What Kind of Eczema is It?
What is Eczema?
Eczema, which is sometimes also called dermatitis, is the name used for a group of conditions that cause skin inflammation. According to the Dermatology Information Service of the University of Heidelberg, eczema affects more than 10% of all adults and is even more common in infants and children, although the precise prevalence depends on the specific type. Eczema is caused by a combination of external, irritating agents and the body’s immune response to them; none of the types are contagious—that is, eczema cannot be passed from one person to another.
Eczema has no known conventional cure, though its symptoms can be managed with conventional medicine, and in some cases avoided altogether. However, most cases can be successfully cured using an integrative approach that corrects or eliminates the underlying causes, and heals the effects the disorder has had on the body.
Types of Eczema
The most common type of eczema, atopic dermatitis, is a chronic (ongoing) skin disorder that affects males and females equally. It is estimated to affect 10-20% of infants and children, and about 60% of affected children will continue to have symptoms as adults. However, it is only one of several different types of eczema. All types of eczema cause areas of skin inflammation, which can lead to skin damage, loss of some of the skin’s protective function, and extreme discomfort. The types are distinguished from one another by their causes and by the appearance and location of affected skin. The types are discussed in greater detail below.
This causes the skin to be dry, extremely itchy, and inflamed, although symptoms can vary greatly from one person to the next. The most consistent characteristic of atopic dermatitis is that it causes the patient’s skin to be extremely itchy. If the skin is scratched, inflammation in the area increases, which causes reddening and swelling. Eventually, the affected skin can crack, “weep” clear fluid, and crust over. If the skin doesn’t get a chance to heal, it can become rough, leathery, and scaly in texture, and can also become infected.
Atopic dermatitis is caused by the interplay of genetic makeup and environmental factors. All “atopic” diseases are allergic conditions with a strong genetic component, such as allergic asthma, hay fever, and atopic dermatitis. The conditions are clearly connected to one another: about 75% of children with atopic dermatitis will also develop asthma or hay fever and children whose parents had one of these conditions are much more likely to develop atopic dermatitis. Atopic dermatitis, like other atopic diseases, appears only in people who have an inherited predisposition for it.
What causes this predisposition to develop the disease? It appears that people with atopic diseases have some degree of immune system malfunction. Atopic dermatitis is associated with abnormal levels of certain immune system proteins. This causes the body’s immune system—designed to fight off invaders such as bacteria and viruses—to become over-reactive and attack the body as well as foreign substances.
People with atopic dermatitis also seem to have exceptionally dry skin, because their outer skin layer loses moisture more readily than in most people. When the outer layer of skin is extremely dry, it loses its ability to protect the inner, living layer of skin. This damage combined with immune system malfunction make the skin more vulnerable to irritation and infections.
Allergic Contact Eczema
Another common type of eczema, allergic contact eczema, occurs primarily in adults. It causes symptoms similar to those of atopic eczema: inflamed areas skin become red, itchy, and weepy. The main difference between allergic contact eczema and atopic eczema is cause. Allergic contact eczema is caused by a hypersensitive immune response to a particular foreign substance; atopic eczema is not caused by a single allergic reaction, but by an ongoing skin disorder that makes the skin hypersensitive to many different irritants and conditions.
Allergic contact eczema requires pre-exposure to the allergen (allergy-causing substance) before a reaction will occur. This initial contact sensitizes the skin to the allergen, so that the skin will react to later exposures. When the skin reacts to the allergen, it will do so only where it actually contacts the allergy-causing substance—symptoms are localized to the spot that touches the allergen.
The most common causes of allergic contact eczema are reactions to poison ivy and to metal jewelry, both of which stimulate a strong immune response in many people.
Contact eczema, also known as irritant contact eczema, is similar to allergic contact eczema in that inflammation is limited to the area of skin that actually contacts the irritant. The skin reacts to the irritant by becoming red, itchy, and burning. Contact eczema does not require pre-exposure in order for the reaction to occur because it is usually caused by a strong irritant, such as an acid, alkali solution, or detergent. It also does not require a genetic predisposition to eczema, because it is caused by irritants that are powerful enough that they will eventually damage anyone’s skin. In severe cases, the irritants can cause chemical burns. This condition is often associated with workplace accidents
This is a common chronic disease that causes skin inflammation in areas containing sebaceous (oil) glands. In infants, it is called cradle cap. It appears as yellow, oily, scaly patches on the scalp, which can become inflamed and ooze. Inflamed patches spread quickly and can also appear on other parts of the baby’s body. Although this type of eczema appears unpleasant, it does not seem to make the baby uncomfortable and usually clears within a few months.
The adult form of seborrheic eczema is more commonly known as dandruff. It affects about 5% of adults and is more common in men than in women. It causes greasy, scaly patches on the scalp, which usually cause moderate to intense itching. Adult seborrheic eczema may be caused by a type of yeast.
Like most other types of eczema, seborrheic eczema usually cycles through more intense “flare-up” periods and periods of relapse, when it is less active. When the disease is not active, irritants such as sun exposure, heat, or irritating skin care products can cause flare-ups to begin.
This type of eczema occurs on the palms of the hands and the soles of the feet. It is a chronic condition characterized by deep blisters filled with clear fluid, which are often extremely itchy and burn. At later stages, the affected areas may peel; develop deep, painful cracks; become scaly or crusty; or suffer from secondary infections.
