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Signs and symptoms of eczema. Eczema Symptoms and Causes: Understanding Atopic Dermatitis

by alexxlab

What are the main signs and symptoms of eczema. How is atopic dermatitis diagnosed. What triggers eczema flare-ups. What are the most effective treatments for managing eczema symptoms. Can eczema be cured or prevented. How does eczema affect quality of life. Are there different types of eczema.

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Recognizing the Telltale Signs of Eczema

Eczema, also known as atopic dermatitis, is a chronic skin condition characterized by inflammation, itching, and redness. Identifying the symptoms of eczema is crucial for early diagnosis and effective management. The hallmark signs of eczema include:

  • Dry, sensitive skin
  • Intense itching (pruritus)
  • Red, inflamed skin patches
  • Rough, leathery, or scaly skin texture
  • Oozing or crusting
  • Swelling
  • Dark colored patches on the skin

These symptoms can vary in intensity and location depending on the individual and the type of eczema. Do the symptoms of eczema change with age. Indeed, they often do. In infants, eczema typically appears on the face, cheeks, chin, and scalp. As children grow older, it may affect the creases of elbows and knees. In adults, eczema commonly occurs on the hands, neck, inner elbows, and behind the knees.

Understanding the Root Causes of Atopic Dermatitis

While the exact cause of eczema remains unknown, research suggests that it results from a combination of genetic and environmental factors. People with eczema often have an overactive immune system that responds to irritants by producing inflammation. This inflammation leads to the characteristic symptoms of eczema.

Several factors contribute to the development and exacerbation of eczema:

  1. Genetics: A family history of eczema, asthma, or hay fever increases the risk of developing atopic dermatitis.
  2. Immune system dysfunction: An overactive immune response can lead to inflammation in the skin.
  3. Environmental triggers: Certain substances or conditions can trigger eczema flare-ups.
  4. Skin barrier defects: People with eczema may have a defective skin barrier, making it more susceptible to irritants and allergens.

Is there a connection between eczema and other health conditions. Research indicates that individuals with eczema are more prone to developing asthma, hay fever, and food allergies. This relationship is often referred to as the “atopic march” or “allergic march.”

Identifying Common Triggers for Eczema Flare-Ups

Understanding and avoiding triggers is crucial for managing eczema symptoms. Common triggers include:

  • Dry skin
  • Irritants (soaps, detergents, fragrances)
  • Stress
  • Hot and cold temperatures
  • Sweating
  • Certain fabrics (wool, synthetic fibers)
  • Allergens (dust mites, pollen, pet dander)
  • Hormonal changes
  • Foods (dairy, eggs, nuts, soy)

Can certain foods trigger eczema flare-ups. While food allergies don’t cause eczema, some people find that certain foods can exacerbate their symptoms. Keeping a food diary and working with a healthcare professional can help identify potential food triggers.

Diagnosing Atopic Dermatitis: The Journey to Proper Treatment

Diagnosing eczema typically involves a thorough examination of the skin and a review of the patient’s medical history. A dermatologist may perform the following steps:

  1. Visual examination of the skin
  2. Discussion of symptoms and family history
  3. Patch testing to identify allergens
  4. Skin biopsy (in rare cases)

How is eczema distinguished from other skin conditions. Dermatologists use their expertise to differentiate eczema from similar conditions like psoriasis, contact dermatitis, or fungal infections. In some cases, additional tests may be necessary to rule out other skin disorders.

Effective Treatment Strategies for Managing Eczema Symptoms

While there is no cure for eczema, various treatment options can help manage symptoms and prevent flare-ups. The most common treatments include:

  • Moisturizers: Regular use of emollients helps maintain skin hydration and repair the skin barrier.
  • Topical corticosteroids: These anti-inflammatory medications reduce itching and inflammation during flare-ups.
  • Topical calcineurin inhibitors: Non-steroidal medications that suppress the immune response in the skin.
  • Antihistamines: Oral medications that can help relieve itching.
  • Phototherapy: Controlled exposure to ultraviolet light can reduce inflammation and itching.
  • Systemic medications: For severe cases, oral or injectable medications may be prescribed to suppress the immune system.

What role do biologics play in eczema treatment. Biologic drugs, such as dupilumab, have shown promising results in treating moderate to severe atopic dermatitis by targeting specific components of the immune system responsible for inflammation.

