Eczema

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What is it?

The terms eczema or dermatitis are used to describe certain kinds of inflamed skin conditions including allergic contact dermatitis and nummular dermatitis. Eczema can be red, blistering, oozing, scaly, brownish, or thickened skin and usually itches.

Atopic Dermatitis

A special type of eczema is called atopic dermatitis or atopic eczema. It can occur at any age. It's a long-lasting (chronic) condition that may be accompanied by asthma or hay fever. Atopic dermatitis is most often seen in infants and children, but it can continue into adulthood or first appear later in life.

Atopic dermatitis tends to flare periodically and then subside for a time, even up to several years. The exact cause of atopic dermatitis is unknown, but it may result from a malfunction in the body's immune system.

Even mild atopic dermatitis can be extremely itchy. Self-care measures, such as avoiding soaps or other irritants and applying creams or ointments, can help.

Signs and symptoms of atopic dermatitis include:

  • Red to brownish-gray colored 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

Though the patches can occur anywhere, they most often appear on the hands and feet, on the arms (antecubital fossa), behind the knees, and on the ankles, wrists, face, neck and upper chest. Atopic dermatitis can also affect the skin around your eyes, including your eyelids. Scratching can cause redness and swelling around the eyes. Sometimes, rubbing or scratching in this area causes patchy loss of eyebrow hair and eyelashes.

Atopic dermatitis most often begins in childhood - between the ages of 5 and 7 - and may persist into adulthood. For some, it flares periodically and then subsides for a time, even up to several years. Itching may be severe, and scratching the rash can make it even itchier. Breaking this itch-scratch cycle can be challenging.

What causes it?

The following factors can worsen signs and symptoms of atopic dermatitis:

  • Long, hot baths or showers
  • Dry skin
  • Stress
  • Sweating
  • Rapid changes in temperature
  • Low humidity
  • Solvents, cleaners, soaps or detergents
  • Wool or man-made fabrics or clothing
  • Dust or sand
  • Cigarette smoke

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 color. In adolescence, the skin may be scaly or thickened and easily irritated. The intense itching may continue.

The exact cause of atopic dermatitis is unknown, but is likely due to a combination of dry, irritated skin together with a malfunction in the body's immune system. Stress and other emotional disorders can worsen atopic dermatitis, but they don't cause it.

Atopic dermatitis often occurs along with allergies and frequently runs in families in which other family members have asthma or hay fever. About three out of four children who have signs and symptoms of atopic dermatitis later develop asthma or hay fever.

Areas of concern

Prolonged itching and scratching may increase the intensity of the itch, possibly leading to neurodermatitis (lichen simplex chronicus). Neurodermatitis is a condition in which an area of skin that's frequently scratched becomes thick and leathery. The patches can be raw, red or darker than the rest of your skin. Persistent scratching can also lead to permanent scars or changes in skin color.

Neurodermatitis

Sometimes, scratching can break the skin and cause open sores and fissures that can become infected. A milder form of infection is impetigo, usually due to staphylococcal infection. Having atopic dermatitis predisposes you to this infection. Severe atopic dermatitis can also cause eye complications, which may lead to permanent eye damage. When these complications occur, itching in and around the eyelids becomes severe. Signs and symptoms of eye complications also include eye watering and inflammation of the eyelid (blepharitis) and the lining of the eyelid (conjunctivitis).

When to call us:

  • You notice the above signs and symptoms
  • You or your child are so uncomfortable that you're losing sleep or are distracted from your daily routines
  • You or your child's skin is painful
  • You suspect that your, or your child's, skin is infected
  • You've tried home care steps without success