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Eczema: symptoms, causes and how to treat it

Atopic dermatitis is the medical name for eczema. It is an inflammatory, chronic skin condition, to be distinguished from psoriasis. This skin condition is generally accompanied by itching.

Eczema or atopic dermatitis: what is this skin condition?

Atopic dermatitis is the medical name for eczema. It is an inflammatory, chronic skin condition, to be distinguished from psoriasis. This skin condition is generally accompanied by itching. Eczema also appears to affect patients with a history of asthma, hay fever or allergies more often. Hereditary predispositions are also cited by dermatologists as risk factors for the condition. An abnormality of the skin barrier is thought to be behind the skin inflammation and eczema flare-ups. Other allergenic substances may also trigger these flare-ups. In terms of prevalence, atopic dermatitis is a very common condition, affecting 20% of children and 10% of adults each year. Cities and developed countries are more affected by this skin condition, due to pollution or environmental factors. People with allergies are also more susceptible to this disorder. Most of the time, atopic dermatitis first appears in children before the age of 5, and in infants before the age of one. When it appears during childhood, it tends to disappear naturally or lessen in adulthood. In infants, the skin rashes of atopic dermatitis take on a red colour, with possible crusting on the face, hands, scalp, arms, legs or feet. Weeping (oozing) can also be observed. Diagnosis of eczema is based on the doctor's assessment and the severity of the rash's appearance. The patient's family and personal history must also be reviewed. In addition, the doctor will need to distinguish atopic dermatitis from other conditions (seborrhoeic dermatitis, contact eczema, psoriasis, etc.). Lastly, it is worth noting that eczema is not contagious.

What are the symptoms and causes of eczema?

During the acute (or early) phase, red patches develop, with weeping, crusting, and sometimes even blisters. This rash is very often accompanied by intense itching (pruritus). During its late (or chronic) phase, rubbing and scratching cause lichenified areas (presence of lichen) and dry patches to appear. In children, eczema flare-ups (to be distinguished from psoriasis) start to develop on the face and neck, scalp, eyelids, hands, feet or legs. Many areas of skin can therefore be affected. The location, colour and intensity of the rash vary from one person to another, but it is always accompanied by itching. This is the main symptom in older children and adults. Itching often leads to scratching, which creates a vicious circle that worsens the condition (itch-scratch-itch). Common environmental factors in eczema include:
   • Excessive hygiene: baths and washing that are too frequent;
   • Soaps or products that are harsh on the skin;
   • The presence of a bacterium, Staphylococcus aureus (S. Aureus), on the skin;
   • Harsh clothing (wool and rough fabrics);
   • Sweating;
   • Certain allergens: an allergy or allergic reaction can trigger an eczema flare-up.
The complications of eczema are linked to scratching and rubbing. These allow bacteria to enter the lesions, causing skin, lymph node and subcutaneous tissue infections. The inflammation can also spread and lead to skin peeling. Lastly, people affected by atopic dermatitis are more likely to contract other viral illnesses (such as warts) and fungal infections. Furthermore, anyone can be affected by atopic dermatitis at some point in their life.

How do you treat atopic dermatitis?

Treatments for eczema include:
   • Solutions aimed at relieving itching in everyday life;
   • Skin care products (creams, ointments, lotions, etc.);
   • The use of corticosteroids;
   • Crisaborole (a non-steroidal topical treatment);
   • Immunomodulators (tacrolimus and pimecrolimus);
   • Phototherapy (light therapy);
   • Dupilumab (a monoclonal antibody) by injection;
   • More rarely, antibiotics, particularly in the case of a Staphylococcus aureus bacterial infection;
As for itching, it can be relieved with a topical treatment applied locally to the lesions or taken orally. These treatments can be given at home, although hospitalisation is sometimes necessary for people affected by herpeticum eczema, cellulitis or erythroderma. Preventing eczema involves using specific skin care:
   • Using a soap substitute rather than a regular soap;
   • Applying moisturising creams or ointments straight after bathing, while the skin is still damp;
   • Reducing exposure to water: baths or showers should be limited to once a day. You can clean yourself with a sponge to space out the days with a full shower;
   • Using lukewarm water to wash;
Antihistamines (hydroxyzine, diphenhydramine) can also help relieve itching. However, it is preferable to take these medicines in the evening to avoid the risk of daytime drowsiness. Lastly, emotional stress is often linked to the onset of eczema, so it should be reduced as much as possible.

Eczema: consult online without an appointment for your dermatological concerns

Atopic dermatitis is a common skin condition, particularly in developed countries. It is estimated that eczema affects up to 10% of adults and 20% of children. Its diagnosis and treatment are therefore a public health concern. While hereditary predispositions are cited by doctors, other common triggers of atopic dermatitis include stress, asthma, allergies, and excessive bathing or washing. An abnormality of the immune barrier could also be responsible. Its manifestations vary with age and include itching, the formation of red patches, erythema and scaling on areas of skin. This skin condition should be distinguished from other skin conditions, such as psoriasis, seborrhoeic dermatitis, contact eczema or contact dermatitis. Most often, eczema clears up on its own or lessens drastically in adulthood. Lastly, the main treatments and medicines for eczema include:
   • Moisturising creams and ointments;
   • Topical corticosteroids;
   • And for itching, antihistamines.
When these treatments do not work for patients, the doctor may consider ultraviolet light therapy (phototherapy) or the use of systemic immunosuppressants. In the event of an allergic reaction or in the presence of symptoms such as skin lesions, an online consultation with a dermatologist will provide you with a fast diagnosis (in under 24 hours) and a prescription for treatment if necessary. Take care of your health every day with an online dermatologist from Feeli.