What is eczema?
Eczema is a condition that causes skin to become itchy, red, dry and cracked. It is also known as atopic dermatitis. Eczema is a chronic condition that often develops in early childhood, but can occur at any age. Eczema cannot be completely cured, but it can be managed with proper treatment and care.
Eczema occurs when the skin barrier does not function properly, allowing moisture to escape and irritants to enter. This leads to inflammation and itchiness. Scratching the affected area can further damage the skin and cause more irritation.
There are various types of eczema, but the most common is atopic dermatitis. Atopic refers to conditions involving an overactive immune response such as eczema, asthma and hay fever. Eczema affects over 30 million Americans. It is more common in children, but many adults live with the condition as well.
What causes eczema?
The exact cause of eczema is not known, but it often occurs in people with a family history of allergies or asthma. Factors that may contribute to developing eczema include:
– Genetics – Eczema tends to run in families with a history of allergies or asthma. Defects in genes that affect the skin’s barrier function may play a role.
– Overactive immune system – Eczema is linked to overactivity of the immune system and inflammation. The body overreacts even to harmless substances.
– Environmental triggers – Irritants like soaps, detergents, perfumes, dust mites, pet dander and climate can trigger eczema flare-ups.
– Stress and emotions – Stress, anxiety, fatigue and hormonal changes may worsen eczema symptoms.
– Other medical conditions – People with asthma, hay fever and other allergic conditions are more likely to develop eczema.
– Microbes – An imbalance of bacteria and microbes on the skin may contribute to increased skin inflammation.
While the exact cause is unknown, it’s likely a combination of genetic and environmental factors that lead to the development of eczema. Identifying and avoiding triggers is an important part of managing the condition.
What are the symptoms of eczema?
The main symptoms of eczema include:
– Dry, itchy skin – Eczema causes skin dryness and itchiness. Itching tends to worsen at night.
– Red, inflamed areas – Affected areas turn red, inflamed and can blister, ooze and crust over when scratched. Common sites include inside elbows, backs of knees, wrists, face and neck.
– Thick, cracked skin – Chronic scratching and rubbing leads to skin changes like scaly, leathery thickening or darkening in skin color.
– Sensitive skin – Eczema makes skin more sensitive and vulnerable to infections. The affected areas often sting or burn.
– Small, raised bumps – In some cases, small bumps may develop and leak fluid. This is called eczema with postular lesions.
The severity of symptoms can vary between mild, moderate and severe. Flare-ups can occur periodically with times of improvement in between. Keeping the skin moisturized and avoiding triggers is important for controlling eczema.
How is eczema diagnosed?
Eczema can often be diagnosed through a physical examination by looking at the characteristic rashes and areas affected. The doctor will examine the condition of the skin and ask about symptoms. They may also ask about personal and family history of allergies and asthma.
In some cases, a skin biopsy may be done to confirm the diagnosis and rule out other skin conditions like psoriasis or seborrheic dermatitis. This involves taking a small sample of the affected skin for analysis.
Blood tests are not typically required for diagnosing eczema, but may sometimes be done to check for allergy testing or other medical conditions. Common tests include:
– Complete blood count (CBC) – Checks for infection or other conditions
– Allergy testing – Identifies specific allergen triggers
– Immunoglobulin E (IgE) levels – Measures antibodies related to allergies
Patch testing may also be done by placing small amounts of suspected allergens on the skin to check for reactions. Identifying triggers is an important part of managing eczema symptoms.
What is the treatment for eczema?
There is no cure for eczema, but various treatments can help control symptoms. The main goals are repairing and protecting the skin barrier, reducing inflammation and preventing infections. Common treatments include:
– Moisturizers – Hydrating the skin with fragrance-free moisturizers helps restore the protective barrier. Ointments and thicker creams work better than lotions.
– Medicated ointments/creams – Topical steroids, immunomodulators and anti-itch creams help reduce inflammation and itching.
– Antihistamines – Oral antihistamines can help reduce itching, especially at night.
– Antibiotics – Used to treat secondary infections which can develop from broken, oozing skin.
– Phototherapy – Exposure to UV light under medical supervision helps improve severe cases unresponsive to medication.
– Immunosuppressants – In rare cases, oral immunosuppressants may be prescribed to control very severe eczema.
