Patient-doctor teamwork can control eczema

By Brad Yentzer, MD

Itchy, dry, red skin that may include weeping, peeling blisters are symptoms of eczema, a common skin condition that can be severe and long lasting. The exact cause of eczema is not always known, but may be linked to the body’s immune system response to an allergen. Families with a history of allergies or asthma have a greater have risk of developing this non-contagious skin condition.

There are several types of eczema, also called dermatitis, as well as other skin conditions that have similar symptoms as eczema. While eczema is generally a benign, albeit annoying condition, some of those similar conditions pose serious health risks. Any unusual itchy, red and blistered patches of skin where the cause is not known should be seen by a dermatologist for a definitive diagnosis.

Of the major types of eczema, children are more likely to have atopic dermatitis, a chronic and inflammatory form of the disease. Atopic dermatitis usually begins in childhood, often in the first six months of the life, but it can also persist into adulthood. Symptoms may include dry, scaly skin, redness, itching, cracks behind the ears, a rash on the cheeks, arms and legs and open, crusted or weepy sores. The symptoms may lessen after a few weeks and then worsen in a flare-up. Contact dermatitis is more common in adults. It usually appears on the hands, or parts of the body that touched an irritant or allergen. The contact can cause the skin to itch, become inflamed and sometimes blister. Some metals such as nickel, and plants such as poison ivy, can cause contact dermatitis.

What are the common irritants or allergens that can trigger eczema?

The most common substances include: plants and botanical-based products, fragrances, metals (nickel), solvents, detergents, and certain preservatives. These allergens may be found in everyday materials in our personal care products and can trigger eczema to flare-up.

What products might trigger eczema?

Soaps and fragrances are the most common causes of an eczema flare-up. Some commercial and homemade soaps are produced using lye that is too harsh for sensitive skin. Those soaps, and many body washes and shampoos, contain fragrances that can trigger eczema. Use mild, fragrance-free soaps. Babies also do fine with a simple and safer warm-water bath.

Who is at risk for developing eczema?

Infants are at higher risk for eczema because their skin and immune system are still developing. Eczema may evolve in appearance as children age. Understanding the type of eczema they have as well as its symptoms and triggers are important for treating and managing the condition.

What are the types of eczema?

Major types of eczema include:

Atopic dermatitis – an inherited skin condition associated with the body’s immune system and certain skin proteins.

Contact eczema – a localized reaction where the skin has come into contact with an allergen.

Dyshidrotic eczema – eczema of skin on palms of hands and soles of feet characterized by blisters or vesicles.

Neurodermatitis – itching due to local nerve damage or neuropathy

Nummular eczema – circular patches of irritated skin that can be crusted, scaling, and itchy.

Seborrheic dermatitis – oily, scaly yellowish patches of skin, usually on scalp and face.

Scabies – a type of contagious mite that may trigger itching and rash

Stasis dermatitis – skin irritation on lower legs, usually related to swelling and circulatory problems.

Tinea – some fungal infections can have the appearance of eczema

How is eczema diagnosed?

There is no single test to diagnose eczema. Ruling out other conditions that cause skin irritations may require several tests to make an accurate diagnosis of eczema.

Common diagnostic tests include:

Clinical exam – the primary test is a physical exam by a qualified dermatologist.

Patch testing – substances are placed on the skin to test for skin allergies.

Skin biopsy – a piece of skin is removed and sent to the dermatopathologist.

How is eczema treated?

There is no cure for eczema, but there are treatments that can control the condition, heal the affected skin and prevent flare-ups. Doctors will suggest a treatment plan based on a patient’s age, symptoms and current state of health. For some people, eczema goes away over time, and for others, it remains a life-long condition.

The discomfort from itchy, dry skin of eczema can be relieved by moisturizers formulated with mild ingredients to reduce the chance of a skin reaction. Topical steroids may also be prescribed to control eczema symptoms.

Dr. Brad Yentzer is certified by the American Board of Dermatology. He opened CMA Dermatology, 2 Ascot Place, Lansing in April 2017 and organized its scheduling to accommodate urgent and non-urgent patient appointments. He is on the medical staff of the Cayuga Health System and can be reached at (607) 339-0456.

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