Treatment
Eczema
Eczema is an inflammatory skin condition affecting up to 15 million people in the US. Eczema is common in young children, however, almost 50% of them will grow out of it by the time they reach adulthood.
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Reviewed by Dr Roy Kedem, MD
Information last reviewed 09/29/20
‘Eczema’ refers to a group of skin conditions that cause dry, irritated skin. There are several different types of eczema, including contact dermatitis - a type of skin irritation resulting from contact with a particular substance.
Eczema is caused by the immune system sending inflammatory signals to the skin. This can cause rashes, itchiness, and other eczema symptoms. In the case of contact dermatitis, the immune system is triggered by contact with an irritating substance.
Eczema is not a fatal disease; however, it can have a significant impact on quality of life.
Eczema is caused by a range of different stimuli depending upon the type of eczema. It is a good idea to identify what triggers your eczema, so you can avoid it as possible. Cold, damp or dry weather can trigger eczema.
Allergens which can trigger eczema include:
Eczema often occurs as a consequence of an allergic reaction. This is called contact dermatitis. In addition, atopic dermatitis is more common in people who have allergies, such as a pollen allergy. Therefore, eczema and allergies often come together, but you do not need to have any allergies to have eczema.
Different types of eczema can look very different from each other. There are seven types of eczema. The symptoms of each are outlined below:
Depending on the type of eczema you experience, the affected skin patches may be raised or flat. Contact dermatitis, atopic dermatitis, dyshidrotic eczema, and nummular eczema are particularly likely to have raised patches.
The area of skin affected by eczema can become larger. Eczema is not contagious and cannot be spread to other areas of the body through skin-to-skin contact.
Hives are red, itchy, raised areas of skin. Some types of eczema, including atopic dermatitis and contact dermatitis, can present with hives.
Some types of eczema do lead to swelling of the skin. However, swelling can also be a symptom of infection, so it is a good idea to watch out for other symptoms of infection, such as:
Areas of skin affected by eczema are more prone to infection as the skin is damaged. Scratching your skin increases the chance of infection, as it causes further damage, providing an opportunity for microbes to enter the body. Therefore, it is important to avoid scratching eczema-affected areas. If you notice any symptoms of infection, you should speak to your doctor.
Eczema doesn’t always hurt, but it can be painful for some people, particularly if the eczema is severe. If your eczema causes you significant pain, you may want to speak to your doctor, as they may be able to offer you stronger treatment.
Eczema does not cause a fever. However, eczema-affected areas can be susceptible to infection. Infections may cause a fever and the following symptoms:
If you have any of the above symptoms, you should seek medical attention as soon as possible.
Eczema is an inflammatory reaction. During an inflammatory reaction, blood flow to the affected area increases causing redness and itching.
Seborrheic dermatitis often affects the scalp but does not directly cause hair loss. However, it can be itchy, and excessive scratching can damage the hair follicles and lead to hair loss.
Eczema can leave scars. This is not always preventable, but you should try to avoid scratching, or picking at scabs to reduce the chances of permanent scarring.
Depending on the severity of the scars, they may go away over time. Steroids and laser therapy may help you to get rid of eczema scars that do not heal naturally.
Eczema is usually diagnosed through an examination of the affected area and your medical history. Tests are not usually required, although skin samples may be taken to confirm a diagnosis or rule out other conditions.
There are several different types of eczema. To determine which type of eczema you have, you should speak to your doctor or a dermatologist. The different types of eczema have different characteristics. The following table may help you identify which type of eczema you have, but you should always seek medical advice for diagnosis and treatment.
Most people need to use some treatment to get rid of eczema during a flare-up, but there is no known eczema cure. Eczema usually recurs once you have had it; however, some people do grow out of eczema as they get older.
The first-line treatment for mild eczema is emollient creams. Emollients are moisturizing creams that help the skin repair itself. Following this, a steroid cream can be tried. Steroid creams contain corticosteroids and come in a range of different strengths. Your doctor will prescribe a strength that is appropriate for the severity of your eczema. If the steroid cream you have been prescribed does not adequately treat your eczema, your doctor will prescribe you a more intense cream. Corticosteroids are also available in ointments, lotions, and shampoos if an alternative preparation is required (e.g. a shampoo would be most appropriate for seborrheic eczema affecting the scalp).
There is no cure for eczema, but there are several treatments available, including emollients and steroid creams. Some people do grow out of eczema as they get older, so you may find that your eczema goes away over time.
An Eczema flare will generally resolve if the area is shielded from further irritation. Emollients work by preventing the skin from drying out, and steroid creams help to reduce the swelling and redness during a flare-up.
When you first start experiencing eczema symptoms, you should make an appointment with your doctor or dermatologist. Depending upon the type of eczema and the severity of your condition, they will probably prescribe you emollients and steroid creams. It is also a good idea to identify any possible eczema triggers such as allergens or stress.
When eczema flares up, you should use the treatment you have been prescribed, usually both emollients and steroid creams. If you do not have any medication left, you should order more or request a new prescription. You should try to avoid scratching the affected area to reduce the chances of infection.
You should continue with treatment as your eczema heals and for a few days after the symptoms have resolved. As your eczema is healing, it can be tempting to scratch or pick at your skin. You should avoid doing this as much as possible, because this interferes with the healing process and can lead to scarring and infection.