– Biologic injections – Newer injectable biologics can target specific proteins involved in eczema inflammation.
Along with medications, good skin care practices are essential – like avoiding irritants, moisturizing frequently, bathing in lukewarm water and reducing scratching. Treatment is tailored according to severity and aimed at keeping flares under control.
What is the prognosis for eczema?
Eczema is a chronic condition without a cure, but the prognosis is generally positive if properly managed. Many infants and children outgrow or see great improvement in eczema by the time they are teenagers. However, some continue experiencing symptoms into adulthood.
With appropriate treatment and avoidance of triggers, eczema can be effectively controlled in most people. Flare ups may occur periodically due to various triggers. During these periods, symptoms may worsen for days or weeks before improving. Prompt treatment can help shorten flares.
While symptoms may wax and wane over time, the overall severity of eczema often decreases with age. A study found that around 70% of children with moderate to severe eczema early in life outgrew the condition by age 12. Adults with eczema tend to have milder symptoms confined to specific areas like hands and feet.
For a minority of patients, eczema may persist as a severe, chronic condition requiring intensive treatment. But this can be well-managed with continued care, allowing those with severe eczema to live full lives. Overall, eczema responds well to treatment and has a good long-term outlook.
Can you live a normal life with eczema?
Yes, most people are able to live normally with proper eczema management and treatment. But for some, eczema can negatively impact daily life and routines.
Here are some ways eczema may affect normal living, and tips to overcome them:
Sleep problems
Eczema’s itch-scratch cycle often disturbs sleep. Tips to improve sleep:
– Take antihistamines before bed to reduce nighttime itching
– Keep bedroom cool and use humidifier
– Apply creams/ointments to lock in moisture
– Wear mittens to avoid scratching
– Use wet wraps or bandages on problem areas
Skin infections
Open, oozing lesions are prone to developing bacterial infections. Tips to prevent infections:
– Avoid excessive scratching to minimize skin breaks
– Keep skin clean and moisturized
– Use topical antibiotics when prescribed
– Watch for signs of infection like oozing, fever
– See a doctor promptly if infected
Social and emotional impact
Eczema symptoms and appearance may cause embarrassment or affect self-esteem. Tips for support:
– Find good medical and cosmetic camouflage of visible rashes
– Join eczema support groups to find community
– Seek counseling if eczema causes depression or isolation
– Practice self-care and stress management techniques
Activity limitations
Flares may restrict physical activities or sports. Tips to stay active:
– Use moisturizers before and after activities
– Exercise in cooler, less humid weather
– Wear sweat-wicking fabrics to stay drier
– Avoid overheating and hydrate well during activities
– Take breaks to cool down and reapply creams
Work/school problems
Severe flares may impede productivity at work or school. Tips to manage:
– Schedule important work during periods of low flares
– Communicate with supervisors/teachers about condition
– Work from home during bad flares if possible
– Take medicines to control symptoms as prescribed
– Make reasonable accommodations for disability if needed
Treatment costs and time
Frequent doctor visits, tests and medications require time and money. Tips to reduce costs:
– Maintain good insurance coverage for condition
– Seek copay or prescription assistance if eligible
– Buy generic medicines when possible
– Order treatments and refills by mail for convenience
– Ask about payment plans if facing large treatment bills
With the right treatment and self-care, most people can manage eczema flares effectively and live normal, active lives. While eczema cannot be cured, its impact can be minimized with ongoing skin care, trigger avoidance and medical therapies.
Conclusion
Although living with eczema poses certain challenges, most people are able to manage their symptoms and carry on with regular activities. Avoiding triggers, maintaining proper skin care, and using medications as directed can help control flares.
While eczema may frequently impact sleep, emotional health, work and social life, there are many effective ways to prevent or overcome these problems. Working closely with your healthcare providers to find the right treatments for your individual needs is key.
Eczema requires patience and commitment to ongoing skin care regimens. But with the right treatment plan, people with eczema can absolutely live fulfilling, “normal” lives. Eczema does not have to stop someone from being successful in work or academics, maintaining relationships and staying active.
With more research, future treatments may offer even better, longer-lasting control of stubborn eczema symptoms. But even currently available therapies allow most eczema sufferers to manage flares and live the life they want. Eczema does not have to control your life if you take charge of managing your condition.