Emerging Therapies and Research in Eczema Treatment

The field of eczema treatment is constantly evolving, with new therapies and approaches being developed. Some promising areas of research include:

  • JAK inhibitors: A new class of medications that target specific inflammatory pathways
  • Microbiome-based therapies: Treatments that aim to restore the balance of beneficial bacteria on the skin
  • Personalized medicine: Tailoring treatments based on an individual’s genetic profile and specific type of eczema

Are there any natural remedies that can help manage eczema symptoms. While scientific evidence is limited, some people find relief from natural remedies such as coconut oil, colloidal oatmeal baths, or dietary changes. It’s important to consult with a healthcare professional before trying any alternative treatments.

Living with Eczema: Coping Strategies and Lifestyle Adjustments

Managing eczema goes beyond medical treatments. Adopting certain lifestyle changes can significantly improve quality of life for those with atopic dermatitis:

  1. Establish a regular skincare routine
  2. Use gentle, fragrance-free products
  3. Avoid known triggers
  4. Manage stress through relaxation techniques
  5. Wear soft, breathable fabrics
  6. Maintain a cool, humid environment
  7. Practice good sleep hygiene

How can eczema impact mental health and social life. The visible nature of eczema and the constant discomfort can lead to anxiety, depression, and social isolation. Support groups and counseling can be beneficial for addressing the psychological aspects of living with a chronic skin condition.

Eczema in Different Age Groups: From Infancy to Adulthood

Eczema can affect individuals at any age, but its presentation and management may vary across different life stages:

Infantile Eczema

In babies, eczema often appears as red, weepy rashes on the face, scalp, and extremities. Gentle skincare, avoiding irritants, and maintaining a consistent routine are crucial for managing infantile eczema.

Childhood Eczema

As children grow, eczema may become more localized to the creases of elbows and knees. Education about trigger avoidance and proper skincare is essential for both children and caregivers.

Adult Eczema

Adult-onset eczema or persistent eczema from childhood may require a combination of treatments and lifestyle adjustments. Occupational factors and stress management become increasingly important in adult eczema care.

Can eczema develop later in life. While eczema often begins in childhood, it’s possible for adults to develop the condition for the first time, a phenomenon known as adult-onset atopic dermatitis.

The Role of Prevention in Eczema Management

While it may not be possible to prevent eczema entirely, certain strategies can help reduce the risk of flare-ups and minimize the severity of symptoms:

  • Identify and avoid triggers
  • Maintain proper skin hydration
  • Use mild, fragrance-free skincare products
  • Manage stress levels
  • Control environmental factors (temperature, humidity)
  • Follow a healthy diet rich in anti-inflammatory foods

Is there a link between early exposure to allergens and eczema development. Research suggests that early introduction of potential allergens, particularly in infants at high risk for atopic conditions, may help prevent or reduce the severity of eczema and other allergic diseases.

The Importance of Early Intervention

Early diagnosis and treatment of eczema can help prevent the condition from worsening and reduce the risk of complications. Parents and caregivers should be aware of the early signs of eczema and seek medical advice promptly if they suspect their child may have the condition.

Eczema Research: Current Trends and Future Directions

The field of eczema research is dynamic and rapidly evolving. Current areas of focus include:

  1. Genetic factors: Identifying specific genes associated with eczema risk
  2. Immunological mechanisms: Understanding the complex immune pathways involved in eczema
  3. Skin barrier function: Developing treatments to improve skin barrier integrity
  4. Microbiome research: Exploring the role of skin microbiota in eczema development and management
  5. Precision medicine: Tailoring treatments based on individual genetic and molecular profiles

What advancements can we expect in eczema treatment in the coming years. Ongoing research in areas such as targeted therapies, skin barrier repair, and microbiome modulation holds promise for more effective and personalized eczema treatments in the future.

The Role of Clinical Trials in Advancing Eczema Treatment

Clinical trials play a crucial role in developing new treatments for eczema. These studies help researchers evaluate the safety and efficacy of potential therapies before they become widely available. Patients interested in participating in clinical trials should discuss options with their healthcare providers.

Eczema and Comorbid Conditions: Understanding the Connections

Eczema is often associated with other health conditions, collectively known as atopic disorders. These include:

  • Asthma
  • Allergic rhinitis (hay fever)
  • Food allergies
  • Allergic conjunctivitis

Additionally, people with eczema may be at higher risk for certain skin infections due to the compromised skin barrier. How does the presence of comorbid conditions affect eczema management. The presence of multiple atopic conditions often requires a multidisciplinary approach to treatment, involving dermatologists, allergists, and other specialists to address all aspects of a patient’s health.

