Eczema. The Skin The skin is the body's outer covering. It protects us against heat, light, injury and infection. It also regulates body temperature.

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1 Eczema Introduction Eczema is a term for several different types of skin inflammation. Most types cause red, swollen and itchy skin. Another name for eczema is dermatitis. While eczema is not dangerous, it is an ongoing disease. You can prevent some types of eczema by avoiding irritants, stress and allergens. Medicines and other treatments are also available. This reference summary explains eczema. It covers the causes and symptoms of the condition. It also talks about diagnosis and treatment of eczema. The Skin The skin is the body's outer covering. It protects us against heat, light, injury and infection. It also regulates body temperature. Weighing about 6 pounds, the skin is the body's largest organ. It has 2 main layers: the outer epidermis and the inner dermis. The epidermis, or outer layer of the skin, is mostly made of flat, scale-like cells called squamous cells. Under the squamous cells are round cells called basal cells. The deepest part of the epidermis is made of cells called melanocytes. Melanocytes produce melanin, which gives the skin its color. Epidermis Dermis 1

2 The dermis, the inner layer of the skin, contains: Blood vessels. Nerves. Lymph vessels. Hair follicles. Glands. The skin s glands produce sweat, which helps regulate body temperature. They also produce sebum, an oily substance that helps keep the skin from drying out. Sweat and sebum get to the surface of the skin through tiny openings called pores. The skin contains a fine network of nerves. This network gives us the ability to feel sensations and pain. Skin Glands Types of Eczema The most common type of eczema is atopic dermatitis, or AD. It is an allergic condition that makes your skin dry and itchy. Atopic refers to a tendency to develop allergy conditions. Dermatitis means inflammation of the skin. Atopic dermatitis is an ongoing condition. It is associated with the presence of a specific allergic antibody. Antibodies are made by the immune system in response to a specific allergen. Some skin irritants can make AD worse. These include: Household chemicals. Rough clothing. Soap. Allergy triggers can also make AD worse. Some examples of allergy triggers are dust mites and certain foods. People who live in cities and dry climates may be more likely to get AD. It is most common in babies and children. Sometimes children outgrow the condition. In other cases, AD may remain a problem into adulthood. 2

3 There are many other types of eczema. Some of these include: Contact eczema. Dyshidrotic eczema. Neurodermatitis. Nummular eczema. Seborrheic eczema. Stasis dermatitis. Contact eczema happens when an irritant or allergen touches the skin. It is sometimes called irritant contact eczema or allergic contact eczema. When the skin is touched by the irritant or allergen, it becomes red and itchy. Examples of substances that can cause contact eczema are: Chemicals. Cosmetics. Nickel. Poison ivy. Dyshidrotic eczema causes the skin on the palms of the hands and soles of the feet to be irritated. It can also cause clear, deep blisters that itch and burn. This type of eczema may become painful. Neurodermatitis causes scaly patches on the head, lower legs, wrists or forearms. These patches are caused by a localized itch, such as an insect bite. People may scratch affected areas during the day without realizing it. They may also scratch while asleep. This can lead to an infection. Nummular eczema causes the skin to have coin-shaped spots of irritation. The spots can be crusted, scaling and very itchy. This type of eczema affects more men than women. Seborrheic eczema is also known as dandruff. It causes the skin to have yellowish, oily, scaly patches on the scalp and face. The patches may appear on other parts of the body as well. The skin of the patches often sheds and falls off in flakes. Stasis dermatitis causes the skin on the lower legs to become irritated. It most often happens due to a blood flow problem. Over time, it may cause the skin to have brown stains. 3

4 Symptoms Eczema may affect any area of your skin. Where it appears depends on the type of eczema you have. Eczema tends to affect the: Back of the knees. Face. Feet. Hands. Inside of the elbows. Wrists. Eczema almost always causes itchy skin in the affected area. It also causes a rash. The itching may start before the rash appears. Areas of skin affected by eczema may appear: Red and swollen. Scaly. Thickened. Very dry. Eczema may also cause the affected skin to have small, raised bumps. Since the affected skin is itchy, many people want to scratch the affected area. But this may cause an open wound. Open wounds may allow germs to enter the skin and cause an infection. Scratching the skin may also cause: Cracking or crusting of the skin. Increased redness and swelling. Raw, sensitive skin. Weeping clear fluid. The symptoms of eczema tend to flare up every so often and then go away. These flare-ups may be caused by coming into contact with an irritant or allergen. Being too hot or too cold may also cause a flare-up in some people. 4

