Eczema

How does eczema affect us?

Eczema is a skin condition that affects children more than adults. People suffering from eczema produce less fat and oils to maintain their skin.

Lack of enough oil and fats on the skin surface makes the skin dry and itchy. Due to dry skin, small gaps are opened that allow bacteria to penetrate through. The bacteria cause infection and inflammation.

How is eczema diagnosed?

The pharmacist will conduct a visual examination of your skin and ask questions about the severity of your eczema symptoms. The pharmacist will also find out more about your lifestyle habits and the first time you experienced an eczema symptom.

The information you give will help the pharmacist determine the factors causing eczema symptoms and recommend the right eczema treatment. 

Types of eczema

• Atopic dermatitis
• Seborrheic eczema
• Contact dermatitis
• Stasis dermatitis
• Dyshidrotic/Pompholyx/ eczema
• Nummular dermatitis/Discoid eczema/
• Stasis dermatitis.

Atopic eczema

Atopic eczema presents as an itch on the creases and body folds. It affects areas such as elbows, hands, back of the knees, armpits, fingers, neck, eyelids, breasts, wrists, mouth, and lips.

It is most common in children but it disappears on its own when children attain their teenage years. Atopic dermatitis forms as a red inflammation and bumps on the skin's surface.

It can also appear on other parts of the body such as the chest, armpits, back, genitals, groin, breast, and in between the buttocks.

Seborrheic eczema

Seborrhoeic eczema also called dandruff, seborrheic eczema, and seborrheic psoriasis.

This type of Eczema causes a red rash on the affected skin or dandruff on the scalp. Seborrhoeic eczema most commonly affects the scalp and the sides of the nose where sebaceous glands are found in large quantities.

It can also appear on other parts of the body such as the chest, armpits, back, genitals, groin, breast, and in between the buttocks.

Contact dermatitis

Irritants and allergens both trigger contact dermatitis. Irritants such as perfumes, soaps, and detergents damage the skin. Allergens trigger the immune system to react in a manner that affects the skin.

It is characterized by red, itchy scaly skin that leads to a burning sensation. Contact eczema can affect any skin area but it's most common in knuckles and hands.

Stasis dermatitis

Stasis or Varicose eczema, also called venous, or Gravitational dermatitis. It's a long-term cutaneous condition. It is characterized by red/brown patches on the affected skin area. This type of eczema commonly affects the lower legs and is most common in middle-aged adults.

People with poor circulation of blood, varicose veins, and blood clots are more likely to develop venous dermatitis. Poor blood circulation increases the pressure on the lower legs, making the blood leak into the small veins of the legs.

If not treated, Stasis eczema can cause skin thinning, a condition that makes your skin fragile enough to cause a varicose leg ulcer.

Nummular dermatitis/Discoid eczema

Discoid eczema is commonly found in adults with dry skin. It appears as a coin-shaped disc on the affected skin area. Discoid eczema affects areas such as the trunk, forearms, and lower legs.

Dyshidrotic/Pompholyx/ eczema

Pompholyx eczema is also referred to as dyshidrotic eczema. If you are suffering from pompholyx eczema you will experience blisters on the palm of your hands, alongside your fingers, and at the soles of your feet. The blisters make your skin severely itchy and inflamed.

Asteatotic eczema

It is also referred to as eczema cracquele. Asteatotic eczema is caused by the low amount of oils on the skin surface due to frequent scrubbing, low humidity temperatures, and over-cleansing.

Asteatotic eczema mostly affects people above 60 years old and presents itself on dry rough clustered patches on the affected skin areas. You will likely find asteatotic eczema in the thighs, shins, upper back, and lower back.

Asteatotic eczema causes itching, soreness, and red and pink fissures.

How Can I prevent eczema flare-ups:

• Use a humidifier during the winter seasons 
• Avoiding cosmetic products that irritate the skin
•  Avoiding very hot baths that expose you to high temperatures 
• Regular use of emollient to keep your skin well-hydrated 
• Avoiding eczema triggers such as allergens and chemical substances 

There are 2 main treatments for eczema 

Emollients 

Emollients are moisturizers used to treat mild to moderate eczema. Eczema patients should apply emollients at least 3 -4 times a day to keep their skin hydrated, soft, supple, and less itchy.

Emollients are available in the form of creams, ointments, and lotions. You should apply emollient treatments directly on your skin after taking a shower or when moisture is still trapped on the skin. 

Emollient treatments include:

• Balneum medicinal bath oil and
• Dermal cream(cleanser)

Steroid creams: Topical corticosteroids are used to treat severe eczema symptoms. They are preferred when the affected skin area is extremely inflamed and red.

Steroid creams are applied in the form of very thin layers on the area of treatment,1 or 2 times a day.

Topical corticosteroids are divided according to the strength of the steroid treatment and the severity of eczema symptoms.

Below are examples of tropical corticosteroids based on their strengths, preferred areas of treatment, and severity of eczema symptoms

Weaker steroid treatments are typically prescribed for mild cases in sensitive skin areas.

• Eumovate cream/ ointment, and hydrocortisone cream

Stronger steroid treatments such as Betnovate cream or ointment are suitable for thicker skin areas like knuckles, palms, and soles, typically for moderate severity.

• Betnovate cream/ ointment

Strongest steroid treatments available include Betacap, Betnovate scalp lotion, and Elocon scalp lotion, particularly for severe scalp conditions.

Ckeck if you have Eczema

Symptoms of Eczema

• Skin thickening: The affected skin areas get thicker than the unaffected areas. You may experience splitting of the skin, especially in bent skin areas such as behind the knees.  Inflammation causes your skin to split since your skin is not flexible enough to bend.

• Itching: Eczema rashes cause an itching sensation.
• Blisters: Blisters are tissue fluids that ooze out of the affected skin cells
• Discoloration on the skin: Skin discoloration is a result of bacteria infection getting deeper into the skin layers.
• Crusts: Crusts are formed as a result of the fluid that pops out of an inflamed skin area. The fluid is rich in protein. The formed protein patches are the crusts.
• Dry skin
  
• Leathery patches on the skin