Eczema or atopic dermatitis (AD) is a type of inflammation of the skin or dermatitis which results in itchy, red, swollen, and cracked skin. Clear fluid may come out from the affected areas, which often thicken over time. This condition typically starts in childhood with changing severity over the years. Scratching affected area worsens symptoms and people can have an increased risk of skin infections. Many people with eczema develop hay fever or asthma.

Atopic dermatitis is not contagious. Things that make it worse include wool clothing, soaps, perfumes, chlorine, dust, and cigarette smoke.

AD affects about 20% of people at some point in their lives and is more common in younger children. More than 10 million cases are reported in India per year.

How does Eczema affect your body?

Eczema affects the skin and causes red, inflamed patches that are accompanied by intense itching. This inflamed reaction has been linked to a malfunction in the body’s immune system. People with eczema have lower levels of a particular cytokine (a protein) and may also have higher levels of a different cytokine protein that prompts allergic reactions. This imbalance is most likely to blame for confusing the immune system and causing it to create the inflammation.

What are the causes of Eczema?

  • Genetics– Many people with eczema have a family history of atopy. About 30% of people with AD have mutations in the gene, which increase the risk for early onset of atopic dermatitis and developing asthma.
  • Hygiene hypothesis– According to this, children brought up in a modern environment are less likely to be exposed to allergens at a young age, and, when they are finally exposed, develop allergies.
  • Allergens– Exposure to allergens, either from food or the environment, can exacerbate existing AD.
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What are the risk factors of Eczema?

Risk factor for atopic dermatitis includes personal or family history of eczema, allergies, hay fever or asthma.

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What are the symptoms of Eczema?

Atopic dermatitis symptoms vary from person to person and include:

  • Dry skin.
  • Severe itching; especially at night.
  • Red to brownish-gray patches; on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp.
  • Small, raised bumps leaking fluid and crust over when scratched.
  • Thickened, crackedskin.
  • Sensitive, swollen skin from scratching.
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How is Eczema diagnosed?

AD is typically diagnosed clinically, meaning it is diagnosed based on signs and symptoms alone, without special testing.

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How to prevent & control Eczema?

  • Moisturize your skin at least twice a day using creams, ointments and lotions and petroleum jelly on your baby’s skin. This may help prevent development of atopic dermatitis.
  • Avoid triggers that worsen the condition including sweat, stress, obesity, soaps, detergents, dust and pollen.
  • Certain foods, including eggs, milk, soy and wheat may cause flare in infants and children.
  • Limit shower baths to 10 to 15 minutes and use lukewarm water rather than hot.
  • Take a bleach bath to help prevent flares because diluted-bleach bath decreases bacteria on the skin and related infections, no more than twice a week.
  • Use only gentle and mild soaps which can help remove natural oils.
  • After bathing gently dry your skin with a soft towel and apply moisturizer while your skin is still damp.

Treatment of Eczema – Allopathic Treatment

Light therapy– This is used for people who either don’t get better with topical treatments or who rapidly flare again after treatment. Phototherapy involves exposing the skin to controlled amounts of natural sunlight or artificial ultraviolet A (UVA) and narrow band ultraviolet B (UVB) either alone or with medications.

Medications used:

  • Topical corticosteroids– Topical steroids such as, hydrocortisone, have proven effective in managing AD.
  • Systemic immunosuppressant– These include cyclosporine, methotrexate, interferon gamma-1b, mycophenolate mofetil and azathioprine and help fight infections.
  • Antidepressants and naltrexone– These may be used to control pruritus (itchiness).
  • Crisaborole– This medicine was approved as a topical treatment for mild-to-moderate eczema.
  • Dupilumab– This is a biologic agent, approved to treat moderate-to-severe eczema.

Treatment of Eczema – Homeopathic Treatment

  • Graphites– This is used to treat eczema that thrives in warm, moist places such as the folds of the elbows, behind the knees, behind the ears, and between the toes.
  • Psorinum– This is useful for severe itching that leads to constant scratching. Eczema will ooze a thick secretion with a foul odor is also treated with psorinum.
  • Sulphur– This is used to treat eczema, itchy enough to cause violent, damaging scratching, which is often followed by a burning sensation.
  • Rhustox– Indicated to treat eczema found on the face and scalp, and around the mucous membranes.
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Eczema – Lifestyle Tips

  • Moisturize your skin at least twice a day using bath oils, creams, ointments or sprays.
  • For a child, the twice-a-day regimen might be a cream before school and an ointment before bedtime.
  • Apply an anti-itch cream to the affected area such as, hydrocortisone cream. This can temporarily relieve the itch and applythis no more than twice a day to the affected area, after moisturizing.
  • Take an oral allergy or anti-itch medication including nonprescription allergy medicines (antihistamines).
  • Don’t scratch or itch, rather press on the skin. Trim nails of children and have them wear gloves at night.
  • Apply bandages to protect the skin and prevent scratching.
  • Choose mild, non-alkaline soaps without dyes or perfumes.
  • Use humidifierin house which adds moisture to the air inside.
  • Wear cool, smooth-textured clothing in hot weather or during exercise to prevent excessive sweating.
  • Stress and other emotional disorders can worsen eczema, thus treat stress and anxiety.

What are recommended exercise for person with Eczema?

Low-impact exercise such as Pilates or yoga, which improve mobility, muscle strength and reduce stress. These exercises can be practiced for at least an hour.

Eczema & pregnancy- Things to know

  • Pregnancy-induced eczema is the most common skin problem that occurs during pregnancy.
  • Eczema during pregnancy is not dangerous for either mom or the baby.
  • AD can occur for the first time during pregnancy or if had in the past then pregnancy could trigger a flare-up.
  • It is estimated that about 20 to 40 percent of women who experience eczema during pregnancy have a history of eczema before becoming pregnant.
  • Treating eczema is similar to the ones used for non-pregnant women.

Common complications related to Eczema

  • Asthma and hay fever-Atopic dermatitis sometimes precedes these conditions. More than half of young children with AD develop asthma and hay fever by age of 13.
  • Chronic itchy, scaly skin-Neurodermatitis (lichen simplex chronicus) starts with a patch of itchy skin and can cause the affected skin to become discolored, thick and leathery.
  • Skin infections– Repeated scratching that breaks the skin can cause open sores and cracks which increase the risk of infection from bacteria and viruses, including the herpes simplex virus.
  • Irritant hand dermatitis-People whose work requires their hands to be wet often andexposure to harsh soaps, detergents and disinfectants can develop this condition.
  • Allergic contact dermatitis-Common in people with atopic dermatitis.
  • Sleep problems-Itch-scratch cycle can cause poor sleep quality.

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