When you think about red, itchy, flaky skin, your mind goes straight to eczema. And it is right to do so. But, what we often don't know is the fact that eczema is not just one condition.
There are seven different types of eczema and the following text will be your guide through the symptoms and treatments of these uncomfortable conditions.
ATOPIC DERMATITIS
As opposed to healthy skin, skin affected by atopic dermatitis cannot retain moisture accordingly, nore it can as a barrier protect from bacteria and irritants.
The primary risk factor for developing eczema is a family history of eczema, followed by allergies, hay fever, or asthma.
The most common signs and symptoms are itchy, dry, sore, and painful skin, rashes that can ooze and bleed when scratched, which can lead to infection.
The treatment of this condition usually includes :
Skincare
- Use of mild soaps and lukewarm water
- Gently patting the skin after showering
- Use of fragrance-free moisturizers and their application to skin after bathing, to help lock in moisture and reduce dryness.
Trigger management
It is crucial to know your triggers and avoid them.
Triggers can be stress, harsh soaps, detergents, dust, pollen, and certain foods.
Medication
Topical corticosteroids, non-steroidal topicals, and biologics prescribed by a medical professional.
CONTACT DERMATITIS
This condition occurs, as the name itself suggests, by coming in contact with irritants or allergens.
There are two main types :
Allergic contact dermatitis
The body reacts to a substance - allergen, like poison ivy, fragrance, and preservatives.
Food and medicine can also be triggers, and in those cases, it is called systemic contact dermatitis.
Irritant contact dermatitis
It occurs more often than allergic contact dermatitis.
When a substance irritates the skin’s outer layers it leads to a painful and itchy rash.
Common causes are :
- acids
- drain cleaners
- certain plants
- harsh soaps and detergents
Skin affected by contact dermatitis can be red, swollen, stinging, flaky or scaling, itchy, and painful.
Treatment
Treatment for both types of contact dermatitis is the same.
- Avoidance of anything that might cause a reaction, or finding a way to minimize the contact
- Anti-itch corticosteroid creams
- Oral steroids for easing rash symptoms that don't respond to antihistamines or other treatments
- Immunosuppressive medication in severe cases
NEURODERMATITIS
A non-contagious skin condition defined by itching and scratching cycles.
Itching can be very intensive and lead to problems with sleep and overall quality of life.
It usually appears on the easy-to-reach areas like the head, neck, wrists, forearms, ankles, etc.
Skin is itchy, leathery, or scaly texture on the affected areas (patches), red or darker than the healthy skin.
The cause is unknown, and it may all start because of a simple irritation of the skin like a bug bite or a label on a shirt.
In some cases, neurodermatitis is associated with chronic skin conditions such as dry skin, eczema, or psoriasis. Stress and anxiety can trigger itching too.
Treatment
- Resisting the urge to rub or scratch the affected areas
- Daily moisturization, cool compresses, oatmeal baths, and wearing loose fit clothing
- Avoidance and elimination of triggers
- Topical corticosteroids for inflammation and softening of thickened skin
- Non-steroidal topical ointments and occlusive creams with salicylic acid and calcineurin inhibitors for itch control
- Lidocaine patches (a numbing agent) and capsaicin (chili pepper component) for desensitizing nerve endings that cause itching
- Oral medication like antihistamines might also help the urge to scratch
DYSHIDROTIC ECZEMA
Dyshidrotic eczema, also called Pompholyx ( bubble in old Greek), is a specific type of eczema that causes small itchy blisters on palms, feet, edges of fingers, and toes.
It mostly runs in families or appears in people that have other types of eczema.
This condition can be triggered by:
- metals (especially nickel)
- stress
- seasonal allergies
- hot humid weather
- jobs where the hand are frequently in water (hairdressers, healthcare workers)
- detergents and harsh soaps
The skin is usually harsh, with blisters, itching, and burning. Those blisters often dry off and then peel, leaving new sensitive skin prone to infections.
Treatment
It is important to know and avoid triggers, to find a way to manage stress, and to have regular and proper skincare.
- Mild cleansers, gentle pat drying and moisturizing creams with skin barrier repairing ingredients like ceramides can help prevent flares
- Wearing gloves (best with cotton lining) and cotton or silk socks can also be beneficial
- Topical corticosteroids in combination with cool compresses applied to the affected area can lead to improvement, as well as UV light treatment
- Soaking in potassium permanganate solution helps with blisters that leak, drying them and reducing infection risk
- Antihistamines and sedating antihistamines are prescribed if the itchiness affect sleep
NUMMULAR ECZEMA
Nummum is a Latin word for coin, which is why this type of eczema is named nummular eczema. These coin-shaped patches are itching and burning, sometimes even oozing, while the skin around the lesions is usually scaly and inflamed. Coin-shaped patches are found on arms, legs and torso.
