Living with Eczema (Atopic Dermatitis)

Introduction

Living with eczema involves a unique set of issues that extend beyond simply skin irritation.

From constant itching to the emotional toll of visible flare-ups, persons struggling with this chronic condition navigate a complicated combination of physical discomfort and psychological distress daily.

The constant itch, inflammation, and damaged skin from eczema aren't just physical issues. They take a toll on emotional well-being, impacting social interactions, self-esteem, and quality of life.

Managing eczema requires a multidimensional strategy encompassing skincare routines, dietary considerations, and stress management approaches. This blog will discuss eczema, its types, causes, symptoms, treatment, and how to live with it.

Understanding Eczema (Atopic Dermatitis)

Eczema, also known as atopic dermatitis, is a chronic, long-lasting skin condition that causes inflammation and redness.

It is most common in children but can affect people of any age. It is not contagious and cannot be transmitted from one person to another.

Atopic dermatitis causes the skin to be exceedingly irritating. Scratching causes increased redness, swelling, cracking, "weeping" clear fluid, crusting, and scaling.

Types of Eczema 

When most people refer to eczema, they typically mean atopic dermatitis, the most common and chronic type of eczema. Other common types that may match your particular symptoms are:

Contact dermatitis

Contact dermatitis is a skin condition caused by the skin coming into contact with an irritant or an allergen, causing itchy, red, or even blistered skin. 

The inflammation goes away after treatment and removal of the irritant or allergen. Contact dermatitis can be mistaken for a fungal infection.

Discoid/nummular dermatitis

Discoid/Nummular Dermatitis is an eczema that causes round red spots on the skin. It usually appears on the legs.

Dyshidrotic dermatitis

Dyshidrosis is a type of eczema that causes small blisters on your hands, fingers, and the soles of your feet. Symptoms of dyshidrotic eczema usually start as severe itching and burning of the skin on the hands and fingers.

This further develops into tiny itchy blisters on the palms and sides of the fingers that may weep fluid.

Seborrheic dermatitis

Itchy, red, scaly rashes spread throughout oily skin areas such as the sides of your nose, behind your ears, eyebrows, eyelids, and scalp are the symptoms of seborrheic dermatitis.

Symptoms of Eczema

The most important point is that eczema symptoms vary from person to person.

A person's skincare routine will also affect the affected areas differently. Eczema may look different on one person than on another adult or child.

Different forms of eczema may emerge in different body parts at different times.

Eczema symptoms include:

• Itching
• Dry, sensitive skin
• Skin inflammation, discoloration
• Scaly areas of rough, leathery skin
• Creasing or oozing
• Swelling

Causes of Eczema

There are a number of causes that may trigger eczema symptoms.

These can vary from person to person.

Overactive immune system: Atopic dermatitis, the most common type of eczema, results from an overactive immune system that causes the skin barrier to become dry and itchy. This condition can occur on any part of the body and has varied symptoms.

Environmental factors, like weather fluctuations, particularly cold and dry situations, might worsen symptoms.

Skin irritants include soaps, detergents, scents, and specific materials.

Common allergens, such as pollen, dust mites, animal dander, and specific foods might cause symptoms in persons who are sensitive to them.

Emotional stress has the potential to worsen symptoms of eczema.

Bacterial or viral infections might result in worsening symptoms.

Foods: Dairy products, eggs, nuts and seeds, soy products, and wheat can cause eczema flares.

Hormones: Females may experience increased eczema symptoms when their hormone levels are changing, such as during pregnancy and at certain points in the menstrual cycle.

Diagnosis of Eczema

Typically, a dermatologist will diagnose eczema using a two-step process: a physical examination and a review of medical history.

During the physical examination, the doctor will closely examine the skin, the location, colour, and structure of the rash.

They will also inquire about the symptoms such as itching and dryness, as well as any triggers that may exacerbate the condition.

In some cases, a dermatologist may need to conduct additional tests to rule out other causes or to identify triggers.

Skin Prick Test: A skin prick test or a blood test is performed to determine if any allergies could be affecting the skin.

Patch Test: Small amounts of various substances are applied to the skin to see if they trigger an allergic reaction.

Skin Biopsy: In rare cases, a skin biopsy is performed, which involves a microscopic examination of the skin to ensure an accurate diagnosis.

Treatment of Eczema

While there is no cure for eczema, several strategies can help manage and alleviate symptoms:

Skincare Routine

Moisturisation: Apply moisturisers on a regular basis to keep the skin hydrated and the skin’s barrier function intact. Use products that are free of fragrance and dyes, as well as products that don’t irritate the skin.

Luke warm water bath: When bathing, use lukewarm warm water and fragrance-free, gentle cleansers. Hot water can strip the skin of its natural oils, so it’s best to avoid it.