Some types of eczema can cause the skin to peel. This can be mild, like the peeling after sunburn, or more severe revealing raw skin underneath. It is important that you continue with your eczema treatment as prescribed, but if you feel your eczema has worsened, you may want to discuss this with your doctor.
Eczema is vulnerable to infection, especially if the skin is broken. Symptoms of infection include:
a yellow crust over the affected area, liquid coming from the wound, swelling, inflammation, fever and chills. If you experience any of these symptoms, you should seek medical attention as soon as possible. Depending upon the type and severity of infection, you may be prescribed antibiotics or even admitted to the hospital.
Not all treatments are effective. Sometimes, it can take a while to find the treatment that works best for you. If your eczema symptoms don’t subside within two weeks of treatment, you should return to your doctor, as there may be stronger treatments that they can prescribe.
Several types of eczema can produce blisters. This includes dyshidrotic eczema, nummular eczema, atopic dermatitis, and contact dermatitis. However, the blisters can appear differently in each type of eczema:
If you experience eczema blisters, you should avoid anything that may break the skin. This includes itching, scratching, rubbing, bursting, or piercing the blister. Breaking the skin increases the healing time and increases the chance of infection and scarring.
The best eczema cream for you depends upon the type of eczema you experience and how severe it is. Your doctor will always try to prescribe the weakest effective treatment for your condition. This is because steroid creams can produce side effects, and the stronger the medication, the greater risk of side effects. It can take a while to find the best treatment for your eczema, so if you find that your treatment is not having an effect after 2-3 weeks, you should speak to your doctor. They may be able to prescribe something more effective.
If you only have mild eczema, it may be treated with emollient creams. If emollients are not effective, steroid creams are the best option. A doctor will always help you weigh up the risks and benefits of a treatment before prescribing.
Some food allergies can trigger a flare-up of eczema, but they do not cause the condition itself. The following allergies or intolerances are associated with eczema:
It may be a good idea to avoid some of these foods if you notice an association between them and your eczema flare-ups.
There is limited evidence to suggest that certain foods can help to reduce eczema flare-ups, but the following foods may help to reduce flare-ups of eczema:
Eczema scars may be permanent depending upon the severity of the scarring and how well your body heals itself. Excessive scratching of the affected areas can lead to more severe scarring. Steroids and laser therapy may be an option to reduce the appearance of scars if necessary.
There is a subtype of contact dermatitis, known as textile contact dermatitis. Your skin reacts to the texture of the fabric and the dyes, cleaning products or other chemicals contained in the fabric. Sweating can exacerbate contact dermatitis, so if you are experiencing eczema as a result of your clothes, try wearing natural fabrics, such as cotton and silk, which are more breathable. In addition, people who wear tighter clothes and people who are obese are more likely to get textile contact dermatitis; therefore, you may want to wear loose-fitting clothes and consider weight loss to reduce your eczema symptoms.
Sweat contains water and other substances such as urea, lactate, and sodium. Sodium, in particular, can dehydrate the skin and cause irritation and soreness. If you find that you get eczema where you sweat, you may want to try wearing loose-fitting, breathable clothing to stop the sweat from being trapped against your skin. In addition, there are some prescription antiperspirants, such as Anhydrol Forte, that may be able to help if you feel you sweat excessively.
Eczema and psoriasis have similar symptoms but are different conditions. Generally, the itching and pain associated with eczema are considered to be worse than that of psoriasis. Psoriasis, however, may be more difficult to treat.
Symptoms of eczema and scabies can be very similar but they have very different causes: eczema is caused by an inflammatory reaction, whereas scabies is a mite infestation. For this reason, scabies is highly contagious through skin-to-skin contact. As mentioned, eczema is not contagious.
Like eczema, scabies can produce an intensely itchy rash. In scabies, this rash can spread across the entire body, whereas in eczema, it tends to be localized to specific areas depending upon the type of eczema. In addition, a scabies rash often consists of redness with lots of small pimple-like lumps. You may also see subtle lines on the skin, where the mite has burrowed and laid eggs. It is common for mites to burrow between the toes and fingers. Eczema rashes are highly variable but often involve dry, flaky skin.
Symptoms of eczema and heat rash can be distinguished in the following way: A heat rash is caused by excessive sweating, where glands become blocked, resulting in a rash a few days later. The rash consists of small red spots and a prickly feeling. Eczema rashes can vary, depending upon type, but often involve dry skin or small blisters. Both eczema and heat rash can cause itchiness, redness and mild swelling. A heat rash should disappear after a few days, whereas eczema can take several weeks, and requires medical treatment.
Rosacea affects the skin on the face only, whereas eczema can affect a range of different areas. Seborrheic eczema does affect the face in similar places to rosacea; however, seborrheic eczema is characterized by greasiness and dandruff, whereas rosacea produces persistent redness and sometimes small red bumps. Other symptoms of rosacea include eye discomfort and an enlarged nose.
Dermatitis is an inflammation of the skin. Contact dermatitis, atopic dermatitis, neurodermatitis, seborrheic dermatitis, and stasis dermatitis are all different types of eczema.
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
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