What is Eczema and How to Treat It by Bryan LaRue

By at December 24, 2011 | 3:08 pm | Print

What is Eczema and How to Treat It by Bryan LaRue

Eczema is a skin condition that affects many individuals and is also called atopic dermatitis. The word eczema comes from the Greek word “to boil over”. “Eczema affects 10% to 20% of infants and about 3% of adults and children in the U.S.” (Wang 2011) Many cases can cause permanent scarring and infections in the affected areas if not treated properly. Aside from the medical problems eczema can cause, it may also cause psychological effects including self-image and anxiety issues.

There are multiple types of eczema; one type is contact dermatitis, which is an inflammation of the skin caused by contact with an irritant. Contact dermatitis includes coming into contact with substances like poison ivy, latex, detergents, etc. Another type is seborrheic dermatitis. This causes flaky white or yellow colored scales on oily areas. (Atopic Eczema, National Library of Medicine) The most common type is atopic eczema. It occurs mostly in infants and most grow out of the condition later in life. It is an inflammatory condition of the skin that occurs as redness, scaling, dryness, flaking, blistering or cracking. Eczema is not contagious and is believed to be genetic. Eczema typically runs in families with a history of other allergies or asthma. This paper will discuss atopic eczema.

“The cause of atopic eczema is complex and as yet not fully understood.” (Peate 2011) It is believed that it is caused that the epithelial layer suffers defects that are the result from abnormalities in structural proteins. (Peate 2011) This causes the skin to be more prone to allergens and irritants that cause the reaction in the skin. A cause of atopic eczema is believed to be an overactive response or hypersensitivity to an irritant. Some things that can worsen one’s eczema can include allergies to pollen, mold, dust mites or animals. Climate changes can also affect “flare-ups” by having the person be too hot or too cold, as well as humidity of the weather. Household soaps and detergents with added fragrances tend to also worsen the condition. Stress is also a leading factor to cause flare-ups.

The diagnosis of eczema is typically given by a dermatologist by observing family history and the physical appearance of the eczema. Doctors will want to test the patients for any allergies as these are possible triggers for the eczema or may cause flare-ups or worsen the condition of the patient. Health care providers can also examine lesions to dismiss other possible causes of the symptoms, and while a skin biopsy can be done, it is rarely necessary.

While eczema cannot be cured, it can be treated to lessen the symptoms. People with eczema can also take precautions to avoid substances or situations that can cause flare-ups. The treatment of eczema is mostly to relieve the itchiness that the rashes cause to prevent scratching which can lead to infections. Since some allergies cause break-outs in rashes it is important for one to know their allergies and avoid them. Antihistamines can help lessen the reaction to allergies as well as keep the itching down to a minimum. They do this by blocking histamine receptors which create the itching sensation. Histamine is a substance in the body that acts in defense and is released when a foreign substance enters the body. (Lewis 2011) Many antihistamines are sold over the counter while more powerful ones may need a prescription. Light therapy and cyclosporine can also be used in people that do not show improvements with other treatments. Although since light therapy uses UV light which in higher doses could lead to skin cancer.

Other treatments for atopic eczema are topical medications that are placed directly onto the skin. These include hydrocortisone cream, or other prescription creams that typically include corticosteroids. “This class of substances is related to a natural hormone that can diminish an inflammatory response. In particular, glucocorticosteroids…” (Treating Eczema With Steroids) “Corticosteroids mimic the effects of hormones your body produces naturally in your adrenal glands…corticosteroids suppress inflammation. (Prednisone and other corticosteroids) These treatments are prescribed by dermatologists in the mildest form possible at first to minimize side-effects. They may however prescribe a higher potency for short periods of time.
Another type of medication for very severe cases is oral or injected corticosteroids. While these can eliminate inflammation and rashes quickly they can have greater side-effects than their topical counterpart.

Topical steroids while good for the short run can cause problems if used for long periods of time. Glaucoma and cataracts are known side-effects if corticosteroids are applied around the eye so doctors strive to use more mild medications in those areas. Other complications can include skin effects such as stretch marks and spider veins as well as acne if corticosteroids are used on the face. High blood pressure is also common in patients with pre-existing hypertension. (Treating Eczema with Steroids) These side-effects and more are the reason the more potent corticosteroids are typically avoided or used for shorter periods of time.
Immunosuppressants can also be used to treat eczema as a newer form of treatment. These work by altering the immune system response to prevent flare-ups. Two types of this medication are Elidel and Protopic. “The FDA has warned doctors to prescribe Elidel and Protopic with caution due to concerns over a possible cancer risk associated with their use.” (Wang, 2011) In particular, an immunosuppressant causes the patient more susceptible to skin cancer. To combat this sunlight and UV light should be avoided. (Lewis 2011) This kind of treatment is advised only if other available treatments have failed due to the health risks. Since these drugs suppress the immune system, people taking them are more susceptible to infections and should take other ailments such as sore throats very seriously and consult their doctor.

Another important treatment method is every day skin care. Avoiding scratching affected areas is a difficult but obviously important role in preventing infection. Taking antihistamines can help relieve the itchiness of affected areas. Antihistamines can also help protect against allergies which one should be tested for and try to avoid. Those with pet allergies may see benefits from keeping their pet groomed to reduce the amount of pet dander. Regular moisturizing of affected areas is important and may reduce the needs for medication. One should use lotions approximately two to three times a day to keep the skin moist. It is important to use moisturizers or ointments that are chemical and fragrance free. This is because chemicals can cause adverse reactions and induce flare-ups. While bathing it is important to not use harsh soaps that can damage the skin or to scrub too hard. After bathing it is advised to moisturize the skin immediately to help trap moisture in the skin and prevent it from drying out. Also it is helpful to keep a humidifier in the home to prevent an environment that is too dry and will cause break-outs. Avoiding clothing that is rough and can irritate the skin will also help reduce worsening conditions. These practices, while not eliminating eczema, will help prevent the condition from becoming worse. It is important that even while taking medication to practice these habits as they will work together.

While the direct cause of eczema is complex and unknown there are many treatments available. Since it is incurable, practices that avoid or eliminate flare-ups are really all that can be done. It is important to talk to a dermatologist before treatment and during treatment so health risks can be avoided. It is also noted that medicine such as corticosteroids and immunosuppresants have side-effects that are sometimes very dangerous and may not always be the best solution when at home skin care can treat symptoms.

Lewis, Victoria. “Antihistamines.” 7 Nov. 2011. Web.

Lewis, Victoria. “Immunosuppressants.” 7 Nov. 2011. Web.

Peate, Ian. “Eczema: causes, symptoms and treatment in the community.” British Journal of Community Nursing 16.7 (2011): 324-331. Web.

“Prednisone and other Corticosteroids: Balance the Risks and Benefits.” 5 June 2011. Web.

“Treating Eczema with Steroids.” American Academy of Dermatology. Web. United States. Library of Medicine “Atopic Eczema” PubMed Health. 10 Oct. 2010. Web.

Wang, Steven. “Skin Conditions and Eczema.” Webmd, 15 Oct. 2011. Web.



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