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Eczema symptoms, causes, types, prevention, diagnose and treatment

by Thomas P. Russell
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What is Eczema?

Eczema is a general term for a large group of diseases that inflame the skin and are often used interchangeably with dermatitis. The most common symptoms of eczema are itchy skin, red, hot, swollen, and painful skin, and papules. The above is only the performance of the acute eczema stage, as eczema develops, the skin symptoms will also change.

The progress of eczema disease does not stop at the acute stage, repeated episodes of acute eczema, the skin’s keratin metabolism will have problems and lose the function of maintaining water, the patient’s skin tissue will become dry and thick, there will be flaking, the skin color will also turn red or light red, this can also be called sub-acute eczema. If left untreated, it will gradually turn into chronic eczema, with the skin becoming darker and the affected area becoming thick and coarse like a callus-like skin. Eczema is a large group of diseases, and there are some differences in the care and treatment of different types of eczema.

Eczema symptoms, causes, types, prevention, diagnose and treatment | Image: Kind courtesy – freepik

Eczema symptoms

The main symptoms of eczema are erythema, rashes and even blisters that can be red, swollen and itchy. In the acute phase, the wound may exudate. The gradual transition to chronic eczema can lead to thickening of the skin, darkening of the skin color, easy cracking and peeling of the skin, and even large patches of scaling, which can sometimes cause skin pain.

Progression of eczema

The progression of eczema can be from acute to subacute to chronic: –
Acute phase: Prominent red papules appear on the affected area, the skin becomes itchy, red, hot and painful, and sometimes tissue fluid flows due to scratching.
Sub-acute stage: The skin color will change to red or light red, the skin will become dry and thick, and the skin will even flake.
Chronic phase: The skin color becomes darker, the skin becomes thicker and coarser, and the skin becomes like a thick cocoon.

Eczema complications

Complications include Staphylococcus aureus skin infections, as well as the less common herpes simplex virus infections, warts, or infectious plaques, etc. It is also important to avoid excessive itching, which can progress to cellulitis and later cause more serious infectious diseases such as sepsis.

What are the causes of eczema?

Eczema is a large group of diseases that cause eczema for many reasons. It can be roughly divided into two categories: extrinsic and intrinsic reasons :

  • Extrinsic reasons: Frequent contact with irritating substances, such as water, detergents, etc., or clothes with poor perspiration function and airtight materials irritate the skin. This type of dermatitis is also often called contact dermatitis . Eczema is also prone to occur in certain seasons. In summer, it is hot and sweaty, which can irritate the skin and induce eczema. In winter, the weather is dry and the sebaceous glands of the elderly degenerate. Because the sebaceous glands in children have not yet grown, the skin will be excessively dry and cause eczema. If there is eczema on the face, and the calves, arms, etc. where the sebum secretion is scarce are fine, it may be related to the excessive cleaning and maintenance of the skin.
  • Intrinsic reasons: mostly related to personal constitution, it is often found that some specific families are prone to eczema, parents have a history of eczema, and children are also prone to eczema. Many diseases that can cause eczema are often closely related to personal constitution, such as: atopic dermatitis , sweat herpes , seborrheic dermatitis , etc.

Types of Eczema

Atopic dermatitis: The most common form of eczema, patients usually have allergies, also known as atopic dermatitis. It occurs in infants and children, and papules often occur on the face, hands, feet, and knees and elbows of the flexors. The affected area will be scratchy and itchy, gradually leading to thickening and reddening of the skin, and scratching can cause skin infections if the skin is scratched.

Contact dermatitis: There are two types of contact dermatitis, one is irritant contact dermatitis and the other is allergic contact dermatitis. Irritant contact dermatitis usually occurs when the skin comes into contact with irritating substances, while allergic contact dermatitis occurs when the skin comes into contact with allergenic substances, such as cosmetics, paints, etc., often on the hands.

Acne vulgaris: It occurs mainly on the fingers and toes and is of unknown origin. Itchiness is severe, often accompanied by blisters, which may dry and flake after a few weeks. This eczema tends to become chronic and is associated with pain.

Nummular dermatitis: This kind of dermatitis is more common in men and less common in women, with men having their first attack usually in their 50s and women usually in their teenage years. It is often found on the extremities or back of the body and can be tricky to treat. The cause is unknown, but the main triggers are cold, dry air and chemicals such as formaldehyde.

Neurodermatitis: Patients with this type of eczema usually have a habitual, limited itching problem. Neurodermatitis occurs on the scalp, sides of the neck, ears, wrists, back, ankles, and vulva. Patients have a habit of scratching at these areas before the lesions develop, even when they are sleeping. Neurodermatitis is not obvious if the affected area is small, but thickening of the skin and deepening of the skin lines can be observed and may be combined with other infections.

