Eczema or Dermatitis

Q. What Is Eczema/Dermatitis?

Eczema and dermatitis are now generally used to describe the same skin condition. Eczema is one of the commonest reasons for dry, sensitive skin, taking its name from the Greek word Eczema, meaning to boil. This is an apt description of the inflamed rash, which is often accompanied by an intense itching, which makes scratching almost inevitable. One person in ten has eczema at some time in their life and it affects all age groups.


Q. Is there just one type of eczema?

There are many types but everyone experiences similar, unpleasant symptoms. These are some of the main types of eczema:

Atopic Eczema – It is possible to develop Atopic eczema at any age but it is most commonly found in babies and young children. Atopic eczema is thought to run in families and it is a part of some other conditions like eczema, asthma and hay fever.

Seborrhoeic Eczema – There are two types of this condition: one is most commonly seen in babies, and the other is fairly common in young adults. Areas affected tend to be the oily parts of the body, such as the scalp, face, groin and chest. Seborrhoeic eczema is not normally itchy.

Discoid Eczema – This condition is usually confined to the arms and legs and consists of scaly, itchy, coin shaped patches that can blister and weep.

Varicose Eczema – This is a condition of the legs commonly found in elderly people with varicose veins.

Q. What is Atopic Dermatitis?

Atopic Dermatitis or eczema is an itchy, dry, hypersensitive skin disorder affecting many people. It is common in children but can occur at any age. It is not infectious or contagious. The exact cause of atopic eczema is unknown. It may be hereditary. The patient or some family members may have other hypersensitive conditions like asthma or hay fever.

The rash may appear red, wet weepy or dry or thickened and scaly. When the disease starts during infancy, it is sometimes called infantile eczema. This is an itchy, crusted rash that tends to be localized principally on the face and scalp, but can appear at the other sites. Scratching often aggravates the rash. The skin thickens and becomes darker. It is a chronic condition. It can affect any part of the body, particularly the elbow bends, backs of the knees and the neck.

Q. What are emollients?

Emollients are basically simple moisturizers used to combat the dryness of eczema and to protect the skin from further water loss. There is a wide range of products of this kind and it may take you some time to find the one that are suitable for your skin.

Some common questions regarding Atopic Eczema

Q. Since atopic dermatitis is sometimes associated with food allergies, can the elimination of certain foods be of help?

A. Yes, but is not common. Although certain foods will sometimes provoke attacks, especially in infants and young children, elimination of foods rarely brings about an improvement or cure. Nevertheless when all else fails avoidance of common offending foods such as cow’s milk and eggs may be tried for a few weeks.

Q. Are the inhaled and contacted substances in the environment important causes, and should they be eliminated?

A. Yes. Dust and dust forming objects (for example, feather pillows and comforters, kapok pillows and mattresses, dust forming carpets, drapes, toys, and certain rough garments such as wool and coarse silk, worsen the rash. Try to wet mop or vacuum floors rather than sweep. Reduce contact with animal fur. Wear light smooth, soft, non binding clothing. Do not increase the skins dryness by prolonged or frequent hot baths or showers and soap. Use mild soaps or “soap free” soaps or moisturizing soaps.

Bathe or shower with luke warm water and when necessary, sponge gently under the arms, in the groins and other areas where cleansing is imperative. At other times, cleanse the entire skin with a non greasy lotion. Also avoid sudden changes of temperature for instance, coming to air conditioned rooms from the hot outdoors. Try not to rub or scratch; when the itching is severe try to relieve it by dabbing or applying cloths soaked in iced water.

It is important to comply with a treatment. Your dermatologist can usually help you by prescribing external remedies (corticosteroid creams are most effective). Use them sparingly. Apply a thin layer of cream on the rash with your fingers and rub onto the skin till it disappears. Apply at least twice a day, preferably after showering. Do not use strong steroid creams for long periods as over use will harm the skin. Use weak steroid creams when your eczema is mild. Oral medication (sedatives, antihistamines and sometimes antibiotics by mouth) to control the itching and baths with oil are helpful. Moisturizing creams and lotions should be applied after bathing 2-3 times in a day all over the body.

Corticosteroids taken by mouth or given by injections should be avoided if possible. However when all measures fail your physician may prescribe systemic corticosteroids for short periods. Generally 90% of children out grow the condition by early teens, although some continue to have problems even as adults.

Q. Would a change in environment be helpful?

A. For reasons that are not yet known, a radical change of environment like a cool environment, sometimes is the best cure for atopic dermatitis but it is also observed that Asians who have migrated to cold countries like England or Canada suffer from worst atopic eczema than they did in their own country. Many patients get better rapidly in the hospital or if they are given ample attention and their body is moisturized regularly.

Q. Are there any other problems?

A. Bacterial infection (pus) and viral infection (e.g. herpes simplex) can occur. In such a case, antibiotics and antiviral treatment are needed.

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