Eczema and Its Symptoms, Causes, Precautions and Treatment

Eczema describes an itchy, inflamed skin rash. The term eczema comes from a greek word meaning to “boil over” and is used interchangeably with another term, dermatitis, there are several different types, including atopic or allergic eczema.

The most common type of eczema is atopic eczema, sometimes referred to as “allergic eczema”. If someone is atopic they carry a gene that makes their skin react to stress (a virus infection, an irritant in contact with the skin, psychological disturbances) with patches of eczema. Once you have eczema or dermatitis you will always have the tendency to develop it, so episodes may return throughout your life.

Atopic eczema sufferers may also develop asthma or hay fever or may have relations who have those conditions. The gene for atopy tends to run in families but may express itself differently in family members, for example migraine in one, hay fever in another, allergies in another, asthma, etc. All these conditions are close relatives of eczema (dermatitis) and all run in my atopic family.

Though the tendency to develop eczema is undoubtedly genetic, certain foods (most commonly dairy products, eggs and wheat) and skin irritants (such as pet fur, wool or washing powders) can act as triggers, especially in children.

Symptoms of Eczema

• Dry, red, scaly rash, which is extremely itchy, occurring on the face, neck and hands, and in the creases of the limbs.
• The rash usually starts off as minute pearly blisters beneath the skin’s surface. When very severe, the rash may weep.
• The rash usually starts off as minute pearly blisters beneath the skin’s surface. When very severe, the rash may weep.
• When very severe, the rash may weep.
• Sleeplessness may result if the itchiness is very bad.

Aggravating Factors of Eczema

Symptoms vary from mild to severe and can be made worse by:

• climate changes, especially if exposed to cold winds or excessive heat
• water, especially hard water
• soaps, detergents, cleansers, bubble bath, cosmetics, perfume
• pollen, pet hair, animal dander, dust
• stress and anxiety
• synthetic or wool fibres
• certain chemicals: acids, alkalis, oxidizing or reducing agents, oils, solvents
• colds, flu, infections of any kind.

Life Style People Should Follow To Avoid Eczema

1. People with eczema should avoid contact with soap, detergents and other irritants. This means wearing rubber gloves for household wet work, or cotton gloves for cleaning.
2. They should avoid jobs or occupations that expose their skin to irritants, such as in hairdressing, catering, mechanical engineering and perhaps nursing, especially if the eczema affects the hands.
3. Reduce the population of house dust mites in the home by regular dusting and vacuuming of carpets. Dust mile bed covers have benefited some eczema patients, and frequent airing and changing of bed linen should reduce the house dust mile population in bedding.
4. Bed clothes should be washed at 50°C (122 degree F) or more to kill house dust mites.
5. Old mattresses arc more likely to harbour large populations of house dust mite, and furry toys are another source of exposure.
6. Shaking soft toys vigorously or placing them into a plastic bag in the freezer for a few hours helps.
7. Some atopic people are sensitive to cat or dog fur and it makes sense to avoid having these animals as pets when a family member suffers from atopic eczema.
8. The use of make-up can irritate facial skin in a person with eczema, and these preparations should be used with care.
9. It is best to keep the central heating turned as low as is comfortable as it has a tendency to dry out the skin.
10. Cotton clothes are less irritating on eczema skin than polyester or wool.
11. Bathing and showering arc safe, provided that a soap substitute such as aqueous cream is used, or a bath oil is added.
12. Bubble bath should be avoided, as it is a detergent. T he moisturizer that the person uses should be applied after the skin has been patted dry.
13. Holidays in a warm environment arc beneficial as the skin’s moisture is improved and, of course, the person is more relaxed.
14. Although sunlight is usually helpful, atopic eczema may make the skin more sun-sensitive and covering up with cotton clothes and using a sunblocking cream are advised in hot climates to avoid burning.
15. People with eczema can go swimming. Putting an emollient ointment or a barrier cream on the skin before and after swimming reduces irritation.

Should You Care About Your Diet?

In very young children, atopic eczema may be worsened by cow’s milk formula and so infants with eczema are often put on to soya milk, or low-allergy milk feeds. This problem generally settles in the second year of life and cow’s milk may then be tolerated in slowly increasing amounts.