The Eczema-Asthma Connection

The link between eczema and asthma is particularly strong, with many individuals experiencing both conditions. This connection, known as the atopic march, suggests that early intervention and proper management of eczema may help reduce the risk or severity of asthma development later in life.

Eczema in Diverse Populations: Addressing Disparities in Care

Eczema affects individuals across all ethnicities and skin types, but its presentation and impact can vary. Research has shown that:

  • Eczema may be more common and severe in some ethnic groups
  • Skin of color may present unique challenges in diagnosing and treating eczema
  • Access to specialized care and treatments may vary among different populations

How can healthcare providers improve eczema care for diverse populations. Increasing awareness, providing culturally competent care, and addressing socioeconomic barriers to treatment are essential steps in reducing disparities in eczema management.

The Importance of Inclusive Research

Ensuring that eczema research includes diverse populations is crucial for developing effective treatments and understanding how the condition manifests across different skin types and ethnicities. This inclusive approach can lead to more personalized and effective care strategies for all individuals with eczema.

The Economic Impact of Eczema: Beyond the Skin

Eczema not only affects individual health but also has significant economic implications:

  1. Direct medical costs: Expenses related to treatments, medications, and doctor visits
  2. Indirect costs: Lost productivity, missed work or school days
  3. Out-of-pocket expenses: Specialized skincare products, clothing, and home modifications
  4. Quality of life costs: Impact on social activities, relationships, and mental health

What measures can be taken to reduce the economic burden of eczema. Improving access to effective treatments, promoting early intervention, and supporting research into more cost-effective management strategies can help alleviate the economic impact of eczema on individuals and healthcare systems.

The Role of Health Insurance and Policy

Adequate health insurance coverage for eczema treatments, including prescription medications and specialized care, is crucial for managing the condition effectively. Advocacy efforts aimed at improving coverage and reducing out-of-pocket costs can significantly impact the lives of those living with eczema.

Eczema and the Environment: Climate Change and Skin Health

Environmental factors play a significant role in eczema management, and climate change may be exacerbating the condition for many individuals. Consider the following impacts:

  • Increased temperatures leading to more sweating and skin irritation
  • Changes in air quality affecting skin barrier function
  • Alterations in pollen seasons influencing allergic responses
  • Extreme weather events causing stress and disrupting skincare routines

How can individuals with eczema adapt to changing environmental conditions. Staying informed about local environmental factors, adjusting skincare routines seasonally, and working with healthcare providers to develop flexible management strategies can help mitigate the impact of climate change on eczema symptoms.

Sustainable Skincare Practices

As environmental awareness grows, there is increasing interest in sustainable and eco-friendly skincare options for eczema management. This includes products with minimal packaging, natural ingredients, and environmentally conscious manufacturing processes. While these options may appeal to some individuals, it’s important to ensure that any new products are suitable for sensitive, eczema-prone skin.

Eczema types: Atopic dermatitis symptoms

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Atopic eczema – Symptoms – NHS

Atopic eczema causes areas of skin to become itchy, dry, cracked and sore.

There are usually periods where the symptoms improve, followed by periods where they get worse (flare-ups). Flare-ups may occur as often as 2 or 3 times a month.

Atopic eczema can occur all over the body, but is most common on the hands (especially fingers), the insides of the elbows or backs of the knees, and the face and scalp in children.

Eczema on the ankle.

Credit:

DR P. MARAZZI/SCIENCE PHOTO LIBRARY https://www. sciencephoto.com/media/256384/view

Eczema on the back of the knees.

Credit:

SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/494292/view

The severity of atopic eczema can vary a lot from person to person. People with mild eczema may only have small areas of dry skin that are occasionally itchy. In more severe cases, atopic eczema can cause widespread inflamed skin all over the body and constant itching.

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.

Scratching can disrupt your sleep, make your skin bleed, and cause secondary infections. It can also make itching worse, and a cycle of itching and regular scratching may develop. This can lead to sleepless nights and difficulty concentrating at school or work.

Areas of skin affected by eczema may also turn temporarily darker or lighter after the condition has improved. This is more noticeable in people with darker skin. It’s not a result of scarring or a side effect of steroid creams, but more of a “footprint” of old inflammation and eventually skin tone returns to its normal colour.

