What is Eczema?

September 29, 2020

Woman scratching eczema on arm

September is Eczema Awareness Month, and the U.S. Dermatology Partners team is dedicated to promoting education about the diagnosis, treatment, and management of chronic skin conditions like eczema. According to Dr. Arathi Rana of U.S. Dermatology Partners in Sherman and Paris, Texas, “Helping more people recognize and get appropriate treatment to manage eczema is always important, but this year, more individuals with eczema are dealing with extreme flareups. Between stress, face mask irritation, and frequent handwashing, many eczema sufferers are having a tough time managing symptoms right now. The dry, cold winter air that’s just around the corner is sure to cause even more concerns. Whether you think you’re dealing with eczema but you’ve never been diagnosed or you don’t know what to do about severe eczema flareups, your dermatologist is here to help, so don’t wait until the situation is dire to give us a call.” Keep reading to get the answers to many of the frequently asked questions Dr. Rana receives about eczema.

Eczema FAQs and Dermatologist Recommendations

According to Dr. Rana, “Eczema is kind of a catchall term used to reference several different types of dermatitis and eczema, but most people are thinking of atopic dermatitis (red and itchy irritated skin) when they say eczema. No matter what type of eczema you’re dealing with, the condition is caused by oversensitivity due to the skin’s inability to effectively create a barrier to retain moisture and protect the body from external irritants.”

As Dr. Rana mentioned, eczema is a set of chronic skin conditions, including:

  • Atopic dermatitis – The most common form of eczema, atopic dermatitis causes redness, inflammation, and itching. Typically appearing on the face, arms, and legs, this type of eczema usually develops first in childhood, but flareups will likely occur throughout the person’s life.
  • Contact dermatitis – This is a type of eczema that occurs when the skin is exposed (usually repeatedly or for an extended time) to an external irritant, including the sun’s UVA/B rays, allergens, chemicals, and toxins.
  • Dyshidrotic eczema – More common in women, this form of eczema typically impacts the hands and feet, and it is usually linked to the spring allergy season.
  • Nummular eczema – While most types of eczema have a link to genetics, the cause of nummular eczema is unknown, and it can be extremely difficult to diagnose since people have such unique symptoms. However, most flareups include coin-shaped spots, which is why this form of eczema derives its name from the Latin word for coin.
  • Seborrheic dermatitis – Sometimes called cradle cap, this form of chronic eczema can be developed at any age, but it’s most common in infants. This type of eczema develops around the sebaceous (oil-producing) glands, usually on the scalp, nose, and upper back.
  • Stasis dermatitis – This type of eczema occurs as the result of poor circulation and is most common on the lower legs. When pressure builds up in improperly functioning veins, fluid leaks under the skin, causing pain, swelling, itching, and discoloration.

What are the Most Common Eczema Symptoms?

Healthy skin tissue creates a complete barrier, covering and protecting the body, but people who suffer from eczema have gaps in the protective outer layer of skin either congenitally (from birth) or developed due to contact with irritants or other conditions outlined in the previous sections. These microscopic gaps allow more moisture to get out of the body and more external irritants to get in. This means the immune system may be more easily triggered to react, leading to an overreaction to slight injury or irritation and itchy, sensitive skin. Because eczema allows moisture to escape the body more quickly, people with this condition also deal with extra dry skin and longer healing times.

Each type of eczema briefly outlined in the section above has its own unique range of symptoms, so it’s always best to talk to a dermatologist to receive an accurate diagnosis and effective treatment plan. However, some of the symptoms that are experienced by individuals diagnosed with all forms of eczema include:

  • Skin reactivity to perfumes, dyes, and chemicals in skincare, hygiene, and cleaning products
  • Difficulty adequately moisturizing skin and/or noticeably dry patches on the skin
  • Discoloration (reddening)
  • Chronic itching of skin or rashes
  • Rough, dark-colored patches of skin
  • Sores that ooze or take longer to heal
  • Potentially painful swelling and inflammation around irritated patches of skin
  • Generally raw or sensitive skin

What Causes Eczema?

Dr. Rana says, “Eczema is usually genetic, meaning individuals have inherited certain genes that make them more susceptible to this condition. There are many catalysts for eczema flareups, but the underlying issue is that people don’t have a seamless layer of protective outer skin cells. This means their skin gets dry faster, external irritants make their way into the skin’s layers, and irritation and inflammation occur. Most people with eczema know what factors will trigger a flareup, but if you’re newly diagnosed with this condition, tracking your condition to identify triggers is one of the first things your dermatologist will ask you to do.” Each type of eczema has specific triggers, but some common causes of flareups include:

  • Changes in diet
  • New skincare, hygiene, or cleaning products
  • Weather or climate fluctuations (especially extreme heat or cold)
  • Overly dry skin
  • Exposure to chemicals, smoke, perfumes, and other external irritants
  • Infections
  • Allergic reaction (can be specific to skin allergies or in response to ingested allergens)
  • Elevated, sustained stress levels
  • Excessive sweating without proper hygiene and hydration
  • Hormonal fluctuations

Who is at Risk to Develop Eczema?

According to Dr. Rana, “Anyone can develop eczema, but most types, including atopic dermatitis, are much more common for people with one or more family members who have eczema. People with poor circulation, those who handle chemicals regularly, those who are exposed to the sun frequently, and those with allergies are all at elevated risk for this condition. If you’re ever concerned you have eczema, talk to your dermatologist right away about creating a management plan to prevent serious flareups and maintain skin health.”

