Eczema

Eczema

What is a Eczema? Eczema, also known as “Atopic Dermatitis” is an extremely common chronic inflammatory condition of the skin that affects people of all ages and walks of life. Eczema may be termed as a “Disease” however you can “Not” catch it, or give it to someone else and there is no risk of passing it on. Eczema “as it is not fully understood” has been found with new research to be linked to the immune system and more closely resembles an “Allergy” than anything else, this of course leads to mild to severe inflammation and irritation of the skin as the immune system “over reacts” to stimulus.

There are many types of eczema, with the most common one being “atopic dermatitis”. Atopy refers to a hereditary tendency towards eczema, asthma, and allergic rhinitis “hay fever”, people with eczema may also suffer with one of the other conditions as well, these conditions are linked by an increased activity of the allergy component of the immune system. Atopic Dermatitis is most likely caused by a combination of genetic and environmental factors. Genetic causes include differences in the proteins that form the skin barrier. When this barrier is broken down, the skin loses moisture more easily, becoming more dry, easily irritated, and hypersensitive. The skin is also more prone to infection “with bacteria, viruses, or fungi”.

Types of Eczema:

• Allergic contact eczema - The skin gets red, itchy, and weepy because it touches something that the immune system knows is foreign, like poison ivy.
• Contact eczema - The skin has redness, itching, and burning in one spot because it has touched something allergy-causing, like an acid, cleaner, or other chemical.
• Dyshidrotic Eczema - the skin on the palms of the hands and soles of the feet is irritated and has clear, deep blisters that itch and burn.
• Neurodermatitis - Scaly patches on the head, lower legs, wrists, or forearms are caused by localized itch “such as an insect bite”
• Seborrheic Eczema - This skin has yellowish, oily, scaly patches on the scalp, face, and sometimes other parts of the body.
• Stasis Dermatitis - The skin is irritated on the lower legs, most often from a blood flow problem.

Things to know about Eczema:

• Typically begins in early childhood
• Can occur in infants as early as a few weeks old
• Can continue through adolescence and into adulthood
• May occur for the first time well into adulthood
• May be outgrown, however-skin may continue to be dry, irritable, and sensitive

What does Eczema look like?

Atopic eczema can affect any part of the skin, including the face, but the areas that are most commonly affected are the joints at the elbows and knees, hands, the groin, buttocks, back as well as the wrists and neck. Other common appearances of atopic eczema include coin-sized areas of inflammation on the limbs, back, and numerous small bumps that coincide with hair follicles.

The affected skin is usually red and dry, and scratch marks “accompanied by bleeding” are common. When the eczema is very active, it may become moist and weepy “during a flare-up” and small water blisters may develop especially on the hands and feet. In areas that are repeatedly scratched, the skin may thicken, and this may cause the skin to itch more. Sometimes affected areas of the skin may become darker or lighter in colour.

Scratching the affected area can cause:

• Redness
• Swelling
• Cracking
• Weeping “clear fluids”
• Crusting
• Thick Skin
• Scaling

Things that make Eczema worse:

Many factors in a person’s environment can make eczema worse, these include heat, dust, wool, pets and irritants such as soap and detergents. Being unwell, for example or having a common cold can make eczema flare up, this also includes infections with bacteria or viruses. Bacterial infections “usually with a bug called staphylococcus” makes the affected skin yellow, crusty and inflamed “this may need specific medical treatment”. An infection with the cold sore virus “herpes simplex” can cause a sudden painful widespread “on rare occasions dangerous” flare of eczema. “Consult a physician if you believe these factors apply to your recent flair up”.

How is Eczema Treated?

Treatment works best when the patient, family members, and the doctors work together. Treatment plans are based on:

1. Age
2. Symptoms and severity
3. General Health of the patient

Carefully follow the treatment plans that have been laid out to minimize flair ups. Try to notice what is or isn’t helpful as each person is different and how their skin is developed. Symptoms usually improve with the right skin care and lifestyle changes. Eczema treatment goals are to “heal the skin” and “prevent flair ups”. You and your family members should watch for changes in the skin to find out what treatments help the most.

Your doctor will help you:

1. Develop a good skin care routine
2. Avoid things that lead to flares
3. Treat symptoms when they occur

Medications for Eczema “Atopic Dermatitis” include:

• Skin creams or ointments that control swelling and lower allergic reactions
• Corticosteroids
• Antibiotics to treat infections caused by bacteria
• Antihistamines
• Immune system suppressant medications

Gentle skin care to prevent dryness includes:

Bathe daily or every-other-day in order to wash off dirt and other potential irritants. Water should be warm “not hot” and bath time should be limited to 5-10 minutes. Pat dry the skin and immediately apply moisturizer while the skin is still slightly damp. The moisturizer provides a seal to hold the water in the skin.

Finding a cream or ointment that the child likes or can tolerate is important, as resistance from the child may make the daily regimen difficult to keep up. The thicker the moisturizer, the better the barrier it generally provides. Ointments are more effective than creams, and creams more so than lotions. Creams are a reasonable options during the summer when thick greasy ointments are uncomfortable.

• Light Therapy “Exposure to UV or specific spectrum lights”
• Skin care that helps heal the skin and keep it healthy
• Protection from Allergens

Do I have a disease if I have Eczema?

Answer - “No”

Eczema is a random event that does have factors too its appearance. Typically Eczema does not have an associated disease or cause, it is a random occurrence that anyone could have.

Can Eczema be cured?

Answer - “No"

Eczema cannot be cured, but there are many ways of controlling it and it can go into remission for extended periods of time. Most children with eczema improve as they get older “60% clear by their teens”. However, many continue to have dry skin and need to continue to avoid irritants such as soaps, bubble baths, detergents or harsh chemicals.

Information for this article was taken from - Australian Society of Clinical Immunology and Allergy - Eczema Society of Canada - British Association of Dermatologists - The Society of Paediatric dermatology Indianapolis - National Institute of Arthritis and Musculoskeletal and Skin Diseases.

We never know what can happen, its always good to be prepared and have the knowledge we need to help those who need it.

“This material is for information purposes only and is taken from The Canadian Red Cross / Alberta Heart & Stroke Foundation & Alberta Health Services. This information should not be used in place of medical, Technical advice, instructor, and/or treatment. If you have questions, speak to your local Physician or Safety Training Facility.”

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