Occasionally, areas of skin affected by atopic eczema can become infected. Signs of an infection can include:

  • your eczema getting a lot worse
  • fluid oozing from the skin
  • a yellow crust on the skin surface or small yellowish-white spots appearing in the eczema
  • the skin becoming swollen and sore
  • feeling hot and shivery and generally feeling unwell

See a doctor as soon as possible if you think your or your child’s skin may have become infected.

Read more about infections and other complications of atopic eczema

Page last reviewed: 05 December 2019
Next review due: 05 December 2022

causes, what it looks like, types, stages, symptoms, diagnosis, treatment

Causes

Classification

Symptoms

Complications

Diagnosis

Treatment

Prevention and prognosis

Eczema is an inflammation of the skin of a non-infectious nature. Among the main manifestations are redness and itchy blisters that contain fluid. May become chronic. The name “eczema” comes from the word “boil”, and it came from the fact that the bubbles in this disease are similar to those that appear in boiling water.

Eczema can occur on the hands, feet, face. The disease can appear regardless of age and gender, but women are more susceptible to it. The reasons for this are unknown, perhaps it is due to the hormonal background or more frequent contact with household chemicals. Most often it has a professional nature: when the skin is constantly exposed to chemicals, allergens, especially against the background of a weakened immune system.

Eczema is not contagious and is not transmitted to other people, since microorganisms do not participate in its development.

Causes and triggers

It is now established that the cause of eczema is primarily hidden in genetics: a predisposition to it is inherited. If one of the parents has this disease, then the probability of its occurrence in children is up to 40%, and if two parents have it, up to 60%.

With a large number of synthetic substances in the modern world, from household chemicals to food additives, as well as allergens, stress, the likelihood of eczema with a genetic predisposition is very high. Moreover, in such cases, severe forms often occur, which are difficult to treat and give complications.

However, in order for the disease to manifest itself even with a predisposition, the influence of some predisposing factors is required, including:

  • existing allergy to household chemicals, dust or other substances;
  • endocrine diseases;
  • regular stress, neurotic conditions;
  • chronic inflammatory processes of infectious origin, including caries;
  • chronic diseases of internal organs – liver, stomach, intestines and others;
  • avitaminosis;
  • hormonal disruptions during puberty, menopause, against the background of taking medications and other treatment.

    • If a person has any of the above, this does not guarantee manifestations of eczema. However, some factors can cause its appearance at any time, for example, hypothermia, trauma with skin damage, alcohol consumption, contact with chemicals, including cosmetics, or those that are part of food, severe stress and anxiety.

    The disease begins when an autoimmune reaction is triggered, that is, the body produces antibodies against skin cells. This occurs when several factors are combined at once: predisposition, contact with chemicals, the action of antigens from chronic infectious foci, against the background of a decrease in immunity. As a result of autoimmune processes, inflammation appears on the skin with characteristic watery vesicles.

    Classification

    There are different forms of eczema that can vary greatly, and here are a few of the most common:

    1. True. It usually appears on the face and limbs. The affected areas of uneven shape alternate with healthy ones, have vesicular vesicles, papules, pustules. The skin turns red, weeping erosions form on it. In the chronic form, the skin coarsens, becomes dry, abscesses may appear when combed erosions become infected.
    2. Nummular or nummular eczema. It is provoked mainly by allergic reactions and chronic infectious processes in the oral cavity or respiratory system. It looks like coin-shaped plaques 1-3 cm in diameter, with vesicles, areas of wetting, crusts. In women, it usually occurs during puberty, and in men – closer to 60 years.
    3. Microbial eczema. Usually occurs around infected wounds or areas of pyoderma. May have a different shape with a clear border. In the center, purulent or serous crusts appear, when peeled off, areas of weeping are exposed. Itching is strongly pronounced, which provokes infection of the affected areas.
    4. seborrheic eczema. It starts on the head under the hair, in places where the sebaceous glands accumulate. Then it moves to other areas of the body. The skin is hyperemic, edematous, with yellow papules and covered with yellow crusts.
    5. Varicose eczema. It develops against the background of varicose veins, on the legs, near varicose ulcers. Severe itching is characteristic.
    6. sycosiform form. It is formed during infection and inflammation of the hair follicles and spreads beyond the hairline. It occurs on the face, under the armpits, on the pubis. This form is characterized by weeping and severe itching.
    7. Dyshidrotic eczema. It affects the skin of the palms and feet, where hyperemic areas appear with small bubbles containing liquid.
    8. Professional. Occurs due to the influence of production factors. Usually this is frequent contact with allergens – chemicals, antibiotics, metals. It often happens to those who often immerse their hands in water: dishwashers, cooks, cleaners, orderlies. It manifests itself in the contact zone as true eczema and disappears if the irritating factor is removed, for example, to change jobs.
    9. Dry eczema. It usually appears in older people on the background of too dry skin. Usually affects the hands or feet, and not only the epidermis, but also the dermis. It is manifested by redness, the formation of papules, peeling, ulcers. Severe itching, soreness, burning sensation are characteristic.