Seborrheic dermatitis: Seborrheic dermatitis causes increased dandruff, which can occur throughout the head in infants, and in the brow area and sides of the nose in adults. The main cause of seborrheic dermatitis is an abnormal proliferation of dermatophytes, which leads to rapid shedding of epidermal cells and causes a dermatitis reaction.

Stasis dermatitis: This type of dermatitis occurs in patients with varicose veins. This is the first time that a person’s skin has been damaged by a bruise. As the disease progresses, the affected area may even develop hyperpigmented plaques.

Eczema prone groups

Allergy sufferers
Older people
Infants and toddlers

Eczema prevention tips

1. The principle of skin cleansing: In winter, unlike summer, the face produces more oil to cover dirt and chemicals, so use appropriate cleansing products. Use a mild cleanser or cleanse with water to get rid of any remaining dirt.

2. People with allergies need to avoid contact with potentially allergenic substances, such as cosmetics, paints, dust mites, etc. You can also pay attention to observe if there are specific substances that will definitely produce eczema, and you can effectively prevent it in the future by avoiding them.

3. Keep your body dry and wipe off sweat appropriately during the summer months or when exercising to avoid excessive skin irritation. You can also wear cotton clothing, and you should change your clothes when they are full of sweat.

4. The creams, lotions or natural oils that you use need to be especially careful that these products are free of fragrance, alcohol, preservatives and emulsifiers to avoid over-stimulating the skin.

5. Avoid excessive stimulation of the skin with hot water, hot springs and sauna must be moderated.

6. Regular work and rest without staying up late.Avoid excessive stimulation of the skin with hot water, hot springs and sauna must be moderated.

7. Avoid excessive stimulation of the skin with hot water, hot springs and sauna must be moderated.

How to diagnose eczema?

Eczema is diagnosed through consultation with a professional physician, observation of skin symptoms, and information about the patient’s medical history. In some cases, the affected skin can be removed for microbiological examination to determine if the eczema is caused by a specific microbial infection.

Eczema Treatment

Basic treatment principles:
If there is a lot of exudate and a wet surface, it may indicate a bacterial infection and require additional antibiotics; if there are multiple lesions, rubbing is not enough and oral medication may be required. For example, severe atopic dermatitis may require immunomodulators, neurodermatitis may require oral steroids, dandruff caused by seborrheic dermatitis may require a specific shampoo, and bruised dermatitis may require elevation of the affected area.

Individualized treatment:
Generally speaking, different types of eczema can be treated according to their course: subacute and chronic phases do not require steroid treatment if they are not severely inflamed, but rather require good maintenance and oiling to increase the skin’s protective power. If it is allergic or irritating substances, you need to avoid contact. In acute or severe eczema, steroids are required. There are many levels of steroids, and the doctor will choose the right steroid depending on the condition and location. For example, if the skin under the crotch is thin, a lower concentration of steroids will be chosen, and usually one to two weeks of rubbing will make it better.

Eczema care highlights

1. Avoid using harsh soaps when bathing during eczema flare-ups. Avoid contact with chemicals such as laundry detergents and cleaning agents.

2. Do not use excessively hot water in the shower and shorten the bathing time.

3. Keep your hands well cleaned and avoid scratching when eczema is itchy to avoid infection.

4. Avoid makeup when inflamed: Avoid makeup when your skin is inflamed, otherwise it will heal very slowly and may even get worse or recur. Let the skin rest for a week, adjust the way you clean and maintain it, do not put on makeup, and apply ointment, and it will definitely improve.

5. If makeup is absolutely necessary, first apply a mild steroid ointment, then a layer of barrier cream, and finally apply makeup. It is best to use mineral makeup, because powder is more difficult to absorb than water, and its allergenicity is relatively low. Powder, honey Powder will be a little better than liquid foundation.

6. Follow your doctor’s instructions and take medication to heal.

Eczema medical care reminder

At the initial stage of medical care, patients and family members should know: –

  • Do further tests need to be done?
  • How did the eczema get there?
  • What are the treatment options? What will happen if I don’t treat it?
  • Will the eczema continue to get worse? What problems will it cause to my body?
  • What are the things I need to take care of in my life? Do I need to adjust my diet or lifestyle?
  • When do I need a follow-up visit or further tests?

When eczema has been diagnosed, the caregiver should know: –

  • What stage of eczema is the patient in?
  • What are the usual symptoms to watch out for?
  • Do you need to take medication on a long-term basis? Is there a chance of reducing or stopping the medication in the future?
  • What are the side effects of the medication? What should I be aware of when taking medication?
  • Do you need to adjust your diet or lifestyle?
  • When is the next follow-up visit or follow up?

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