Eczema

Is your skin inflamed? Dry, itchy, red? Sometimes flaring up with crusty fluid-filled bumps? Well, if it’s winter, it could be just the winter-itch. Or more.

Skin dries out when the protective oils in the outermost layer, the stratum corneum, are depleted, reducing the water-holding capacity of the skin. This dry skin may become red, itchy and scaly – and eventually lead to a condition referred to as Eczema.

Eczematous, or inflamed skin, can surface in adulthood or be a challenge since childhood. For some individuals, the flare-ups could lessen, or disappear, with maturity. For others, the inflammation may just increase and subside alternately throughout their life. But whatever its other characteristics, eczema is never contagious.

The exact cause for the symptoms of eczema remains unknown and there is no identified cure. However, there are effective treatments and remedies to ease discomfort during inflammation and prevent future outbreaks.  A visit to the dermatologist to help identify the type of eczema, its causes or triggers, and subsequently, the best course of action can contribute to relieving the symptoms.

Eczema: Many types, many triggers

Atopic Dermatitis and Contact Dermatitis are the most commonly seen types of eczema. Infants and children are most affected by Atopic dermatitis, which is an inherited condition characterised by dry, sensitive, itchy skin. Some children outgrow the condition whereas others battle it through adulthood.

When the skin gets inflamed due to an immune reaction following contact with an allergenic substance, such as poisonous ivy or perfumes and preservatives in cosmetics, the condition is referred to as Allergic Contact Dermatitis. Irritant Contact Dermatitis, on the other hand, is an inflammation due to repeated exposure to chemical substances that damage the protective outer layer of skin- harsh soaps, detergents and cleaning products often trigger this type of dermatitis.

Contact Dermatitis can be either acute or chronic. Acute eczema is characterised by swelling, redness and itchiness, whereas chronic eczema is identified by thickened, leathery skin with excessive ridges- a condition known as lichenification.

Lichenification also commonly occurs as chronic thick, itchy plaques on the back of the neck, wrists, ankles, lower legs and inner thighs with Lichen Simplex Chronicus eczema.

Acute, recurrent eruptions of multiple tiny blisters on the palms, sides of fingers and soles of the feet point to Dyshidrotic Eczema. Whereas Stasis Dermatitis is a chronic eczema which is associated with varicose veins and affects the lower legs.

Yellowish-brown, greasy, scaly patches on the nose, chest, scalp and eyebrows of adults indicate Seborrheic Eczema.  This type of eczema follows a course of natural waxing and waning.

And stubborn, coin-shaped eczema plaques on the outer hands, arms and legs indicate Nummular Eczema. Moisturizers help relieve this condition which may be related to skin dryness.

Treatment of eczema. It begins with caring for dry skin.

Management of dry skin is essential for treating eczema. Dry skin has an increased sensitivity to irritants, so your daily skincare regimen should include gentle cleansing routine followed by heavy-duty moisturising.

Cleansing do’s:

• Bathe in warm water, not hot water
• Long baths or showers can actually dry out your skin. Ironic but true. Keep it short, no longer than 10 minutes
• Use mild soap or gel designed for sensitive skin
• Pat the skin partially dry and seal-in the water by moisturizing within three minutes
• Reapply moisturizer whenever needed
• Bath oil can also be rubbed directly onto the skin. Avoid adding the oil to bath water.

Get smart about moisturising. Get moisture-wising.

Choose the ideal solution for your skin by wising up on moisturisers.

There are four basic classes of body moisturisers. Here they are in descending order of moisturising power:

• Ointment Moisturiser: This has the maximum ability to trap moisture in the skin. Aquaphor and Petroleum Jelly come under this category.
• Oil moisturiser: Bath oils, which are best applied right out of the bath. Apply directly to damp skin after a light towelling. Baby oils, and other oils of vegetable or mineral origin make efficacious moisturisers.
• Cream moisturisers: Usually white in colour, they get absorbed when rubbed into the skin without leaving a greasy feel.
• Lotion moisturizers: These are the lightest form of moisturizers and are suspensions, in alcohol and water, of oily chemicals.

Anti-itch products containing pramoxine, menthol or camphor are generally safe to use. But be judicious about using over-the-counter anti-inflammatory and itch-suppressing solutions. If any application causes more burning or itching do consult your doctor.

Apply topical cortisone (steroid) on red eczematous patches. In severe cases oral steroids and antihistamines may be required.

Raising the humidity levels in your environment would help a lot.

Can certain foods cause eczema or aggravate it?

There is no evidence pointing to any connection between specific foods and symptoms of eczema.  But some people perceive a link between some foods and their symptoms, and try an Elimination diet where they completely cut out the suspect food from their diet. Do consult a doctor before doing so.

Quite separately, cutting foods out may be helpful in the unconnected case of food allergies however, since the allergy may cause hives or skin problems that resemble eczema and cause severe discomfort of a similar nature, but are not the same.

Foods that help decrease eczema symptoms

Research has shown that probiotics – a type of live bacteria – found in yogurt or supplements may relieve some symptoms of eczema in children. Omega-3 fatty acids, found in fish and fish oil, have also been observed to decrease inflammation caused by eczema.

In conclusion, however, the best bet may be to opt for a healthy well-balanced diet – with plenty of fresh fruit, vegetable, whole grains and low-fat dairy. A consultation with your dermatologist will certainly go a long way!

Medically Reviewed By: Dr.Mohamed Asif