Eczema: Symptoms, Causes, & Treatment

Eczema is a chronic skin condition marked by dry and itchy skin. The skin lesions usually appear in skin folds like the elbow or neck creases or behind the knees.

The condition is common in children; however, no age is exempt from contracting the disease. About 80% of the cases of eczema begin early before the age of five years.

Eczema, also called atopic dermatitis, tends to appear in flare-ups with periods of remission in between. There is no cure for eczema, yet self-care and medications help the symptoms manageable.

Causes of eczema

Our skin acts as a barrier and functions to safeguard from external stimuli (pathogens, heat, allergens, irritants, etc.) in addition to retaining moisture. Anything that disturbs the protective protocol of skin cause skin lesions as eczema.

The condition is suggested to arise from a genetic variation that affects the skin physiology making it more prone to the damaging effects of external stimuli.

The fact that eczema patients often have a family history of disease seconds genetics as the causative factor. Most patients also present with a history of hay fever or allergic asthma.

In children, allergic reactions to foods may be the underlying factor in disease initiation.

Autoimmunity is also suggested to contribute to the development of eczema. The hyperactive response of the immune system to skin proteins results in eczematous skin.

Some common triggers for eczema attack include;

• Stress
• Food allergies
• Chemicals found in cleaners and detergents
• Rough, scratchy clothing material (wool) and synthetic fibers
• Raised body temperature and increased sweating
• Temperature changes and sudden drop in humidity
• Animal dander
• Upper respiratory tract infections

Symptoms of eczema

The skin lesions of eczema may appear anywhere on the body. However, they are most commonly found on the arms, inner elbows, backs of the knees, or head, particularly the cheeks and the scalp skin.

Eczema typically presents with flares and remissions of signs and symptoms like;

• Itchy, dry, and irritated skin that may appear raw and swollen
• The affected skin is rough, flakey, and inflamed and appears red
• The skin lesions are intensely itchy, especially at night
• The skin may have red or brownish-grey patches
• Some types may present with small, raised bumps that ooze fluid upon scratching, followed by crust formation.
• Complicated cases with infection have dry crusty patches of yellow-coloured ooze.
• The skin may become thick and scaly.

The red to brownish-grey colored patches appear mainly on the hands, feet, ankles, wrists, neck, upper chest, eyelids, elbows, and knee bends. Eczematous lesions in infants affect the face and scalp.

When to see a doctor

See a dermatologist if;

• There are signs of superadded bacterial infection
• The symptoms worsen despite over-the-counter remedies
• Symptoms are severe enough to affect daily activities

Treatment of eczema

Lifestyle modifications and medication help manage the symptoms of eczema.

• Medications

Over-the-counter (OTC) antihistamine medication taken orally helps relieve itching. These include cetirizine (Zyrtec), diphenhydramine (Benadryl), fexofenadine (Allegra), and loratadine (Claritin), etc.

Steroid-containing cortisone creams and ointments relieve itching and scaling. Treatment is usually started with low-potency steroid medication.

Superadded bacterial infection requires antibiotic management. This can be given as topical preparation for the skin lesion alongside oral therapy.

In severe and resistant cases, a doctor may prescribe immune-suppressing therapy. This helps to keep the hyperactive immune system in check in case of a flare-up.

• Light therapy

Light and phototherapy using sun lamps help reduce the frequency and severity of eczema attacks, clear up the skin lesions and prevent any superadded bacterial infections.

• Lifestyle modifications

Every patient is an individual with different sets of triggers inciting an attack. Therefore, learning to identify the triggers and avoiding them remains the mainstay of managing eczema.

Avoid wearing rough fabrics, using harsh soaps, detergents, and moisturising skin are some of the lifestyle remedies.

Cold compress and soaking in a lukewarm bath help to alleviate the symptoms during a flare-up.

• Alternative therapy

Acupuncture, aromatherapy, and relaxation techniques to manage stress (yoga, meditation, etc.) are suggested to help eczema. Consuming green tea and topical application of coconut, sunflower, borage, and primrose oils are also said to help. However, herbal and alternative treatments should always be adopted under a doctor’s consultation.

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