Definition & Clinical Appearance
Eczema is a group of skin conditions that cause skin to become irritated. Teens who have it may develop rashes more easily and more frequently than others. There are many forms of eczema, but atopic eczema is the most common form. Doctors don't know exactly what causes atopic eczema, also called atopic dermatitis, but they think it's caused by a difference in the way a person's immune system reacts to things. Skin allergies may be involved in some forms of eczema. Eczema isn't contagious, but most people with eczema have family members with the same condition, so researchers think it's inherited or passed through the genes. In general, it's fairly common - about 3% of all the people in the United States have eczema. People with eczema also may have asthma and certain allergies, such as hay fever.
Signs and Symptoms
It can be difficult to avoid all the triggers, or irritants, that may cause your eczema to flare or become worse. In teens and young adults, the itchy patches of eczema usually break out where the elbow bends; on the backs of the knees, ankles, and wrists; and on the face, neck, and upper chest - although any part of the body can be affected. If you have eczema, at first your skin may feel hot and itchy. Then, if you scratch, your skin may become red, inflamed, or blistered. Some teens who have eczema scratch their skin so much it becomes almost leathery in texture. Other teens find that their skin becomes extremely dry and scaly. Even though a lot of teens experience eczema, the symptoms quite a bit from person to person.
Aetiology
The exact cause of atopic dermatitis (eczema) is unknown. Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is likely related to a mix of factors: Dry, irritable skin, which reduces the skin's ability to be an effective barrier.
Contributing Factors
In some people with eczema, food allergies (such as allergies to cow's milk, soy, eggs, fish, or wheat) may bring on or worsen eczema. Allergies to animal dander, rough fabrics, and dust may also trigger the condition in some teens.
Start of Pathology / Onset
Any age
Location
Skin
Prophylaxis / Prevention
Eczema can't be cured, but there are plenty of things you can do to prevent a flare. For facial eczema, wash gently with a nondrying facial cleanser or soap substitute, use a facial moisturizer that says noncomedogenic/oil-free, and apply only hypoallergenic makeup and sunscreens. In addition, the following tips may help:
• Avoid triggers and substances that stress skin. Besides your known triggers, some things you may want to avoid include household cleaners, detergents, lotions, and harsh soaps.
• Too much exposure to water can dry out your skin, so take short warm, not hot, showers and baths and wear gloves if your hands will be in water for long periods of time. • Clothes made of scratchy fabric like wool can irritate your skin. Cotton clothes are a better bet.
• An unfragranced moisturizer such as petroleum jelly will prevent your skin from becoming irritated and cracked.
• Even though it's difficult to resist, scratching your itch can worsen eczema and make it more difficult for the skin to heal because you can break the skin and bacteria can get in, causing an infection. • Sudden changes in temperature, sweating, and becoming overheated may cause your eczema to kick into action.
• Medication. Follow your doctor's or dermatologist's directions and take your medication as directed.
• Avoid unnecessary stress. Stress can aggravate eczema, so try to relax.
Prognosis
Prognosis is affected by several factors such as the type of eczema and response to treatment. Atopic eczema: This type of eczema occurs primarily in children. Some factors associated with poor prognosis include patients with severe disease, early age of onset, family history, and associated rhinitis or asthma.
Medical Treatment
Diagnosing atopic eczema can be difficult because it may be confused with other skin conditions such as contact dermatitis, which occurs when your skin comes in contact with an irritating substance like the perfume in a certain detergent. In addition to doing a physical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. Your doctor will also help you identify things in your environment that may be contributing to your skin irritation. For example, if you started using a new shower gel or body lotion before the symptoms appeared, mention this to your doctor because a substance in the cream or lotion might be irritating your skin. Emotional stress can lead to eczema flares, so your doctor might enquire about stress. Once your doctor has diagnosed the condition, he or she may suggest avoiding the things that may be triggers for your eczema. The doctor may also prescribe medications to soothe the redness and irritation of eczema. External creams or ointments that contain corticosteroids are frequently prescribed to help control itching. Your doctor might also recommend medications you take internally, such as antihistamines or corticosteroids. In teens who have severe eczema, ultraviolet light therapy may help clear up their condition and make them more comfortable. Newer medications that change the way the skin's immune system reacts are also prescribed in some cases. Allergy testing is sometimes used to help people who have eczema that doesn't respond to normal treatment, especially if a teen has asthma or seasonal allergies. If a person is tested for food allergies, he or she may be given certain foods (such as eggs, milk, soy, or nuts) and observed to see if the food causes an eczema flare. Food allergy testing can also be done by pricking the person's skin with an extract of the food substance and observing the reaction. But sometimes allergy testing can be misleading because the person may have an allergic reaction to a food that is not causing the eczema flare. If a person is tested for allergy to dyes or fragrances, a patch of the substance will be placed against the person's skin and he or she will be monitored to see if skin irritation develops.