears on the hands, neck, face, and legs.
  • Burning - the rash may burn as well as itch
  • Oozing - clear fluid may ooze from the rash when scratched
  • Cracks - over time painful cracks may form on the rash
Causes of Eczema

The exact cause of eczema is not known. An abnormal function of the immune system is believed to be a factor. We do know that it is related to other allergies but the immune system does not react to eczema the same way it does with other allergic reactions. People with eczema do have the IgE antibodies (immunoglobulin E) that produced by the immune system with other allergic reactions. Eczema develops because contact with an external trigger (something that touches the skin) causes an allergic reaction. Eczema can develop on first contact (in days to weeks) or over time with repeated contact (in months to years). Contact with just about anything can cause eczema but some of the most common triggers include the following:

  • Soaps
  • Detergents
  • Cleaning agents
  • Cosmetics
  • Jewelry
  • Gloves
  • Clothing
  • Food handling
  • Rubbing
  • Sweating
  • Emotional or Mental Stress

Risk Factors for Eczema

Most people who have eczema have other allergies such as food allergies, hay fever, or even asthma, or have a family history of other allergies. Eczema is not contagious. You can't catch it from someone. Things that may cause eczema to flare up include illness, physical, emotional or mental stress, and exposure to irritants.

Types of Eczema

Atopic dermatitis is the most common form of eczema but there are several specific forms of eczema.

Atopic dermatitis
This is the most common form of eczema and people often use the two terms interchangeably. Atopic dematitis can be defined as a chronic skin disease characterized by itchy, inflamed skin. It is believed to be caused by an abnormal function of the body's immune system. This type of eczema tends to come and go, depending upon exposures to triggers or causative factors. The skin becomes extremely itchy and inflamed, causing redness, swelling, cracking, weeping, crusting, and scaling. Atopic dermatitis tends to run in families, and people who develop the condition often have a family history of allergic conditions such as asthma or hay fever. Atopic dermatitis most often affects infants and young children but can affect adults as well.

Contact Eczema
Contact eczema (contact dermatitis) is a localized reaction that occurs in response to contact with a specific allergen or irritant. Developing a rash from contact with poison ivy, poison oak, and poison sumac are examples of contact eczema. Other examples of contact eczema include reactions to soaps, laundry detergents, nickel (present in jewelry), cosmetics, fabrics, clothing, and perfume. People with a history of allergies have an increased risk for developing contact eczema.

Seborrheic Eczema
Seborrheic eczema (seborrheic dermatitis) is a form of eczema which causes skin inflammation with no known cause. It usually can not be associated with a trigger or allergen. Seborrheic Eczema can be distinguished from other forms of eczema by it's yellowish, oily, scaly patches which typically occur on the scalp, face, & sometimes other parts of the body. "Cradle Cap" in infants is a good example of seborrheic eczema. Dandruff is another example. Itching is not always a symptom in this type of eczema. Seborrheic Eczema tends to run in families. Oily skin, infrequent shampooing, emotional stress, and weather conditions can all increase a person's risk of developing seborrheic eczema.

Nummular Eczema
Nummular eczema (nummular dermatitis) is an itchy rash characterized by coin-shaped patches on the skin that may be crusted, scaling, and extremely itchy. The patches are usually found on the arms, back, buttocks, and lower legs. This type of eczema is relatively rare and mostly affects older men. The condition tends to be chronic, with periods when it gets much better or worse.

Neurodermatitis, also known as lichen simplex chronicus, is a chronic skin inflammation caused by a scratch-itch cycle that begins with a localized itch (such as an insect bite) that becomes intensely irritated when scratched. This form of eczema results in scaly patches of skin on the head, lower legs, wrists, or forearms. Eventually, the affected skin becomes thick and leathery. Stress can worsen the symptoms of neurodermatitis. Once treatment is started and the itch-scratch cycle is stopped, it can take months for the skin to return to normal. It is more common in women than men and usually affects people between the ages of 20-50.

Stasis Dermatitis
Stasis dermatitis is a skin irritation on the lower legs, that generally occurs in people with a problem with circulation known as venous insufficiency, in which the function of the valves within the veins has been compromised. Because of this poor circulation, fluid builds up in the legs causing swelling. The swollen skin becomes irritated, red, itchy, and can be painful. Stasis dermatitis occurs almost exclusively in middle-aged and elderly people. Without treatment the skin can blister and ooze and ulcers can form.

Dyshidrotic Eczema
Dyshidrotic eczema (dyshidrotic dermatitis) involve the skin on the palms of the hands and the soles of the feet. It is characterized by clear, deep blisters that itch and burn. It is also known as vesicular palmoplantar dermatitis, dyshidrosis or pompholyx. The cause of dyshidrotic eczema is unknown. This type of eczema is more common during the spring and summer months and in warmer climates. Males and females are equally affected, and the condition can occur in people of any age.

Treatment for Eczema

Treating eczema can be as simple as removing or avoiding the trigger that is causing the skin irritation. This can be as simple as switching soap. For other eczema sufferers it's not that simple so they need treatment. In treating eczema, most doctors will start patients on basic therapies which can be done at home. In cases of mild eczema, these home therapies may be all that is needed. Taking good care of your skin is most important in controlling eczema. Taking a warm or room temperature (not hot) baths or showers will help keep skin from becoming too dry. Hot water is very drying to the skin. Oils added to the bath water may also be recommended. Use a mild soap or body cleanser. Avoid soaps, cleansers, lotions etc. with fragrances or other irritating substances. Dry yourself very carefully (pat dry, don't rub) and apply a good moisturizer, immediately after drying, to help conserve the skin's natural moisture. Keep the rash and surrounding area clean to prevent infection of broken skin. Avoid wearing tight-fitting, rough, or scratchy clothing. As hard as it is, try to avoid scratching the rash. You may want to cover the area with a gauze dressing. These are all things that will at least help in eczema. Some people may need further treatment such as medication. Medications commonly used in treating eczema include Corticosteroid creams and ointments (Cortizone) to relieve itching, which can be purchased at your local drug store. If the eczema is more severe, your doctor may prescribe a stronger, prescription steroid cream. If these don't work, the doctor may prescribe oral corticosteroid medication. An antihistamine such as Diphenhydramine (Benadryl) in pill form may be taken for the itching. Antihistamines often cause drowsiness, so it's best to take these at night, and never operate an automobile or heavy machinery until you know how the medication affects you. There are newer drugs called topical immunomodulators available to help treat eczema. These medicines help control inflammation and reduce immune system reactions when applied to the skin. Examples include Elidel and Protopic. Because clinical trials have shown an increased risk of skin cancer with these medications, the FDA has warned that they should only be used short-term and only after other available eczema treatments have failed. For severe cases not responding to other treatment, alternate treatments may be tried. These include coal tar, PUVA (psoralen + ultraviolet A light), and drugs that suppress the immune system.

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