eczema: definition, symptoms, causes, treatments
Eczema is a common skin condition, which can be soothed with good practices and appropriate care. Discover all our advice on how to understand, soothe and prevent your rashes.
All about eczema
Eczema is a common inflammatory skin condition that causes itching, dry skin and rashes. Eczema is often used to describe any inflammatory skin condition, but eczema, also known as dermatitis, is actually the name of a group of different skin inflammations. Atopic eczema is one of them, and certainly the most common.
Eczema is a common condition that causes dry, itchy, inflamed skin.
Eczema is one of the most common skin disorders. Whether in Canada or other countries, eczema develops mainly in allergy-prone people, or those genetically predisposed to it due to heredity.
Eczema can affect anyone. However, certain groups are slightly more likely to develop the condition, such as children, women and the elderly.
Eczema can appear anywhere on the body. However, the most common places where you'll notice symptoms are on the hands, neck, elbows, ankles, knees, feet, face, inside and around the ears or lips.
Depending on the type of eczema you suffer from, symptoms may appear all over the body or be localized to specific areas.
You can suffer from different types of eczema, such as :
- Eczema on the eyes
- Eczema on the face
- Eczema on the hands
- Eczema on the feet
Eczema can appear during childhood, adolescence or adulthood. Newborns can also suffer from eczema in the first weeks and months after birth. Eczema often appears very early, before the age of 5, and may persist into adolescence and adulthood, or disappear altogether.
There are seven types of eczema, but it can be difficult to tell the difference between them because symptoms often overlap.
Atopic dermatitis is the most common type of eczema. It can appear anywhere on the body and mainly affects children, but can persist into adulthood. Symptoms include itching, rashes, swelling, fluid-filled bumps and cracking. Atopic dermatitis can be painful and lead to aggressive scratching, which can then become a source of infection. It usually develops when the skin's barrier function is damaged.
Contact dermatitis comprises two types of dermatitis:
- Allergic contact dermatitis: an allergic reaction to an allergen that may take several days to develop after exposure.
- Irritant contact dermatitis: an irritant reaction to an irritant substance such as detergents, soap or cleaning products, which develops rapidly after exposure. Irritant contact dermatitis is more common than allergic contact dermatitis.
Contact dermatitis occurs when the skin becomes inflamed or irritated on contact with a substance. This substance is either one to which you are allergic, or one that irritates your skin. The rash can form anywhere on the body, and symptoms take the form of red bumps, itching and pain.
Bullous eczema, also known as dyshidrosis, is responsible for the appearance of small blisters on the hands and feet. The causes of this type of eczema are unknown, but triggers can be linked to allergies, stress and perspiration of the hands and feet.
Most common on the scalp, hands, neck, wrists, knees or elbows, nervous eczema, also known as stress dermatitis, is characterized by itching and excessive scratching.
The causes are unknown, but this type of condition usually appears in cases of extreme stress, anxiety or depression.
The symptoms of nummular eczema are circular patches on the external parts of the body. These patches ooze and can be very dry and sensitive. This is a chronic condition in which patches can last for weeks or even months, and flare-ups can occur repeatedly.
Varicose eczema, also known as stasis dermatitis, occurs on the lower legs due to poor circulation and fluid accumulation. Legs are itchy, red and dry. Venous insufficiency causes water and blood cells to accumulate in the lower legs. This condition often appears in the elderly, but can also be associated with heart or kidney disease.
Cracked eczema is defined by skin furrowed with linear red cracks less than 1 mm wide. It usually develops on the extensor surfaces of the lower limbs. This type of eczema mainly affects the elderly, in whom a reduction in sebaceous and sweat glands has been observed, which is thought to be responsible for the appearance of this type of eczema.
Other skin conditions may be confused with the above-mentioned types of eczema. However, they do not fall into the eczema category, but correspond to other skin inflammations. These include :
- Scabies
- Psoriasis
- Seborrheic dermatitis (dandruff on scalp and head)
- Herpes
- Certain mycoses
- Rarer conditions such as dermatitis herpetiformis
Eczema symptoms depend on the type of eczema encountered, but the following symptoms are the most common:
- Dry, itchy skin
- Plaques
- Swelling
- Scaly, crusty skin
- Discolored skin
Symptoms vary from person to person, but always include itching. Eczema may appear red on fair skin, while on darker skin it takes on a gray, brown or purple color.
What causes eczema?
Many factors can contribute to the onset of eczema symptoms, but there is no single main cause. Here are some of the most common causes:
Genetic factors
Genetics play an important role in eczema. If someone in your family suffers from eczema, you are more likely to develop the disease. Children whose parents suffer from eczema, asthma or hay fever are at greater risk of developing eczema.
