Eczema

Signs and symptoms of eczema vary from individual to individual. Following are the common signs that a person suffering from eczema will show:

• Dry skin
• Itching especially in the night that can be severe
• Red to brownish-grey patches, particularly on the feet, hands, ankles, neck, wrists, upper chest, eyelids, inside the bend of the elbows and knees
• Small, raised bumps that can leak fluid on scratching
• Thickened, scaly, cracked skin
• Raw, swollen, sensitive skin from scratching

Eczema usually develops before the age of 5 years and it can continue into adolescence and adulthood.

You must see a doctor in case you or your child:

• Is very uncomfortable that the disease is affecting daily activities and sleep
• Has a skin infection
• Continues to suffer symptoms even after trying home remedies

Seek immediate medical help for your child in case he or she has a fever or the rash looks infected.

Eczema is caused by gene variation which affects the ability of skin to provide protection. This further allows the skin to be affected by environmental factors, allergens and irritants. In children, food allergies can also play a role in causing eczema.

The main risk factor for eczema is having a personal or family history of eczema, hay fever, asthma and allergies.

Complications of eczema can include:

• Asthma and hay fever: Eczema in some cases precedes these medical conditions. More than half of young children who are patients with eczema develop asthma and hay fever by the age of 13 years.
• Chronic itchy, scaly skin: The skin disease known as neurodermatitis begins with a patch of itchy skin. If you scratch the area then it becomes even itchier.
• Skin infections: repetitive scratching breaks the skin which may cause cracks and open sores. These increase the risk of infection from virus and bacteria.
• Irritant hand dermatitis: This condition commonly occurs in people whose work needs their hands often wet and exposed to harsh disinfectants, soaps and detergents.
• Allergic contact dermatitis: This disease is common in the patients with eczema.
• Sleep problems: The itching can cause poor quality of sleep.

The following prevention measures can help to prevent attacks of eczema and minimize the drying effects of bathing:

• Moisturize your skin at least two times a day: Creams, lotions and ointments seal in moisture. Using a good product or products can be highly helpful to prevent the development of eczema.
• Try to identify and avoid stimulates which worsen the condition: reduce your exposure to triggers as sweat, dust, stress, pollen, obesity, soaps and detergents. Children may suffer flares from eating some types of foods as milk, soy, eggs and wheat.
• Take shorter baths or showers: Limit your baths to 10 to 15 minutes and use warm water.
• Take a bleach bath: A diluted-bleach bath reduces the bacteria on the skin and associated infections.
• Use only gentle soaps: Use of deodorant soaps and antibacterial soaps can take away more natural oils and they can dry your skin.
• Dry yourself carefully: After bathing, you should gently pat your skin dry with the help of a soft towel. Then apply moisturizer on the damp still.

No lab test is needed to diagnose eczema. Your doctor can diagnose by reviewing your medical history and examining your skin. He or she can use patch testing or some other tests to find out other skin conditions that accompany your eczema.

In case you suspect some food to cause rashes in your child then tell the doctor.

Atopic dermatitis can be continual thus you can require trying different treatments over months or years to control the condition. Signs and symptoms can return even if treatment is successful.

It’s important to diagnose the condition early so that its treatment can be started. In case regular moisturizing and other home remedies fail to treat your condition then your doctor can recommend you one or more of the following treatments:

Medicines

• Creams: Creams which control itching and repair the skin can be prescribed by the doctor as corticosteroid cream or ointment. Apply these creams as directed by the doctor after you moisturize. Other creams that contain drugs called calcineurin inhibitors as tacrolimus and pimecrolimus affect your immune system. They are for the use of children older than 2years of age. They help to control the skin reaction. Avoid exposure to strong sunlight after applying these products.
• Drugs to fight infection: antibiotic creams are prescribed in case your skin has a bacterial infection or crack. He or she can prescribe oral antibiotics for a short period to treat an infection.
• Oral drugs which control inflammation: For very severe cases, the doctor can prescribe oral corticosteroids as prednisone.
• A newer option for severe eczema: Injectable biologic called dupilumab is used to treat the patients with severe eczema who do not respond well to its other treatments.

Therapies

• Wet dressings: Wrapping the affected area of skin with topical steroids and wet bandages is an effective treatment for the severe cases of eczema. This is done in a hospital otherwise you can ask your doctor about the technique to do it.
• Light therapy: This treatment is done in people who do not get better with topical treatments. The simplest type of light therapy involves exposing the skin to restricted amounts of natural sunlight. Other types use artificial ultraviolet A and narrowband ultraviolet B either alone or with medicines. Phototherapy is not used in infants and it is less commonly used in young children.
• Counseling: Counseling can help those people who are frustrated or embarrassed by their skin condition.
• Relaxation, biofeedback and behaviour modification: These approaches can be helpful to people who habitually scratch.

Infant Eczema

Treatment for infantile eczema includes:

• Avoiding extreme temperatures
• Identifying and avoiding skin irritants
• Lubricating skin of the baby with bath ointments, oils or creams

Consult the doctor of your baby in case these measures do not improve the rash or if the rash appears infected. Your baby can require a prescription medicine to treat the rash or an infection. The doctor may also prescribe an oral antihistamine which can lessen the itch and cause drowsiness so as to ease discomfort and nighttime itching.

Medicines

• Creams and ointments: Overuse of corticosteroid creams can cause side effects as thinning of the skin. Creams that contain drugs called calcineurin inhibitors as tacrolimus and pimecrolimus affect the immune system of a person. These drugs can cause cancer.
• Oral corticosteroids: They can cause serious side effects on long-term use.
• Injectable biologic: They are very expensive.

Therapy

• Light therapy: Long-term light therapy can cause harmful effects as an increased risk of skin cancer and premature skin ageing.

Self-care measures that can decrease the itching and soothe inflamed skin are as follows:

• Moisturize your skin at least two times a day: Use a product that works for you. You can try bath oils, sprays, creams or ointments. For a child, moisturize the skin two times a day, before bedtime and before school.
• Apply an anti-itch cream to the affected area: A non-prescription hydrocortisone cream, can be useful to relieve the itch temporarily. Do not apply it for more than two times a day to the affected skin after moisturizing.
• Take an oral allergy medicine: Medicines as antihistamines can be helpful in case itching is severe. However it causes drowsiness, thus it is better to take these medicines before bedtime.
• Do not scratch: Try pressing on the skin, rather than scratching when you itch. If you cannot keep from scratching then cover the itchy area. In case of children, it is helpful to trim their nails and have them wear gloves while they are sleeping.
• Apply bandages: To protect the skin and prevent the scratching cover the affected area with bandages.
• Take a warm bath: Sprinkle the bath water with uncooked oatmeal and baking soda which is made for the bathtub. Bathe for 10 to 15 minute and then pat dry. Apply moisturizer when the skin is still damp.
• Choose mild soaps without perfumes and dyes: Use non-alkaline soap and rinse off the soap completely.
• Use a humidifier: Dry and hot indoor air can scorch sensitive skin and can make itching and flaking worse. A portable home humidifier adds moisture to the indoor air.
• Wear smooth-textured clothing: Rough, tight or scratchy clothing can decrease the irritation. During summers or during exercise wear appropriate clothing to prevent excessive sweating.
• Treat anxiety and stress: Stress and other emotional conditions can worsen eczema. Acknowledging those who try to improve your emotional health can help.

Eczema can be stressful, embarrassing or frustrating especially for adolescents and young adults. It can disturb their sleep and may result in depression. You should seek psychological support from counsellors, friends or family.