Eczema

June 3, 2020

4 min read

Eczema is a skin condition that is also called atopic dermatitis. Eczema is characterized by itchy, red skin. Eczema is most common among children, but the condition can cause skin problems at any age. According to the National Institutes on Health (NIH), as many as 30% of children and adults may have eczema. Eczema is a chronic disease and is also associated with asthma and other allergies. One of the major risks of eczema is vulnerability to viral, fungal, and bacterial skin infections. Eczema often begins before children enter school and can occur in infancy.

Signs and symptoms of eczema are varied and can be challenging to cope with. Symptoms include dry skin and itching. Eczema itching can become very severe, especially at night. Additional signs and symptoms include:

Brownish-gray, pink, and red patches of itchy skin
Small raised bumps which can become similar to blisters
Thick, cracked, scaly skin
Raw, sensitive and swollen skin

Eczema outbreaks can appear on the feet, ankles, wrists, and hands. Eczema can also appear on the upper chest, eyelids, inside of knees and elbows. Babies can have eczema on their scalp, face, and back of their legs and bottom.

According to the National Eczema Association, although the ultimate cause isn't certain, researchers believe there is a genetic component to eczema, and that both genetic causes and environmental triggers can cause the condition. An over-reactive immune system is common in people with eczema. A mutation in a gene that creates a protein called filaggrin, a substance that helps the body maintain a strong top layer of skin, is associated with some cases of eczema. The National Eczema Association says that a lack of filaggrin leads to weakened skin, which can become dry, itchy, and prone to infection.

Like other immune conditions, eczema can flare up at times, and be more under control at times. The condition can be triggered by a variety of substances and the environment. The National Eczema Foundation warns people with eczema that they can get worse if their skin is dry, or if they're exposed to the following irritants:

Metal (particularly nickel)
Cigarette smoke
Household cleaners
Soaps
Fragrances
Wool and polyester fabrics
Antibacterial ointments
Formaldehyde
Some antibacterial ingredients (isothazolinones)
Shampoo and lotion thickeners (cocamidopropyl betaine)
Leather dyes
Ingredients in temporary tattoos

Most people with eczema know that they need to be careful about which types of laundry detergent, body wash, shampoo, soap, and fabric softener they use (if at all). Eczema is a frustrating condition, and sensitivity to different substances can change over time. In addition to external triggers, stress is also a common factor in eczema flare-ups. Some people can experience eczema flare-ups while they are under stress. Then, the eczema flare-up results in more stress, which can become a cycle.

Eczema is also part of the "atopic triad," which can run in families. The triad consists of eczema, allergies, and asthma. As many as 30% of children with eczema also develop food allergies, according to the National Institutes of Health. Recent research shows that children with eczema and food allergies have differences in the structure and molecules of their skin which are hallmarks of both conditions. The skin changes can especially indicate a potential life-threatening peanut allergy. Children with these skin changes also had a greater amount of Staphyloccocus aureus in their skin, making them more vulnerable to skin infection.

Prescription medications can help eczema, from basic medications like corticosteroid creams to anti-infection drugs. Some people with eczema can benefit from oral corticosteroids like prednisone, but these drugs are not able to be used for long periods because they cause serious side effects. A new drug, dupilumab (Dupixent) has been approved by the FDA for treating severe eczema. Dupilumab is an injected biologic medication. Light therapy and wet dressings can also relieve eczema, although the Mayo Clinic reports that light therapy can have negative side effects, including skin cancer. Relaxation, biofeedback, and counseling can relieve the stress that eczema can cause, or that can contribute to flare-ups of the condition.

The National Eczema Association offers many resources for people with eczema and parents of children with Eczema. The Association provides advocacy for patients, informs people of their rights, and offers guidance for people in dealing with insurance companies. The Association also provides self-help resources and access to support groups. Eczema, as well as the other parts of the "atopic triad" can be frustrating and stressful, as well as potentially serious health threats. Help is available, and although eczema is a chronic condition, it can be improved and controlled. Research continues into the causes of eczema and potential cures.