    Eczema in children also occurs, children from the age of 3 months can get sick. In them, the disease can affect any area of ​​\u200b\u200bthe head, except for the nasolabial triangle, as well as the buttocks and limbs.

    The disease goes through several stages of development: first there is hyperemia of the skin, itching, then papules form, then vesicles with fluid and weeping when they open. This is the stage of weeping eczema, when infection of the affected skin is possible. Then these areas dry up and crusts form. Further, the crusts are exfoliated, the skin is restored.

    Symptoms

    Symptoms of different forms of eczema are somewhat different, but they are also characterized by common manifestations:

    • skin redness, swelling;
    • the formation of vesicles with vesicular contents;
    • severe itching.

    Also, this pathology is characterized by the opening of vesicles and the formation of crusts, under which areas of weeping are noticeable. At the stage of recovery, these crusts begin to peel off.

    Complications

    Pathology can be complicated by the addition of an infection. Then the affected areas can fester and symptoms of intoxication will appear, with an increase in temperature and a deterioration in well-being. Infection can cause ulceration of the skin, which can visibly damage a person’s appearance.

    The most dangerous complication is erythroderma, when inflammation covers 90% of the skin. This disease has a high mortality rate.

    Diagnosis

    To diagnose eczema, a dermatologist conducts an examination and questioning whether a person has relatives with this disease, allergic reactions, and type of activity. Skin hyperemia, erosion, gray crusts and weeping allow a preliminary diagnosis, but some research may be required.

    Among them:

    • biochemical blood test;
    • blood test for immunoglobulin E;
    • sowing discharge to identify microorganisms and determine their sensitivity to antibiotics – to exclude the microbial form and treat secondary infections.

    You may also need to consult other specialists: an endocrinologist, a gastroenterologist, a psychoneurologist.

    Treatment

    For the treatment of eczema, an individual approach is required, since it is necessary first of all to eliminate the provoking factors. A hypoallergenic diet is prescribed, with the exception of foods such as fish, fatty meats, cocoa and coffee, citrus fruits, and legumes.

    If the disease is caused by external factors, they should be eliminated: move to a more environmentally friendly place, change jobs, exclude contact with disease-provoking factors, including at home.

    The following drugs are also used to treat eczema:

    • antihistamines – to reduce itching;
    • desensitizing – to stop inflammation and normalize metabolic processes in the skin;
    • glucocorticosteroids – with volumetric weeping eczema or the absence of results from treatment with other drugs;
    • antibiotics – if a microbial form is detected or a secondary infection has joined.

    Immunostimulating drugs may also be prescribed to increase the body’s defenses. Along the way, the therapy of the underlying disease should be carried out, if this has been detected, and first of all, the pathologies of the gastrointestinal tract. It is possible to prescribe sedatives to normalize the central nervous system.

    Lotions with astringents can be used locally – this accelerates the formation of crusts and their drying. Ointments and creams for eczema based on corticosteroids and antiseptics have also proven effective.

    Prevention and prognosis

    With proper and timely treatment, after a few days, itching and inflammation are noticeably reduced. Recovery occurs in 3-4 weeks, so the prognosis for uncomplicated forms of eczema is favorable. In the complicated form, it depends on the accompanying problems and the possibilities for their treatment.

    For the prevention of eczema, hygiene rules should be observed and contact with allergens should be avoided. Proper skin care is also important – keeping it clean, using emollients and moisturizers, but damage and the use of harsh products should be avoided.

    The author of the article:

    Shapovalova Valeria Olegovna

    cosmetologist, dermatologist, trichologist

    work experience 7 years

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