Eczema

An Overview

Atopic eczema (atopic dermatitis) is the most common form of eczema, a condition that causes the skin to become itchy, dry and cracked. Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It’s common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically. It may be accompanied by asthma or hay fever. No cure has been found for atopic dermatitis. But treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps, moisturize your skin regularly, and apply medicated creams or ointments. Atopic eczema is more common in children, often developing before their first birthday. But it may also develop for the first time in adults. It’s usually a long-term (chronic) condition, although it can improve significantly, or even clear completely, in some children as they get older.
Gaps open up between the skin cells as they are not sufficiently plumped up by water. This means that the skin barrier is not as effective as it should be, and bacteria or irritants can more easily pass through. These then trigger an inflammatory response, which causes the redness in eczema flares. Although the exact cause of eczema is not known, an ‘over-reactive’ immune system is understood to be involved.

Other types of eczema include:

• Discoid eczema – a type of eczema that occurs in circular or oval patches on the skin
• Contact dermatitis – a type of eczema that occurs when the body comes into contact with a particular substance
• Varicose eczema – a type of eczema that most often affects the lower legs and is caused by problems with the flow of blood through the leg veins
• Seborrhoeic eczema – a type of eczema where red, scaly patches develop on the sides of the nose, eyebrows, ears and scalp
• Dyshidrotic eczema (pompholyx) – a type of eczema that causes tiny blisters to erupt across the palms of the hands

Symptoms of atopic eczema

Atopic eczema causes the skin to become itchy, dry, cracked and sore.
Some people only have small patches of dry skin, but others may experience widespread inflamed skin all over the body.
Inflamed skin can become red on lighter skin, and darker brown, purple or grey on darker skin. This can also be more difficult to see on darker skin.
Although atopic eczema can affect any part of the body, it most often affects the hands, insides of the elbows, backs of the knees and the face and scalp in children.
People with atopic eczema usually have periods when symptoms are less noticeable, as well as periods when symptoms become more severe (flare-ups).

Causes of atopic eczema

Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is related to a gene variation that affects the skin’s ability to provide this protection. This allows your skin to be affected by environmental factors, irritants and allergens. In some children, food allergies may play a role in causing eczema. The exact cause of atopic eczema is unknown, but it’s clear it is not down to one single thing.
Atopic eczema often occurs in people who get allergies. “Atopic” means sensitivity to allergens.
It can run in families, and often develops alongside other conditions, such as asthma and hay fever.
The symptoms of atopic eczema often have certain triggers, such as soaps, detergents, stress and the weather.
Sometimes food allergies can play a part, especially in young children with severe eczema.
You may be asked to keep a food diary to try to determine whether a specific food makes your symptoms worse.

Diagnosis

No lab test is needed to identify atopic dermatitis (eczema). Your doctor will likely make a diagnosis by examining your skin and reviewing your medical history. He or she may also use patch testing or other tests to rule out other skin diseases or identify conditions that accompany your eczema.

Treatment

Atopic dermatitis can be persistent. You may need to try various treatments over months or years to control it. And even if treatment is successful, signs and symptoms may return (flare). There are a number of different topical treatments for atopic eczema – that is, treatments that can be applied to the skin: emollients (medical moisturisers), topical steroids and topical calcineurin inhibitors. For more severe eczema, treatments include phototherapy, oral steroids, oral immunosuppressant drugs, and a biologic drug.
It’s important to recognize the condition early so that you can start treatment. If regular moisturizing and other self-care steps don’t help, your doctor may suggest one or more of the following treatments:
Medications
• Creams that control itching and help repair the skin. Your doctor may prescribe a corticosteroid cream or ointment. Apply it as directed, after you moisturize. Overuse of this drug may cause side effects, including thinning skin.
Other creams containing drugs called calcineurin inhibitors — such as tacrolimus (Protopic) and pimecrolimus (Elidel) — affect your immune system
• Drugs to fight infection. Your doctor may prescribe an antibiotic cream if your skin has a bacterial infection, an open sore or cracks. He or she may recommend taking oral antibiotics for a short time to treat an infection.
• Oral drugs that control inflammation. For more-severe cases, your doctor may prescribe oral corticosteroids — such as prednisone. These drugs are effective but can’t be used long term because of potential serious side effects.
• Newer option for severe eczema. The Food and Drug Administration (FDA) has recently approved a new, injectable biologic (monoclonal antibody) called dupilumab (Dupixent). It is used to treat people with severe disease who do not respond well to other treatment options.
But there’s currently no cure and severe eczema often has a significant impact on daily life, which may be difficult to cope with physically and mentally.
There’s also an increased risk of skin infections.
Many different treatments can be used to control symptoms and manage eczema, including:
• self-care techniques, such as reducing scratching and avoiding triggers
• emollients (moisturising treatments) – used on a daily basis for dry skin

Prevention

The following tips may help prevent bouts of dermatitis (flares) and minimize the drying effects of bathing:
• Moisturize your skin at least twice a day. Creams, ointments and lotions seal in moisture. Choose a product or products that work well for you. Using petroleum jelly on your baby’s skin may help prevent development of atopic dermatitis.
• Try to identify and avoid triggers that worsen the condition. Things that can worsen the skin reaction include sweat, stress, obesity, soaps, detergents, dust and pollen. Reduce your exposure to your triggers.
Infants and children may experience flares from eating certain foods, including eggs, milk, soy and wheat. Talk with your child’s doctor about identifying potential food allergies.
• Take shorter baths or showers. Limit your baths and showers to 10 to 15 minutes. And use warm, rather than hot, water.

Hope this Symptoms and cure article will be helpful to all. Do not forget to share your valuable suggestions if any.

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