Although the precise cause of dyshidrotic eczema is unknown, doctors speculate that genetic predisposition, fungal infections, and contact with allergy-causing substances may all play roles in development of the disease. The condition is more likely to develop in people who spend a lot of time with their hands in water, such as nurses and food preparation staff. Onset of the disease is also associated with stress.
Also known as discoid eczema, it is characterized by extremely itchy, coin-shaped patches of skin inflammation, usually located on the arms, back, buttocks, and legs. The irritated skin areas can become crusted and scaly. Its cause is unknown, but it appears more frequently during cold weather and on patients with extremely dry skin. It is a chronic (ongoing) condition that can be triggered or worsened by many of the irritants that affect other types of eczema.
Because so many of the symptoms of nummular eczema overlap with those of other forms of eczema, some physicians do not believe that this is an independent disorder.
Neurodermatitis is a type of eczema initially triggered by a localized irritation, such as an insect bite or too-tight clothing. The irritated skin hyper-reacts to the initial irritation. It becomes extremely itchy, and becomes even more irritated if scratched, rubbed, or even touched. Scratching triggers an itch-scratch cycle: the more the area itches, the more the patient scratches, which causes the area to itch even more. This cycle causes scaly patches of skin to develop around the original bite area. Continued scratching can also break through the skin, and eventually will cause the skin to thicken and roughen.
This is a chronic (ongoing) condition. Its cause is not known, but its onset can be triggered by irritants such as wool clothing. It results in itching so severe that it can disrupt sleep. This makes it a particularly difficult form of eczema to treat, because the irritated areas cannot heal until the patient stops touching them.
This type of eczema is characterized by scaly, greasy-looking skin on the lower legs or ankles and the development of an itchy rash. It is usually associated with circulation problems, which cause fluid to pool around the ankles and in the lower legs. Eventually, this fluid buildup impacts the skin, which becomes irritated and develops a rash. As the condition worsens, the skin thins, becomes more fragile, and can develop painful sores. Effective treatment requires treatment of the underlying circulation problem as well as treatment of the affected skin.
Living with Eczema
Regardless of the type of eczema, the condition can be managed, and sometimes, cured. Patients and physicians need to work together to create a treatment plan. This plan will include workable lifestyle changes to incorporate a skin care regimen and help the patient to avoid eczema triggers and skin irritants. It may also include stress management, as stress and emotional distress can play a large role in the development and severity of eczema. Many with eczema benefit from the emotional support and information available from eczema support groups. The treatment plan may also include a strategy for symptom treatment, including medications, how and when to use them, and may also use different complementary therapies.
With knowledge and a plan, people with eczema can manage the condition and live full and successful lives. On the other hand, some health practitioners have assisted patients to achieve a complete victory over eczema through a comprehensive strategy that incorporates nutrition, lifestyle changes, emotional work, and natural therapies to eliminate symptoms and strengthen the body’s natural healing ability.
For articles on related topics, and allergy treatment options, go to:
“All About Atopic Dermatitis.” National Eczema Association for Science and Education. http://www.nationaleczema.org/lwe/aboutad.html (Accessed October 22, 2007.)
“All About Atopic Dermatitis.” National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health. < http://www.niams.nih.gov/Health_Info/Atopic_Dermatitis/atopic_dermatitis_hoh.pdf (Accessed October 22, 2007.)
American Academy of Dermatology. <http://www.skincarephysicians.com/eczemanet/index.html> (Accessed October 22, 2007.)
“Dermatitis: Treatment.” Mayo Clinic.com. http://www.mayoclinic.com/health/dermatitis-eczema/DS00339/DSECTION=7 (Accessed October 22, 2007.)
Dermis: the Dermatology Information Service (Department of Clinical Social Medicine, University of Heidelberg) http://eczema.dermis.net/content/index_eng.html (Accessed 24 October 2007.)
“Eczema: Frequently Asked Questions.” National Eczema Society. www.eczema.org/faqfile.htm(Accessed October 22, 2007.)
International Eczema/Psoriasis Foundation http://www.internationaleczema-psoriasisfoundation.org/seborrheic_dermatitis.php4 (Accessed 24 October 2007.)
“What is Atopic Dermatitis?” National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health. http://www.niams.nih.gov/Health_Info/Atopic_Dermatitis/atopic_dermatitis_ff.pdf (Accessed October 22, 2007.)
“Metal is Most Common Trigger for Allergic Contact Dermatitis.” American Academy of Dermatology Press Release. www.aad.org/public/News/NewsReleases/Press+Release+Archives/Skin+ConditionsFowlerMetalItch.htm (Accessed October 22, 2007.)
“The Truth about “Other” Therapies for Atopic Dermatitis.” .” American Academy of Family Physicians, EczemaNet Article.
www.skincarephysicians.com/eczemanet/other_therapies.html (Accessed October 22, 2007.)
“Atopic Dermatitis: Possible Complications.” American Academy of Family Physicians, EczemaNet Article. www.skincarephysicians.com/eczemanet/complications.html (Accessed October 22, 2007.)
“Clinical Trials: Is One Right for Me?” American Academy of Family Physicians, EczemaNet Article. www.skincarephysicians.com/eczemanet/clinical_trials.html (Accessed October 22, 2007.)
“American Academy of Dermatology Issues Statement in Response to FDA Decision Related to Two