Eczema
MEDICAL DERMATOLOGY
What Is Eczema?
Eczema refers to a group of conditions that cause the skin to become red and itchy. In some cases, the skin may appear cracked, and blisters and scales may form. Eczema exists in various forms, with atopic dermatitis being the most common, especially among children. It is often accompanied by asthma or hay fever. Other types include contact dermatitis (allergic reactions) and dyshidrosis (blisters on hands and feet).
What Are the Signs and Symptoms of Eczema?
Symptoms of eczema vary according to the type and the age of the person. Signs may start in infancy, with dry and itchy patches affecting the cheeks and scalp. The rashes may be so itchy that they interfere with sleep, and lead to bleeding and infections when constantly scratched.
Most symptoms of eczema develop during childhood (before the age of 5) and may persist up to adolescence and adulthood. It is important to note that no two cases of eczema are alike. The most common signs are:
- Red, inflamed skin across much of the body, including the elbows, knees, nape, neck, ankles, legs, wrists, and buttocks.
- Dry and sensitive skin
- Rough, discoloured, scaly or leathery patches of skin
- Itchy and bumpy rashes
- “Weeping”, oozing or crusting blisters
Consult Our Specialist
Most symptoms of eczema develop during childhood (before the age of 5) and may persist up to adolescence and adulthood.
Specialist Skin Clinic provides customised & targeted treatment plans – call to enquire today.
Why Am I Experiencing Eczema?
The exact cause of eczema is still unknown, but genetic factors are long thought to increase one’s risk of developing it. For instance, a child born to a parent or parents diagnosed with eczema or another atopic disease such as asthma and allergic rhinitis has a greater chance of also developing the skin condition.
Eczema is also believed to be triggered by environmental factors such as:
- Allergens (pollen, dander, dust mites, mould)
- Irritants (soaps, shampoos, detergents, and disinfectants)
- Microbes (viruses, bacteria, fungi)
- Food (egg, dairy products, wheat, gluten, citrus fruits, nuts, and seeds)
- Extreme hot or cold temperatures, and high or low humidity
- Hormonal fluctuations
- Stress
Types of Eczema
There are several types of eczema, each with its unique set of symptoms, causes, and eczema treatment options.
Atopic Dermatitis
Atopic dermatitis is the most common form of eczema. It often starts in childhood, typically in the first year of life. Symptoms include rashes and dry, itchy, and scaly skin.
Contact Dermatitis
Contact dermatitis occurs when direct contact with a substance (such as cosmetics, fragrances, jewellery, and plants) or allergy to it causes skin inflammation or irritation.
Dyshidrotic Eczema
Dyshidrotic eczema causes itchy blisters on the feet and hands. It can be relapsing and chronic.
Nummular Eczema
Nummular eczema, also known as discoid eczema, presents as round, coin-shaped spots on the skin. These spots are often itchy and may become scaly, weepy, or crusted.
Seborrheic Dermatitis
Seborrheic dermatitis affects areas of the body with many oil-producing glands like the scalp manifesting as dandruff; eyebrows, sides of the nose, central part of the chest and between the shoulder blades causing itch and scaly rashes.
Stasis Dermatitis
Stasis dermatitis occurs when poor circulation leads to swelling in the lower legs, resulting in itching and skin discolouration. This type of eczema is more common in older adults.
Consult Our Specialist
If you notice any of these symptoms, schedule a consultation with our dermatologists for an accurate diagnosis and treatment plan.
How Is Eczema Diagnosed?
A physical inspection of the affected skin, an assessment of symptoms and a medical history review are often enough for a dermatologist to diagnose eczema or other atopic illnesses.
Generally, no laboratory tests are necessary to diagnose eczema, though doctors may also order skin tests and blood tests to rule out other skin disorders, as well as determine which substances may be causing the eczema or flare-up of the condition.
What Are the Treatment Options for Eczema?
A dermatologist will prescribe medication such as:
- Corticosteroids help reduce itchiness and skin inflammation. They are available in the form of a cream, an injection or pills.
- Antibiotics are prescribed if the eczema is secondarily infected by bacteria.
- Antihistamines help manage itch.
- Topical calcineurin inhibitors work by blocking a specific protein in the immune system of the skin that causes inflammation and itch. These include tacrolimus and pimecrolimus. This helps to clear the eczema. Not only do these help to clear the eczema but they also are used as long-term maintenance therapy.
- Oral cyclosporine is an immunosuppressant for the treatment of severe atopic dermatitis.
- Phototherapy such as narrowband ultraviolet B phototherapy is a kind of light treatment that is safe for the treatment of atopic dermatitis. This is available at our clinic.
- Biologics like dupilumab are effective in treating severe atopic dermatitis with minimal side effects. Suitable for standalone use or with topical corticosteroids, and available at our clinic.
- JAK inhibitors are a group of non-steroid oral medicines for patients with moderate to severe atopic dermatitis. These include baricitinib, abrocitinib and upadacitinib. They work in a novel way to block the proteins that stimulate the immune pathway in atopic dermatitis to reduce itch and inflammation. These are available at our clinic.
- Topical PDE4 inhibitor like crisabarole cream is a new class of topical treatment for eczema. It is a non-steroid alternative for eczema and is suitable for use for adults and babies aged 3 months and up.
What Else Can Be Done to Prevent Flare-ups
- Identify and avoid food, chemicals and materials that trigger or worsen symptoms.
- Keep the skin hydrated by applying eczema-friendly lotions and moisturisers.
- Protect any cracked skin or wounds to prevent infections.
- Avoid scratching or touching the affected skin.
- Avoid sudden temperature and humidity fluctuations.
- Reduce stress levels.
FAQs on Eczema
Can eczema be cured?
There is no definitive cure for eczema. However, treatments can help manage its symptoms and improve your quality of life. These treatments range from topical corticosteroids to phototherapy and biologics.
Is eczema an allergy?
No, eczema and allergies are two different conditions. Allergies typically involve a specific immune reaction to allergens, while eczema is a chronic inflammatory skin condition with various triggers beyond allergens.
Is eczema contagious?
No, eczema is not contagious. It is caused by genetics and environmental triggers and often involves a malfunction in the skin's barrier function.
Does eczema hurt?
Yes, eczema usually causes pain, inflammation, and itching, with symptoms varying in severity from person to person.
When should I see a dermatologist?
It is advisable to seek medical advice from a dermatologist if:
- Your symptoms cause discomfort or interfere with daily activities
- Your skin is infected (signs include redness, warmth, swelling, yellowish crust, or pus)
- Self-management methods have not worked
- Symptoms interfere with your sleep
- The affected areas are widespread
- You notice sudden changes in your symptoms
- You experience side effects from over-the-counter treatments
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