What is eczema?

NOT EVERY itchy skin disorder is eczema. Eczema is an inflammation of the skin which causes redness, bumps, water blebs, flaking or scaling and thickened skin. Eczema, which is also known as dermatitis, can occur on different parts of the skin, in specific age groups, or with certain triggers. Below are four examples of patients with eczema.

1. Anna is 10 months old and has a red rash on her face, outer arms and legs, which is so itchy that she wakes up at night crying. Anna has atopic eczema, the most common chronic skin disease in children. It is an inherited allergic condition, like asthma, urticaria, eczema, hay fever and food allergies. In older children, the rash is often found in the creases of the elbows and knees and the neck. It is extremely itchy, and can disrupt the sleep of children and their caregivers. Atopic eczema goes and comes, and by the age of 10, many children ‘grow out of ’ the disorder. Severe rashes may result in social isolation and depression. Management includes mild soaps, abundant use of moisturizers, and avoidance of triggers: stress, infection, harsh chemicals, and for those with food allergies, particular foods. In addition, your dermatologist or private doctor will prescribe topical medications. 2. Twenty-five year-old Steve has noticed that his dandruff has gotten worse, and now he has a rash on his face. He has been diagnosed with seborrhoeic eczema. In its mildest form it appears as dandruff on the scalp, but in more severe disease, there may be involvement of other areas of the head including the ears, the eyebrows, beside the nose and mouth as well as the middle of the chest and back, underarms and pubic regions. In adults, this is a chronic condition that comes and goes. In babies, seborrhoeic eczema is a transient condition lasting six to12 months. Anti-dandruff shampoos and prescription creams are used for treatment. 3. Candice notices that wherever she wears costume jewellery she develops a rash. She is allergic to nickel which is found in costume jewellery, a condition known as contact allergic eczema. This disorder occurs when a person comes in contact with a substance that they are allergic to, called an allergen. Fragrances, nail cosmetics, latex, cement and nickel are some common allergens. If the allergen is not obvious, then your doctor may recommend allergy tests to identify it. Avoidance of the allergen is an essential part of treatment. 4. Stacy has had varicose veins for many years. After a long day at work, her legs get swollen, and over time, have become dark and itchy. Stacy has stasis eczema, which occurs in persons with varicose veins or other causes of damaged veins. The abnormal veins cannot function efficiently to carry the blood back to the heart, so fluid leaks out into the skin, causing swelling and inflammation. Complications include hardening or sclerosis of the skin and leg ulcers. Elastic stockings and medications may improve blood flow, while steroid creams relieve the inflammation.

These examples highlight the fact that eczema is not one disease, but refers to several distinct skin disorders with different causes and treatments. A skin specialist will be able to tell you which type of eczema you have, and recommend treatment for your condition. Remember, not all eczemas are the same!