• Eggs may worsen eczema, although they may be tolerated in highly processed form, such as in cakes.
• Families may feel that other food items are important and if several foods are suspected or you decide to put your child on a restricted diet, then it is wise to discuss this with a dietitian to make sure your child is getting enough protein, calcium and calories.
• Fortunately, most apparent food allergies gel better during childhood.
• One food item that continues to cause problems in a few atopic individuals is peanuts.
• Tomato sauce and citrus fruits seem to worsen facial eczema because they irritate broken skin and can produce weals around the mouth.

Chinese Herbal Treatments

Recent research has shown ancient Chinese herbal remedies can be very helpful. There arc tablets to take, infusions to drink and creams to rub on. Most dermatologists recognize the effectiveness of these treatments.

What Might The Doctor Do?

1. Your doctor will question you on your family’s medical history, particularly whether anyone has ever suffered from eczema or related conditions such as asthma and hay fever.
2. The doctor will ask you about any changes in diet, whether you have recently changed your washing powders, whether you have just brought a pet into the house and whether natural or synthetic fibres arc worn next to the skin.
3. If your baby has eczema and you’ve just started weaning him from the breast or bottle, your doctor may recommend that you avoid dairy products and continue breast-feeding or use formula milk. If you don’t want to do this, your doctor may recommend that you wean your baby on to soya milk instead.
4. Your doctor may prescribe an anti- . inflammatory skin cream to reduce redness, scaliness and itchiness. In severe cases, very weak steroid creams may be prescribed. These creams should be used very sparingly, especially on a child’s skin.
5. If the itching is causing sleepless nights, your doctor may prescribe antihistamine medicine to improve sleep. If the skin has become infected through scratching, your doctor may prescribe an antiseptic cream or antibiotics.

Your doctor will advise you to add bath oil to bath water and to stop using soap. Soap can be an irritant to the already sensitive skin; the oil will help to keep the skin supple and less dry

What’s The Outlook?

Many children outgrow eczema (and asthma) around the age of seven. They will, however, retain a life-long tendency to develop transient eczema if the body is put under stress and may pass on this tendency to their children.

In adult life, dermatitis isn’t the same as that in a child. The eczema looks different, it’s in different places and it may come and go. It may lake the form of seborrhocic, contact or photo-dermatitis (caused by light).

Eczema in Babies and Children

Baby eczema, also called infantile eczema, is common and usually develops when a baby Is about 2-3 months old, or at 4-5 months when solid foods are introduced. Most children grow out of eczema by the age of three or, if not, by seven.

Some Important Points

• Baby eczema is less common in breast-fed babies than those fed on the bottle.
• Baby eczema isn’t caused by an allergy and allergy tests don’t help.
• Children with eczema don’t benefit from a special diet.

What Should I Do First?

1. If your baby is scratching, look at his neck and scalp, his face, his hands and the creases of his elbows, knees and groin, classic sites tor baby dermatitis.
2. Keep his fingernails short to minimize the possibility of breaking the skin. If the skin becomes broken, put mittens on him to prevent infection.
3. If you’ve just started weaning your breast-fed child, return to breast-feeds until you’ve seen your doctor. If you’ve been using formula milk, return to that.
4. Apply oily calamine lotion to ease irritation and soothe the skin.
5. Soap should be avoided as it de-fats the skin and makes it drier, more scaly and irritable.
6. Avoid woollen or hairy garments; use cotton or linen instead.

What else can I do?

1. Use an emollient cream whenever your child washes. This will keep his skin soft, prevent it from drying out and damp down the itchiness.
2. Underplay the condition in front of your child. Your anxiety can make the condition worse.
3. Keep your child’s fingernails short so that scratching doesn’t cause the skin to break and give rise to infection.
4. Make sure all your child’s clothes, and anything that comes next to his skin, are rinsed thoroughly to remove all traces of powders and conditioners.
5. If the eczema is found to be made worse by pet fur, you may need to consider giving your family pet away.
6. Use an aqueous cream from your chemist as a soap substitute.
7. Use a bath emollient (available from your pharmacist) dissolved in bath water to put a protective layer over your child’s skin.
8. Think about installing a domestic water softener.
9. Dress your child with cotton next to his skin at all times.
10. Don’t eliminate any foods from your child’s diet without your doctor’s supervision.
11. Remove as many irritants from your child’s environment as possible. For example, feather and down pillows can be a source of irritation.

Vaccinations

It is generally safe to vaccinate children with eczema in the usual way. However, if a child has a proven egg allergy, their MMR (measles, mumps and rubella) vaccination should be given In a hospital setting in case there are problems, although this is very rare in practice.