What Is Eczema?
Eczema can be a very frustrating skin condition, but what is it?
Eczema is a term that most people use to refer to the medical condition known as Atopic Dermatitis. There are actually many other types of Eczema so the term technically means "a type of rash". Common usage however, has made it almost synonymous with Atopic Dermatitis, much like the way I say "Kleenex" to refer to a soft, cloth-like "facial tissue".
Atopic Dermatitis is fairly common and can be a very frustrating skin condition. The rash is itchy areas of skin with dry scales and red patches with scratch marks. Over time the skin becomes thick, moist and infected. It can start at any age in people who have inherited the tendency for it. The most common places for the rash is in the folds of the elbows or behind the knees, but it can affect any part of the body.
Many of the patients I have seen in the 25 years I've been practicing dermatology here in the Santa Rosa Area, have signs of being at risk for this type of Eczema. Some of the subtle signs I look for during a skin exam are bumps on the backs of the arms and on the thighs (Keratosis Pilaris), dark circles under the eyes (Dennie-Morgan folds) or extra lines on the palms (hyperlinear palms).
The Atopic Dermatitis type of Eczema is found in approximately 20 percent of kids but only 3 percent of adults. Most people that develop Eczema manifest it when they are young and will gradually outgrow the problem over time. Not everyone is so lucky though and I have seen it present for the first time in adulthood.
The following factors are associated with an increased risk of developing eczema:
- Family members with Eczema.
- Family members with hay fever or asthma. Having these additional medical problems along with Eczema is known as the “Atopic Triad”. People with all three features tend to have more severe Eczema.
- Exposure to cold, dry climates.
- According to some scientific studies ingestion of certain foods including dairy, nuts and shellfish may make Eczema worse. However, it’s important to know that experts don't think that Eczema is exacerbated or caused by these foods.
Did you know that people who have a predisposition for Atopic Dermatitis type of Eczema have extra-sensitive skin?
People with Eczema have skin that is more likely to develop allergic reactions to allergens that touch their skin such as perfumes. I am a stickler for hypoallergenic skin care for everyone because I see so many people with subtle signs that they are prone to Eczema but are unaware of it. I almost exclusively recommend fragrance free products that don't have notoriously allergenic preservatives because so many are sensitive to these additives.
People prone to Eczema also have skin with reduced barrier strength that is prone to dryness and moisture loss. Cold and dry climates will exacerbate this and may trigger a flare up of Eczema. Once active, Eczema is itchy and can lead to an endless cycle that when scratched leads to even more itching. Scratching the rash can also break open the skin causing a wound that can easily become infected. The good news is that this vicious itch-scratch cycle can be "shut down" with good skin care. It’s something that requires constant, vigilant upkeep and a good relationship with your dermatologist.
When I see a patient with Eczema-prone skin, I give them a tutorial on the basic building blocks of good skin care for Eczema control. Start now to help manage your Eczema during the high summer temperatures that can bring on itching and you want to wear skin-baring clothing! Stay tuned for my next post about Eczema titled, "How To Treat Your Eczema".