Eczema - Causes, Symptoms and Treatment
CAUSES
Atopic eczema is believed to be a hereditary condition, being genetically linked. It has been suggested that people who develop eczema are abnormally sensitive to certain allergens. These allergens cause the immune system to overreact, causing inflamed, irritated and sore skin. (This explains why people with severe atopic dermatitis frequently also suffer from hay fever or asthma.)
Irritants like tobacco smoke, chemicals or solvents, even weather (hot, humid conditions or cold, dry ones) can aggravate eczema. Allergens as well - like dust mites, moulds, plant pollens, pets and any number of pollutants - can trigger an outbreak. It´s important to take notice of any allergies & sensitivities and avoid them.
Contact dermatitis can be divided into two distinct problems, which are referred to as direct irritant contact dermatitis and allergic contact dermatitis. The former term refers to exposure to acids, alkaline mixtures, detergents and various other chemicals that acutely inflame the skin. The condition can become chronic with repeated exposure. This form of dermatitis is often encountered in the workplace. Allergic contact dermatitis is caused by exposure to an allergen that sensitises the skin leading to acute inflammation when re-exposure occurs. A crucial distinction between the two is that prior exposure to the agent is necessary for allergic contact dermatitis to occur whereas direct irritant contact dermatitis can occur at the first exposure. For example, most people will develop dermatitis on first exposure to strong chemicals that are acid or alkaline in nature.
Symptoms and Complications of Eczema
Atopic dermatitis appears as red, itchy, dry skin. It tends to first appear in childhood, and may disappear completely before adulthood. It most often affects the area behind the knees and around the elbows, as well as the face. In infants, it often appears on the chest, face, scalp, and neck. Atopic people who contract the herpes simplex virus can be struck by eczema herpeticum, a serious secondary infection of the inflamed skin that causes a worsened rash and fever.
Itch - This is the main symptom, and without it a rash is not due to eczema (unless the itch has been improved by treatment). Itch is also a common feature of many other skin conditions as well as being a symptom of a range of diverse medical conditions not primarily to do with the skin, so although it is an ´essential´ symptom when diagnosing eczema it is not specific for it. We still do not fully understand what causes itch, but nerve fibres specialised in transmitting the itch sensation appear to exist within the skin. Like other nerves, these are ultimately connected to the spinal cord and so to the brain. It used to be thought that the sensation of pain travelled along the same nerve fibres as for itch but this seems now to be unlikely. Interestingly, the two sensations can act against each other.
This involves the palmer plantar region and can be acute or chronic causing deep seated pruritus and vesicle that are filled with sterile fluid. When pompholyx eczema is chronic in nature the vesicles become fissured and are prone to infection. It is more common in hot humid weather.
What is the treatment for eczema
Using emollients (medical moisturisers) and barrier creams may be sufficient to control some mild cases of eczema – available from your pharmacist, or on prescription from your doctor. More specific treatment is often needed in addition to emollients, as described below. For more information on emollients and total emollient therapy, see the website of the National Eczema Society.
There is no cure for this common condition. The main treatments are aimed at controlling and preventing inflammation and itching and include avoiding triggers, frequent bathing and hydrating of the skin, liberal use of moisturizers and lubricants, and the use of steroid creams for flare ups.
Probiotics, or "good" bacteria, are live microbial organisms naturally found in the digestive tract. They are thought to suppress the growth of potentially harmful bacteria, influence immune function, and strengthen the digestive tract's protective barrier.
Steroid medicines that are applied to the skin are called topical steroids. Topical steroids are drugs that treat inflammation. They are very helpful when rash is poorly controlled. Used correctly, topical steroids are safe and effective.
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