Eczema, also known as dermatitis, is a chronic inflammatory skin condition marked by redness, itching, and dryness of the skin. It commonly affects children but can continue into adulthood. Eczema is not contagious, but flare-ups can significantly affect daily life and comfort.
Causes and Risk Factors
- Genetic predisposition
- Immune system hypersensitivity
- Environmental triggers (dust, pollen, soaps, perfumes)
- Extreme temperatures or humidity
- Stress
- Food allergies (especially in children)
- Skin barrier defects leading to dryness
Types of Eczema
- Atopic Dermatitis: Most common form; associated with asthma or allergies
- Contact Dermatitis: Caused by irritants or allergens
- Seborrheic Dermatitis: Affects scalp, face, and oily areas
- Nummular Eczema: Coin-shaped patches
- Dyshidrotic Eczema: Small blisters on hands and feet
Symptoms
- Intense itching
- Red, inflamed skin
- Dry, scaly patches
- Thickened skin (lichenification)
- Cracked or peeling skin
- Small fluid-filled blisters
- Darkening of affected areas (post-inflammatory hyperpigmentation)
Diagnosis
- Physical examination of skin lesions
- Medical and family history
- Patch testing for suspected allergens
- Skin biopsy (rarely needed)
Treatment Options
1. Topical Therapies
- Moisturizers/emollients – essential for repairing the skin barrier
- Topical corticosteroids – first-line treatment for flare-ups
- Calcineurin inhibitors: tacrolimus, pimecrolimus
- Antibiotic creams if secondary infection is present
2. Systemic Treatments
- Antihistamines to reduce itching
- Oral corticosteroids (short-term use)
- Immunosuppressants: cyclosporine, methotrexate
- Biologics: dupilumab (for severe atopic dermatitis)
3. Phototherapy
- UVB therapy for chronic or widespread eczema
Complications
- Secondary bacterial infections
- Sleep disturbances due to itching
- Skin thickening from chronic scratching
- Emotional stress or low self-esteem
Trigger Management
- Avoid harsh soaps, detergents, and perfumes
- Use mild moisturizers regularly
- Keep nails short to reduce skin damage
- Avoid wearing tight or woolen clothing
- Identify and avoid allergens or irritants
- Manage stress with relaxation techniques
Patient Counseling
- Apply moisturizers at least twice daily
- Use prescribed steroid creams only as directed
- Avoid scratching to prevent infections
- Use lukewarm water for bathing
- Report signs of infection such as pus or increased redness
- Follow regular follow-up visits for chronic cases
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