Very dry and sensitive skin, insect bites, scrape, sand burns, may trigger the becoming of this type of eczema.
With the right treatment, eczema usually disappears completely.
Treatment
- Avoiding all the irritating chemicals in soaps, detergents, bubble baths, and shower gels
- Mild or high potency corticosteroids
- Topical antibiotic in case of a Staphylococcus Aureus infection, which can often happen with skin conditions like this
- Astringent compress that helps dry the area and also with a staph infection
- Emollients – moisturizers applied to the skin to stop it from becoming dry
- Antihistamines – medicines that can reduce itching
SEBORRHEIC DERMATITIS
A common, non-contagious skin condition that mainly affects the scalp but can also affect any area where sebaceous (oil) glands are active like the back, chest, face, creases, and bends of the body (armpits, under breasts, genital area).
It is characterized by itchy patches, greasy scales, crusty and powdery flakes.
People born with naturally oily skin are more prone to developing seborrheic dermatitis, as well as people who drink certain medications like lithium and chlorpromazine.
Factors that play a role in development are
- increased androgens
- increased skin lipids
- an inflammatory reaction
- family history
- yeast (Malassezia) that is in the oil secretion on the skin
Stress, cold, dry climate, and alcohol-based products are some of the triggers that may worsen the condition.
The type of treatment depends on the area of the body that is affected and how severe your condition is.
Scalp Treatment
- Over-the-counter dandruff shampoos that contain selenium, zinc pyrithione, or coal tar are great for mild cases
- Shampoos that contain ciclopirox or ketoconazole might be prescribed by a doctor or a dermatologist for long term control
- Shampoo containing betamethasone valerate, clobetasol, fluocinolone, or fluocinolone solution are prescribed in moderate to severe cases
Face and Body
- Topical antifungals like ciclopirox, ketoconazole, or sertaconazole
- Topical corticosteroids including betamethasone valerate, desonide, fluocinolone, or hydrocortisone
- Topical calcineurin inhibitors (alternative to corticosteroids), like pimecrolimus cream or tacrolimus ointment
- In severe cases, a healthcare provider may prescribe an oral antifungal agent or phototherapy
STASIS DERMATITIS
Also called gravitational or venous eczema, appears in cases of poor circulation in the lower legs or when the valves in leg veins are weak and can't push the blood back to the heart.
It can be caused by aging, and can also be a signal that something is wrong with the heart or kidneys.
Apart from poor circulation, risk factors are :
- high blood pressure
- obesity
- history of blood clots in legs
- little to no physical activity
- jobs that require constant sitting or standing
Symptoms are ankle swelling, redness (purple, gray, or ashen in darker skin tones), itching, dryness, and scaling.
Treatment
- Compression stocking and leg elevation to reduce swelling
- Salty food avoidance
- Vitamin C supplementation for flexible and healthy blood vessels
- Topical corticosteroid to calm inflammation, or even topical or oral antibiotics if the skin is infected
For the treatment of all of the conditions mentioned above, it is crucial to consult a doctor or a dermatologist.
As much as it is important to use topical and oral treatments prescribed by them, it is also important to have a regular and proper skincare routine. You can find eczema friendly products at The Eczema Relief Store.
These two complement each other and can't work well without one another.
So by combining these two, you have a key to a door that leads to feeling good in your skin again.
SOURCES
-
Mayo Clinic, “Atopic dermatitis”, MayoClinic
-
American Academy of Dermatology, “Eczema types: Atopic dermatitis overview”, AAD
-
National Eczema Association, “Atopic dermatitis”, NEA
-
Cleveland Clinic, “Contact Dermatitis”, ClevelandClinic
-
Mayo Clinic, “ Contact Dermatitis”, MayoClinic
-
National Eczema Association, “Neurodermatitis”, NEA
-
Mayo Clinic, “Neurodermatitis”, MayoClinic
-
National Eczema Association, “Dyshidrotic Eczema”, NEA
-
NHS, “Pompholyx” NHS
-
National Eczema Association, “ Nummular Eczema”, NEA
-
NHS, “Discoid Eczema”, NHS
-
Mayo Clinic, “Seborrheic Dermatitis”, MayoClinic
-
Cleveland Clinic,” Seborrheic Dermatitis”, ClevelandClinic
-
National Eczema Association, “ Stasis Dermatitis” NEA