A eczema or dermatitis is a skin disease that can appear in various forms. Typical signs are flaking, oozing, blistering and crusting of the skin. The most common causes are allergic reactions to certain substances and other skin diseases or skin inflammations. But poor hygiene can also lead to eczema.
What is eczema?
Schematic representation of the anatomy of the skin as well as the causes and symptoms of allergic skin eczema. Click to enlarge.Eczema is a skin reaction that resembles an inflammation, but is not caused by an infection. At first, the skin turns red, then blisters and becomes wet.
As the disease subsides, it is characterized by severe scaling of the skin and crusting. Although eczema is not infectious, it is summarized under the more modern collective term dermatitis with inflammatory reactions of the skin that take a similar course.
causes
Eczema is divided into three different types. Atopic eczema is also known as neurodermatitis and is usually an overly sensitive skin reaction. The reasons for the formation are not fully understood. However, it is assumed that the symptoms and complaints arise when the affected patient has a genetic disposition for the eczema and then comes into contact with a trigger.
The allergic contact eczema is an allergic reaction of the skin: It is characterized by the fact that the allergy can only be recognized by the development of eczema on the skin. An intolerance to nickel can cause such symptoms as soon as the patient comes into contact with the substance.
Toxic contact eczema, on the other hand, describes the reaction of the skin to a substance that is toxic or harmful to humans. The eczemas are formed as a defense reaction of the skin and are part of the normal reaction pattern when coming into contact with the respective substance.
Symptoms, ailments & signs
Although there are different types of eczema with different clinical pictures, all of them have typical eczema reactions. This is a characteristic sequence of symptoms that go through several stages. Itching is one of the typical leading symptoms of eczema.
Other common signs of eczema are oozing, flaking and the formation of crusts on the affected skin. A distinction must be made between acute and chronic eczema in terms of symptoms. In acute eczema, the skin is initially reddened. In addition, the skin swells and itches. The symptoms usually subside after a few days.
With pronounced eczema, blisters that are filled with liquid appear after the reddening. Shortly afterwards, the vesicles burst and crusts form, followed by dandruff. The scaling is an indication that the eczema is healing. The sequence reddening / swelling - blistering - crusting - flaking often occurs several times in a row.
A typical feature of chronic eczema is the appearance of light red skin. As the disease progresses, swellings, vesicles or papules form. Often times, patients also suffer from burning and itching. The skin is mostly permanently dry and constantly reddened. Because the patient often scratches himself from the itching, there is a risk of side effects such as inflamed nodules and scratch marks. Often skin infections also occur.
When should you go to the doctor?
If the eczema does not go away after two to three days, a doctor should be consulted. Eczema that encompasses large areas of skin or has become inflamed requires rapid diagnosis by a doctor. The same applies if the eczema occurs on the eye or the skin is peeling off in blisters. If you suspect atopic dermatitis, you should speak to your general practitioner or a dermatologist directly. Patients who suffer from a skin disease should clarify unusual skin changes directly with their doctor.
In particular, complaints that cannot be traced back to any other cause and have a significant impact on wellbeing need to be clarified quickly. The doctor will usually first talk to the patient and then perform a physical exam. Simple eczema can usually be recognized and treated in a targeted manner through eye diagnosis. However, if the inflammatory skin disease remains untreated, further complications can arise. You should therefore speak to a doctor at the first signs of eczema.
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Complications
Eczema can cause additional complications. These primarily include skin problems that arise due to the constant itching. Because the patient repeatedly scratches the affected areas, this often leads to an aggravation of the itching or the inflammatory process, which in turn has a negative effect on the healing process.
In addition, the agonizing symptoms can lead to sleep disturbances at night, which means that restful sleep is not possible. The skin changes often affect the patient's external appearance. In extreme cases, working life can no longer be reconciled with the sequelae of eczema.
If sensitization to occupational substances that occur there due to allergic contact eczema is detected in the workplace, there is even a risk of occupational disability. People who suffer from eczema are also prone to other skin infections, including impetigo. Herpes simplex viruses or bacteria such as staphylococci are mostly responsible for skin infections. By scratching the top layer of the skin, the germs can penetrate the skin.