5 Causes The exact cause of eczema is unknown. It may be caused by the immune system s response to an irritant. It is this overactive response that causes the symptoms of eczema. Factors that can cause eczema include: Allergies. Irritating substances. Other diseases. Eczema is commonly found in families with a history of other allergies or asthma. The cause of eczema could be genetic. Defects in the skin barrier could let moisture out and let germs in, which may also lead to eczema. Eczema is not contagious. It cannot be spread from one person to another. Diagnosis Your health care provider will first ask about your symptoms and medical history. A physical exam will be performed. There are no tests that can diagnose eczema. Your health care provider can often diagnose eczema by asking about your symptoms and looking at the affected skin. Many people with eczema also have allergies. You may be tested for allergies to find possible triggers or irritants that may make your eczema worse. Allergy testing may involve: Allergy skin tests. Blood tests. Allergy skin tests may be done in different ways. They often involve placing a small amount of different substances on the skin. Often, the skin is then pricked. If you have a reaction to the substance, you are allergic to it. Blood tests measure the amount of allergen-specific antibodies in your blood. Antibodies are made when the body is exposed to a specific allergen. 5

6 Treatment Treatment for eczema helps relieve symptoms, including itching. Treatment may include: Home treatments, including lotions and cold compresses. Over-the-counter medicines. Tar treatments. Phototherapy. Lotions help to keep affected skin moist. You should apply lotion after bathing or swimming to prevent the skin from drying out. Cold compresses can also help to relieve itching. Over-the-counter medicines include creams, such as hydrocortisone, that reduce inflammation and itching. Antihistamine medicines are also available over-the-counter. These may help lessen itching that is severe. Prescription medicines are also available. Prescription creams and ointments may contain corticosteroids, which reduce inflammation. Topical immunomodulators, or TIMs, may also be prescribed to treat mild-to-moderate eczema. These skin creams work by altering the immune system response. This helps to prevent flare ups. But these medicines should only be used for short-term treatment. Antibiotics may be given if the affected skin becomes infected. Tar treatments may help reduce itching. These treatments contain chemicals and are available in many forms, including: Cream or ointment. Gel. Liquid. Shampoo. Phototherapy uses light applied to the skin to treat eczema. This treatment may use natural sunlight or artificial ultraviolet light. Though effective, long-term light therapy can have harmful effects. 6

7 Treatment may also involve avoiding triggers and irritants that can cause flare ups. You can prevent flare ups by: Avoiding scratchy clothing materials, such as wool. Avoiding sudden changes in temperature and humidity. Avoiding sweating or overheating. Using lotions frequently. You can also prevent flare ups by: Avoiding harsh soaps, detergents and household chemicals. Being aware of foods that may cause an outbreak and avoiding those foods. Reducing stress. Summary Eczema is a term for several different types of skin swelling. Most types cause red, swollen and itchy skin. Another name for eczema is dermatitis. The most common type of eczema is atopic dermatitis, or AD. It is an allergic condition that makes your skin dry and itchy. There are many other types of eczema. Some of these include: Contact eczema. Dyshidrotic eczema. Neurodermatitis. Nummular eczema. Seborrheic eczema. Stasis dermatitis. While eczema is not dangerous, it is an ongoing disease. The exact cause of eczema is unknown. It may be caused by the immune system s response to an irritant. Eczema is not contagious. It cannot spread from one person to another. There are no tests that can diagnose eczema. Your health care provider can often diagnose eczema by asking about your symptoms and looking at the affected skin. You can prevent some types of eczema by avoiding irritants, stress and allergens. Medicines and other treatments are also available. 7

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