Ointments and creams: Corticosteroids and ointments can help reduce inflammation and itchiness. Nonsteroidal options, such as calcium-based creams, can also help.

Medications

Antihistamines: Oral antihistamines can help relieve itching and promote sleep.

Immunosuppressants: Medications that suppress the autoimmune system can be prescribed for severe cases of eczema.

Lifestyle Adjustments

Avoid triggers: Identify and avoid personal triggers that can lead to flare-ups. Identifying specific factors can help avoid flare-ups.

Stress management: Mindfulness, yoga, counseling, and other stress-relieving techniques such as sharing the psychological load and readjusting with the help of professionals can help reduce the mental burden and how it affects eczema.

Emotional support: Seeking support from family and friends, can provide comfort and reduce feelings of isolation. Sharing experiences in support groups with others having similar problems can be particularly beneficial.

Diet: Although there is no definitive link between food and eczema, some people find relief from avoiding certain foods.

Complications Associated with Eczema

Eczema can cause several complications, such as:

Sleep problems: Eczema can make sleeping difficult and interfere with sleep hygiene.

Skin infections: Repeated scratching of the skin can leave the skin susceptible to infection by bacteria and viruses.

Asthma and Hay Fever: Eczema is a risk factor for asthma and hay fever, particularly in children under 12 years old.

Thick and Scaly Skin: Scratching of the skin can cause it to thicken and harden over time.

Living with Eczema

Eczema can be a challenge, but there's hope! Many people navigate daily life with it, and steps can be taken to feel more comfortable and confident.

Here are some recommendations to navigate everyday life with the condition.

Learn about eczema's triggers and what works best. Surround yourself with supportive people, whether it's an online eczema community or a cuddly cat. Sharing experiences can lighten the load.

Educating others about the non-contagious nature of eczema can also reduce stigma and improve social interactions.

Regular check-ins with a dermatologist or allergist ensure an effective treatment plan. 

Don't hesitate to seek professional help if eczema brings down your mood, increases irritability and feelings of being out of the crowd.

Taking these steps can significantly improve your quality of life and boost your psychological immunity to certain conditions.

You've got this!

Conclusion

Atopic dermatitis is a condition that comes with its own unique set of challenges, but with the right treatment and support, it’s completely manageable.

Flare-ups can be significantly reduced and the quality of life will improve by understanding the condition, following a suitable skincare regimen, and recognizing and eliminating triggers.

Medical treatment, lifestyle changes, and the support of the healthcare team and support groups are key to managing the symptoms.

FAQs

Is eczema contagious?

No, eczema is not contagious. It is a chronic skin condition often caused by a combination of genetic and environmental factors, and it cannot be spread from person to person.

Is eczema 100% curable?

Eczema is an epidermal skin condition; it is a long-term condition that can flare up and reappear at any time. The treatments are very effective at reducing the itchiness and dryness of the skin.

Why have I suddenly developed eczema?

Sudden onset of eczema can be triggered by factors such as stress, allergies, changes in weather, new skincare products, irritants, or infections. It's important to identify and avoid triggers and consult a healthcare provider for proper diagnosis and treatment.

Can diet affect eczema?

Yes, some foods can cause eczema in certain people. Dairy, eggs, nuts, and wheat are some of the most common causes of eczema. Keeping a food diary is effective in identifying triggers.

Can I swim if I have eczema?

Swimming is generally suitable for individuals with eczema, but chlorinated water can irritate. It is important to rinse off immediately after swimming and apply moisturizer.

Can pets worsen eczema?

Yes, pets can cause eczema in some people. Cleaning up after our pets and keeping them away from our beds can help.

References

• National Eczema Society. Living with Eczema. Available at https://eczema.org/information-and-advice/living-with-eczema/ (Accessed 28/05/2024).
• National Institute of Arthritis and Musculoskeletal and Skin Disease (2022). Atopic Dermatitis. Available at https://www.niams.nih.gov/health-topics/atopic-dermatitis (Accessed 28/05/2024).
• National Eczema Association. What is Eczema? Available at https://nationaleczema.org/eczema/ (Accessed 28/05/2024).
• American Academy of Dermatology Association (2021) Can Anything Relieve Severe Atopic Dermatitis? Available at https://www.aad.org/public/diseases/eczema/insider/severe-atopic-dermatitis (Accessed 28/05/2024).
• National Library of Medicine (2022) Living with Atopic Dermatitis as a Young Adult in Relation to Health-related Quality of Life and Healthcare Contacts: A Population-based Study. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9609986/ (Accessed 28/05/2024).
• NHS (2023). Atopic eczema. Available at https://www.nhs.uk/conditions/atopic-eczema/ (Accessed 28/05/2024).
• Medical News Today (2023). What to know about eczema? Available at https://www.medicalnewstoday.com/articles/14417 (Accessed 28/05/2024).