Sometimes those affected also suffer from a fungal infection. Particular caution is required if symptoms such as herpes rash, reddening, cold sores and blisters filled with pus occur. If these symptoms appear, a doctor must be consulted quickly. For example, a herpes infection threatens further complications such as swelling of the lymph nodes and high fever.
Treatment & Therapy
Treatment is based on the condition of the eczema and the health of the skin. In the early stages of eczema, it is advisable to choose an ointment with the highest possible water content. The skin loses water through oozing and blistering and therefore needs new reserves in order to be able to initiate the healing process. However, if the eczema is in the later stages, when it forms a scaly crust, a fatty ointment is used to help the skin regenerate healthy cells.
If the eczema subsequently develops bacterial infections, an ointment containing antibiotics and antiseptic substances is also applied. Otherwise, a product that contains glucocorticoids is enough to prevent inflammation of the eczema. Only in severe cases are antibiotics or other healing substances given in tablet form if the eczema is not to be touched.
Outlook & forecast
Eczema has various causes and in the best case scenario it can no longer occur after a single occurrence. However, if a person is prone to this condition, the chances are high that it will recur in the course of life. Especially when the cause is psychological. If eczema has already been treated with an ointment, if it has not yet broken out strongly, it can quickly go away.
The danger, however, is that the irritated and itchy skin will be scratched even further and bleeding areas will develop. Then the skin needs a longer time to recover. A thin gauze bandage around the relevant skin area can help. Constant rubbing of clothing on the skin can also irritate it even more.
If there is a psychological cause, this must also be treated so that the eczema completely disappears. If the sick person comes to rest after a stressful time and thinks about the needs of his body, the eczema will also quickly disappear in this case.
The prospect of curing eczema therefore depends on various factors. However, if the cause of the disease is identified and treated individually and skin irritation is avoided, there is a relatively high chance of curing the disease.
prevention
In the future, people with known allergies will have to stay away from the respective allergen in order to prevent eczema from developing.Most dangerous substances can, however, be avoided easily - if you have an intolerance to nickel, for example, you have to pay attention to the materials used when buying jewelry and be careful when it comes to costume jewelry, because this often contains nickel.
When handling acids or alkalis, which are known to be dangerous, care must be taken to wear the correct protective clothing so that no accidents can occur. Eczema is often caused by accidents at work in companies that work with such substances and where employees come into direct contact with them. If, on the other hand, atopic eczema is present, the doctor should clarify what caused it in order to be able to keep away from the source of risk in the future, in order to avoid the formation and development of further eczema in the future.
Aftercare
In the case of eczema, there are a number of measures and options for follow-up care available to those affected. However, early detection and subsequent treatment should be carried out in the foreground, as this is the only way to prevent further complications and complaints. Self-healing cannot occur with eczema either, so that the person affected is always dependent on a visit to a doctor.
Only through early detection can further complications and complaints be prevented. The treatment itself is usually based on the exact symptoms and is carried out purely symptomatically. The person concerned should always consult a doctor first if anything is unclear or has questions. In general, a healthy lifestyle with a healthy diet has a positive effect on the course of the disease.
A doctor can also order dietary measures to alleviate the symptoms. Sports activities can also have a positive effect on the course of the disease. It is not uncommon for people to be in contact with other affected people, as this can lead to an exchange of information. The life expectancy of the person affected is not reduced by this disease.
You can do that yourself
Eczema is often accompanied by severe itching and scratching of bloody skin. If the symptoms persist, the doctor prescribes cortisone, which, however, is very controversial due to its radical effect. Therefore, many of those affected ask themselves which remedies can be used against the unpleasant eczema.
One behavior that should be avoided is constant unconscious scratching. Since this is particularly difficult during sleep, it is advisable to put on a light bandage or to wear gloves. It is also better not to wear tight clothing that could rub against the skin. Water often feels pleasant on the sore parts of the body, but excessive washing should be avoided as the water dries out the skin and only increases itching.
Creams with a high fat content, petroleum jelly, or cooking margarine should be used. Moisturizing creams are less suitable. If the itching is unbearable, a washcloth soaked in milk can be placed on the skin.
If those affected continue to suffer from eczema despite special creams or medical treatment, their lifestyle and diet should be checked. People are likely to suffer from nutritional deficiencies, eat too much fat, consume alcohol excessively, or smoke too much. All of these things can affect the skin and skin irritation is often a sign of a sick or stressed bowel.