A specific gene involved in skin barrier function can contribute to drier, itchier skin, which is often the starting point for eczema.
An overactive immune system leads to a dry, itchy skin barrier, and this condition can be considered another genetic trigger for eczema. On contact with an irritant or allergen, the immune system overreacts, creating inflammation leading to the first symptoms of eczema.
Environmental triggers
Environmental factors play an important role in triggering eczema. Common eczema triggers are potential environmental irritants such as:
- Allergens: pollen, dust mites, animal dander, molds
- Irritants: soaps, detergents, shampoos, make-up, disinfectants, fresh fruit juices, meats, vegetables, peanuts, dairy products, eggs
- Fabrics: wool, acrylic
Other environmental factors that can trigger eczema symptoms include the following:
- Climate: extreme temperatures and humidity levels associated with dry weather
- Stress: emotional stress can aggravate symptoms
- Diet: certain foods, such as dairy products, nuts and wheat
Eczema has two main phases:
Dry eczema is the starting point of the skin condition when the first symptoms appear.
Subacute eczema lies between acute and chronic eczema. It's a phase in which the skin becomes scaly, cracked or even infected. The condition may become acute again, remain as it is, or progress to a chronic stage.
Eczema contagiousness
Eczema is not contagious, and is only triggered by interaction with environmental factors or a genetic tendency. It cannot be transmitted from one person to another.
To diagnose eczema, a healthcare professional will perform a clinical examination to take a closer look at your symptoms and medical history. The symptoms of eczema can often be confused with those of psoriasis, so your dermatologist may perform other tests such as an allergy test, blood test or skin biopsy to confirm the skin condition.
Complications of eczema
Complications
Eczema symptoms can worsen, leading to complications such as :
- Oozing eczema: a complication of eczema characterized by fluid-filled blisters on the skin. This condition is caused by severe inflammation.
- Erythroderma: severe and potentially fatal inflammation of most of the body's skin.
- Severe lichenification: the result of constant scratching, leading to thick, leathery skin.
- Bacterial infection (e.g. Staphylococcus aureus): infected eczema occurs when bacteria, fungi or a virus penetrate the skin and cause infection.
- Viral infection (e.g. herpes, Molluscum contagiosum): several viruses can cause skin infection, such as herpes.
- Eye problems: eczema around the eyes can cause vision problems, swelling, redness and increased risk of vision loss.
- Allergies: asthma, hay fever, food allergies.
- Post-inflammatory hyper/hypo pigmentation: skin spots darker or lighter than skin tone. Mental health problems: sleep disorders, depression, anxiety.
How to avoid complications
There's no cure for eczema, but there are effective treatments to help you manage and limit your symptoms. Consulting a dermatologist is the best way to find the right treatment for your condition and avoid complications.
There are several strategies for managing and coping with eczema flare-ups:
For most types of eczema, when you identify and know your triggers, you can easily avoid being exposed to them.
Keep a detailed diary to identify specific triggers and help you understand what may be responsible for your flare-ups.
Note your diet, local environment, stress levels and the use of products on your skin.
IThere are several types of treatment for eczema that will help relieve and reduce the onset of your symptoms.
During flare-ups, take medication consistently and according to a healthcare professional's instructions. Treatments may include :
- Natural treatments: bleach, baths, cryotherapy, meditation and acupuncture can help relieve eczema symptoms.
- Over-the-counter products: readily available at any pharmacy, over-the-counter products can help in the early stages of eczema when symptoms are not too severe.
- Prescriptions: for mild to severe eczema, your healthcare professional may prescribe more powerful treatments such as topical medications, corticosteroids, immunosuppressants, injectable biologics and oral medications.
- Phototherapy: UV light can help reduce symptoms and lighten the skin.
After treatment, it may take several weeks for the skin to clear up. If symptoms do not disappear after a few weeks, contact your doctor as soon as possible.
Remember to keep the skin hydrated by moisturizing at least twice a day with gentle, hypoallergenic products, and above all, avoid scratching, as this aggravates symptoms and can lead to infections.
Bioderma's Atoderm range offers several products to help keep your skin moisturized and protected:
- Intensive Balm is an ultra-nourishing, lipid-replenishing face and body balm that provides instant comfort for very dry skin.
- Shower Oil gently cleanses the skin and provides instant hydration that lasts up to 24 hours.
Quality of life with eczema
Finding support groups and organizations dedicated to helping eczema patients can help you cope with the physical and mental consequences of eczema.
Being in touch with others provides emotional support and practical advice.
Organizations like SCE offer support groups, forums and local meetings. To find out more about this association: https://eczemahelp.ca/fr/