Eczema facts
What is eczema?
Rather than a specific health condition, eczema is a reaction pattern that the skin produces in a number of diseases. It begins as red, raised tiny blisters containing a clear fluid atop red, elevated plaques. When the blisters break, the affected skin will weep and ooze. In older eczema, chronic eczema, the blisters are less prominent and the skin is thickened, elevated, and scaling. Eczema almost always is very itchy.
Are there different types of eczema? What causes and risk factors of eczema?
There are at least 11 distinct types of skin conditions that produce eczema. In order to develop a rational treatment plan, it is important to distinguish them. This is often not easy.
Eczema is a nonspecific term for many types of skin inflammation (dermatitis). There are different categories of eczema, which include allergic, contact, irritant, and nummular eczema, which can be difficult to distinguish from atopic dermatitis. These types of eczema are listed and briefly described below. Atopy is a medical syndrome that includes three associated conditions that tend to occur in the same individual: atopic dermatitis, inhalant allergies, and asthma. All three components need not be present in the same individual simultaneously.
What are eczema symptoms and signs?
Almost all patients with eczema complain of itching. Since the appearance of most types of eczema is similar, elevated plaques of red, bumpy skin, the distribution of the eruption can be of great help in distinguishing one type from another. For example, stasis dermatitis occurs most often on the lower leg while atopic dermatitis occurs in the front of the elbow and behind the knee.
What specialists treat eczema?
Eczema often is treated by family physicians, but since there are many causes of eczema, it may be necessary to seek help from a health specialist if things are not improving. Most dermatologists specialize in the diagnosis and treatment of all forms of eczema.
How do health care professionals diagnose eczema?
An accurate diagnosis requires an examination of the entire skin surface and a careful health history. It is important for a doctor to rule out curable conditions caused by infectious organisms. Occasionally, a sample of skin (biopsy) may be sent for examination in a laboratory.
What is the treatment for eczema?
The treatment of acute eczema where there is significant weeping and oozing requires repeated cycles of application of dilute solutions of vinegar or tap water often in the form of a compress followed by evaporation. This is most often conveniently performed by placing the affected body part in front of a fan after the compress. Once the acute weeping has diminished, then topical steroid (such as triamcinolone cream) applications can be an effective treatment. In extensive disease, systemic steroids may need to be utilized either orally or by an injection (shot).
What are home remedies for eczema?
Mild eczema may respond to compresses composed of tepid water followed by room air evaporation. Chronic eczema can be improved by applying water followed by an emollient (moisturizing cream or lotion). Mild eczema can be effectively treated with nonprescription 1% hydrocortisone cream.
Does diet affect eczema?
The role of diet in atopic dermatitis is controversial. There is little compelling evidence that diet plays a significant role for majority of people who have eczema, no matter which type they have.
Is there a cure for eczema?
Each type of eczema requires a specific sort of therapy. The easiest eczemas to cure permanently are those caused by fungi and scabies. Allergic contact eczema can be cured if a specific allergenic substance can be identified and avoided.
Is eczema contagious?
Eczema caused by fungi and scabies is transmissible to others. None of the other types of eczema are contagious.
What is the prognosis of eczema?
Most of the patients with eczema do quite well under the care of a dermatologist who has made an accurate diagnosis. Occasionally, eczema can become infected by microorganisms, such a staphylococci or herpes simplex virus. This is because the normal barrier function of the skin has been damaged by the inflammatory condition. In this situation, the infection could be contagious and require antibiotics treatment. An important signal would be the development of fever and pustules, plus pain at the site of the rash.
Is it possible to prevent eczema?
The judicious use of moisturizing creams or ointments can be an effective treatment for many people in preventing certain types of eczema.
Medically Reviewed on 3/15/2018
References
Wold, Lindsey, Jennifer K. Chen, and Heather P. Lampel. "Hand Dermatitis: An Allergist's Nightmare." Curr Allergy Asthma Rep 14.474 (2014): 1-9.
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