What is eczema?
Eczema, also referred to as atopic dermatitis, is a red, extremely
itchy rash, most common on creases of elbows, wrists, and knees.
It may occasionally occur on neck, ankles, and feet. The rash
becomes raw and weepy on scratching. The itching has a vicious
cycle wherein scratching causes more irritation leading to more
itching and scratching. Atopic dermatitis is most often seen in
infants and children, but it can continue into adulthood or first
appear later in life.
Infantile eczema
When atopic dermatitis occurs in infants, it's called infantile
eczema. This condition begins in infancy and may continue into
childhood and adolescence. Infantile eczema often involves an
oozing, crusting rash, mainly on the face and scalp, but it can
occur anywhere. After infancy, the rash becomes dryer and tends to
be red to brown-gray in colour. In adolescence, the skin may be
scaly or thickened and easily irritated. The intense itching may
continue.
Why does it occur?
Eczema is an inherited type of sensitive, dry skin. A personal
history of allergies, asthma or hay fever or a family history of
eczema is usually present. Flare-ups occur on contact with
irritating substances like soap or chlorine. In some people with
eczema, certain foods cause the eczema to flare up. If any
particular food item like cow's milk or eggs are causing the
flare-ups, avoid that food for 2 weeks. Then give a challenge by
having that food. If the eczema becomes itchy or flares-up within
2 hours of eating the food, it is the cause of eczema and should
be avoided. Stress and other emotional disorders can worsen atopic
dermatitis, but they don't cause it.
How long will the effects last?
It is a chronic condition and will usually not go away completely.
Though there may be periods when the remission may last for a long
time. Early treatment of itching is important to prevent a severe
rash.
What are the symptoms?
Signs and symptoms of atopic dermatitis include:
* Red to brownish-gray coloured patches.
* Itching, which may be severe, especially at night.
* Small, raised bumps, which may leak fluid and crust over when
scratched.
* Thickened, cracked or scaly skin.
* Raw, sensitive skin from scratching.
What is the diagnosis?
There is no laboratory test or skin test that diagnoses atopic
dermatitis. Instead, it's typically diagnosed based on an
examination of the skin and a review of medical history. The
doctor will ask questions about signs and symptoms and whether any
family members have asthma, hay fever or other allergies.
What is the treatment?
Treatments for atopic dermatitis aim to reduce inflammation,
relieve itching and prevent future flare-ups. Over-the-counter
(nonprescription) anti-itch creams, along with other self-care
measures, may help control mild atopic dermatitis. Although atopic
dermatitis is related to allergies, eliminating allergens is
rarely helpful in treating the condition. Occasionally, items that
trap dust — such as feather pillows, down comforters, mattresses,
carpeting and drapes — can worsen the condition. Allergy shots
usually aren't successful in treating atopic dermatitis and might
even make the condition worse.
Local steroid creams are the main treatment for the itching in
eczema. Use these as prescribed by the doctor. After the rash
settles down, use it at least once daily for another 2 weeks. It
can be used whenever the itching or rash develops. Good hydration
of the skin followed by a lubricating cream is the main way to
prevent flare-ups of eczema. Water-soaked skin is much less itchy.
The eczematous skin is very sensitive to soaps, therefore avoid
soaps as much as possible, especially during flare-ups.
Alternatively, use a mild, moisturising soap. The skin is
generally dry in eczema. After a good bath, the skin feels good
due to hydration. The moisture in the skin can be retained by
applying a layer of lubricating cream to the entire skin while it
is damp. Apply it daily after the steroid cream has been applied
to the itchy areas. Avoid applying any ointments or petroleum
jelly because they block the sweat glands, increase the itching,
and worsen the rash, especially in warm weather. Also, soap is
needed to wash them off, which can aggravate the problem. Keep the
fingernails cut short as the scratching with nails will perpetuate
the vicious cycle of itching. Frequent hand washing will avoid any
super-infection of the eczema.
How can it be prevented?
Avoiding dry skin may be one factor in helping prevent future
bouts of dermatitis. Scratchy, rough and woolly clothes make
eczema worse and should be avoided. Cotton clothes are good and
should be worn as much as possible. Avoid triggers like excessive
heat, sweating, excessive cold, dry air, chlorine, harsh chemicals
and soaps.
Prevent Infant Eczema
A patch of eczema that
has been scratched
Eczema, an inflammatory
skin condition
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