How is Eczema Treated?

For newly diagnosed eczema, Dr. Rana suggests, “Make sure you spend some time talking to your dermatologist about what skincare and hygiene products are best. You should also talk about cleaning products, fragrances, and cosmetics that can trigger flareups. Finally, you need to track your flareups to determine what foods, medications, weather conditions, or other factors are contributing to your symptoms. Most dermatologists ask that patients monitor their condition and note specific environmental factors every day for a few months. This gives you and your dermatologist a good idea of what products help your skin health as well as identifying individual triggers.”

Once you have a good plan in place, you will be able to manage most eczema flareups on your own. Some tips to help you reduce discomfort and keep symptoms in check during flareups include:

  • Eczema can be very itchy, but scratching will only further irritate the skin. Instead, apply topical 1% hydrocortisone cream (available in most pharmacies) to help with the itch. You can also take oral allergy medication, which may provide some relief for itchy skin. Cold compresses and ice packs can also be beneficial. If you can’t stop scratching, cover the areas with cloth or bandages to minimize the urge to scratch. For very young children with itchy eczema flareups, wearing mittens may help to deter them from scratching.
  • Soaking in colloidal oatmeal or baking soda can be beneficial to relieve itch. However, avoid extremely hot water that can strip the moisture from the skin. Stay in the tub for around ten to twenty minutes, dry skin by gently patting, and immediately apply a good moisturizer.
  • Review your skincare, hygiene, cosmetics, and cleaning products. Replace any products that have fragrances, dyes, or harsh chemicals (or those that irritate your skin) with gentle, hypoallergenic, fragrance-free options. Your dermatologist can give you specific recommendations, but a good rule of thumb is to look for products that say fragrance-free and that have only a few ingredients.

While there is no cure for eczema, most flareups can be easily managed with appropriate treatment at-home. For very severe or chronic eczema, professional treatments may be recommended by your dermatologist. Some of the professional solutions available include:

  • If over the counter (OTC) topical ointments aren’t effectively managing your symptoms, the dermatologist may prescribe higher strength solutions. Some prescription-strength, topical eczema treatments that may be recommended include corticosteroids, PDE4 inhibitors, calcineurin inhibitors, and skin barrier creams.
  • While exposure to the sun’s damaging UVA/B rays is often a trigger for eczema flareups, harnessing low-level UVB rays through phototherapy treatment can actually be beneficial during severe flareups. Phototherapy uses narrowband UVB rays to relieve itching and decrease irritation and inflammation in the skin while promoting the production of vitamin D and stimulating healthy immune function.
  • When treatments and products applied directly to the affected area don’t improve symptoms, you may be prescribed oral or injected medications to help manage the internal causes of eczema flareups. Specifically, oral immunosuppressants or injected biologics may be prescribed to target and manage specific immune functions that trigger eczema flareups.

Can I Prevent Eczema Flareups?

Dr. Rana says, “Like most chronic skin conditions, prevention is a key aspect of managing the symptoms. Because there’s no cure, taking steps to stave off flareups or minimize the impact of flareups, is essential.” Some recommendations for preventing eczema flareups include:

  • Moisturize – Because eczema sufferers have skin that is prone to dryness, moisturizing is essential. Make sure to use a thick, cream-based moisturizer at least twice a day.
  • Avoid over washing – Don’t shower or bathe too frequently as this can strip moisture from the skin. Right now, many people are washing their hands more frequently, which can trigger an eczema flareup, so try to apply a good healing ointment to hands several times a day and use a mild moisturizing lotion each time you wash your hands.
  • Change showering routines – You should also avoid taking very hot showers or baths, which can dry skin. Use gentle cleaning products on your hair and body. Always avoid anything with fragrance. Even products that use naturally-derived fragrances can cause flareups for some eczema sufferers.
  • Switch laundry detergent – Many people who struggle with eczema don’t think about how their clothes detergent can irritate the skin, but very strong detergents with harsh chemicals can often trigger an allergic response and eczema flareups. Switch to products labeled hypoallergenic or fragrance-free to avoid these concerns. For some eczema sufferers, laundry soap formulated for infants is ideal because these products are made to handle tough baby stains without irritating sensitive skin.
  • Review all products – Several of the recommendations include switching to less irritating skincare and cleaning products, but generally, you should look at the ingredients of all cleaning, cosmetics, hygiene, and skincare products. Monitor any flareups after use, and discontinue using products that contribute to flareups. Replace these products with options with fewer ingredients and without fragrances and dyes.
  • Create and maintain a daily routine – Finally, you should be working with a dermatologist who can help you create and maintain a daily skincare routine that works for you. Visit your dermatologist at least once a year for a skin health checkup.

When Should I Visit U.S. Dermatology Partners for Eczema Treatment?

You may want to visit Dr. Rana in Sherman or Paris or one of our other dermatologists at the U.S. Dermatology Partners practice location nearest to you if you’re experiencing an eczema flareup, you’re having trouble managing symptoms, or even if you haven’t received an eczema diagnosis in the past but you’re noticing the symptoms we talked about in this blog.

When you’re ready to get started scheduling an appointment at U.S. Dermatology Partners, you can use our simple online request form to set up an in-person visit at one of our practice locations. Once our team members hear from you, we’ll be in touch to finalize the details of your visit.

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