What is Eczema?

Eczema is a general term for many types of skin inflammation (dermatitis). The most common form of eczema is atopic dermatitis (sometimes these two terms are used interchangeably).

Eczema can affect people of any age, although the condition is most common in infants, and about 85% of those affected have an onset prior to 5 years of age. Eczema will permanently resolve by age 3 in about half of affected infants. In others, the condition tends to recur throughout life.

Eczema is not contagious, but since it is believed to be at least partially inherited, it is not uncommon to find members of the same family affected.

What are the causes of eczema?

Doctors do not know the exact cause of eczema, but a defect of the skin that impairs its function as a barrier, possibly combined with an abnormal function of the immune system, are believed to be important factors. Studies have shown that in people with atopic dermatitis there are gene defects that lead to abnormalities in certain proteins (such as filaggrin) that are important in maintaining the barrier of normal skin.

Some forms of eczema can be triggered by substances that come in contact with the skin, such as soaps, cosmetics, clothing, detergents, jewelry, or sweat. Environmental allergens (substances that cause allergic reactions) may also cause outbreaks of eczema. Changes in temperature or humidity, or even psychological stress, can lead to outbreaks of eczema in some people.

People with eczema often have a family history of the condition or a family history of other allergic conditions, such as asthma or allergic rhinitis.

What are the symptoms of Eczema?

Dry, reddened skin that itches or burns, although the appearance of eczema varies from person to person and varies according to the specific type of eczema.

Intense itching is generally the first symptom in most people with eczema.

Sometimes, eczema may lead to blisters and oozing lesions.

Eczema can also result in dry and scaly skin. Repeated scratching may lead to thickened, crusty skin.

While any region of the body may be affected by eczema, in children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles. In infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.

Eczema can sometimes occur as a brief reaction that only leads to symptoms for a few hours or days, but in other cases, the symptoms persist over a longer time and are referred to as chronic dermatitis.

What is the treatment for eczema?

The goals for the treatment of eczema are to prevent itching, inflammation, and worsening of the condition. Treatment of eczema may involve both lifestyle changes and the use of medications. Treatment is always based upon an individual's age, overall health status, and the type and severity of the condition.

Keeping the skin well hydrated through the application of creams or ointments (with a low water and high oil content) as well as avoiding over-bathing is an important step in treatment. It is recommended to apply emollient creams such as petrolatum-based creams to the body immediately after a five-minute lukewarm bath in order to seal in moisture while the body is still wet. Lifestyle modifications to avoid triggers for the condition are also recommended.

Corticosteroid creams are sometimes prescribed to decrease the inflammatory reaction in the skin. These may be mild-, medium-, or high-potency corticosteroid creams depending upon the severity of the symptoms. If itching is severe, oral antihistamines may be prescribed.

In some cases, a short course of oral corticosteroids (such as prednisone) is prescribed to control an acute outbreak of eczema, although their long-term use is discouraged in the treatment of this non life-threatening condition because of unpleasant and potentially harmful side effects. The oral immunosuppressant drug cyclosporine has also been used to treat some cases of eczema. Ultraviolet light therapy (phototherapy) is another treatment option for some people with eczema.

Prevention

While there is no cure for eczema, you can take steps to manage your symptoms and lessen the severity of outbreaks. Such measures include

• avoidance of over-bathing;
• applying moisturizer frequently, especially after bathing;
• bathing in warm, not hot, water and using a mild soap;
• limiting or avoiding contact with known irritants like soaps, perfumes, detergents, jewelry, environmental irritants, etc.;
• wearing loose-fitting clothing (cotton clothing may be less irritating for many people than wool or synthetic fibers);
• the use of cool compresses to help control itching;
• avoiding foods that cause allergic reactions;
• exercise, meditation, or other stress-management techniques can help those for whom stress is a trigger;
• wearing protective gloves for activities that require frequent submersion of the hands in water;
• avoiding activities that make you hot and sweaty as well as abrupt changes in temperature and humidity;
• A humidifier should be used in both winter (when the heating dries the atmosphere) and in the summer (if air conditioning is used because it depletes the moisture in the air);
• Maintaining cool temperatures in sleeping areas, because heat can lead to sweating that worsens itching and irritation;
• practicing good skin hygiene even when you are not having symptoms.

Vitamins and Minerals for Eczema

Multivitamins should not be taken as a substitute for eating healthy foods. Taking too much of any vitamin or mineral can be toxic and extremely dangerous. Please consult with a doctor or other trained healthcare professional before taking any dietary supplements.