Eczema is a chronic condition from mild to severe inflammation of the skin that causes itchy patches that may become dry cracked and even leathery. It is common for patients who struggle with eczema to develop asthma or hay fever. Patients with Eczema have extra sensitive skin. The skin barrier is compromised and once a person starts to itch it is nearly impossible to stop scratching due to the release of histamine which causes the itch scratch cycle. Eczema may occur anywhere on the body. The common locations are in the folds of the elbows and behind the knees although may occur anywhere on the body. Climate hot or cold, fragranced products, certain fabrics, sweat and dry skin can be triggers for some. Treatment can consist of prescription topicals, antihistamines, phototherapy, and specific moisturizers to keep the skin barrier intact and in severe cases systemic medication.
What Is Eczema?
Eczema (atopic dermatitis) is an atopic condition presenting with itchy, red, crusty patches of skin. The term ‘eczema’ is broadly applied to a range of persistent skin conditions. These include dryness and recurring skin rashes that are characterized by one or more of the following symptoms: redness, skin swelling, itching, dryness, crusting, flaking, blistering, cracking and oozing. The cause of eczema is unknown but is most likely a combination of genetic and environmental factors.
Eczema (Atopic Dermatitis) is very common. And in many cases, it’s also manageable. In fact, over thirty million (30,000,000) Americans have some form of eczema.
It is most common for babies and children to develop eczema on their face (especially the cheeks and chin), but it can appear anywhere on the body and symptoms may be different from one person to the next. Oftentimes, eczema resolves, as a child grows older. However, eczema can persist into adulthood.
Adults can develop eczema, too, even if they never had it as a child.
Eczema patients are often affected by staphylococcus aureus (also called “staph”) , a gram positive bacteria that can cause an in infection and trigger a flare of eczema.
About 25% of the population has “colonized” (when bacteria are present, but not causing an infection) staph bacteria in their nose. However, more than 90% of patients with AD have “colonized” staph on their skin or in their nose.
However, Eczema itself is not an infection. Eczema is not contagious. A person cannot “get it” by touching another person with eczema. Eczema is genetically linked (it is in the genes), but the heritability (how a person inherits eczema) is not yet understood.
Staph infections affect people with eczema, including those with atopic dermatitis.
Signs and Symptoms of Eczema
Eczema is usually itchy. For many people, the itch is usually only mild, or moderate. But in some cases it can become much worse and inflamed skin develops. Sometimes the itch gets so bad, also known as intractable itching, that people scratch it until it bleeds. This can make eczema worse. This is called the “itch-scratch cycle.”
- Dry, sensitive skin
- Red, inflamed skin
- Very bad itching
- Dark colored patches of skin
- Rough, leathery or scaly patches of skin
- Oozing or crusting
- Areas of swelling
Effects of Eczema
Eczema affects far more than just the skin. Eczema can have a severe and measurable affect on the quality of life. Affected children and parents of children with atopic dermatitis may experience the following:
- Sleep loss
- Absences from school
- Missed work (for parents)
- Emotional distress
Management and Treatment of Eczema
Eczema can be minimized with a proper skin care routine. This includes bathing and moisturizing daily. Avoid showers. Use lukewarm warm baths instead of very hot water. Non-soap cleansers are better for eczema than soaps and detergents. Bleach baths with instructions from a physician can reduce the bacterial count on the surface of the skin.
Some basic things you can do to help control eczema:
- Establish a daily skin care routine – just like a person would for other activities such as teeth-brushing or hair washing. Try not to miss the routine, but be flexible if your symptoms change.
- Recognize stressful situations and events – and learn to avoid or cope with them by using techniques for stress management.
- Be mindful of scratching and rubbing – and limit contact with materials or substances that may irritate your skin. Dress in soft, breathable clothing and avoid itchy fabrics like wool that can further irritate eczema.
There are many different types of treatments. Some target symptoms, others target the immune pathways that cause eczema.
- Over-the-counter remedies such as gentle, non-soap cleansers, petroleum jelly, tar-based products and mineral oil
- Medications available only with a prescription from a doctor, such as topical corticosteroids, topical calcineurin inhibitors (TCIs) and systemic oral drugs
- Antibiotics for infections that worsens eczema
- Phototherapy, which exposes the affected area to light under medical supervision
- Biologic therapy targeting the immune pathway
Conditions Associated with Eczema
Asthma is an allergic condition causing a person’s airways to become inflamed, swollen and narrow. This narrowing makes it difficult to breathe, leading to tightness in the chest, coughing and wheezing. Asthma commonly first appears in childhood and can continue throughout your life.
Symptoms of asthma include:
- Tight chest
- Shortness of breath
- Some people with asthma only experience it from time to time, while many require constant treatment in order to prevent flares.
Asthma is a comorbid condition of atopic dermatitis.
Sometimes also called “hay fever,” allergic rhinitis is inflammation in the nose and sinuses, caused by allergens like pollen, dust mites and pet dander. Many people suffer from seasonal hay fever, depending on what types of pollen they’re allergic to and what time of year those pollens are most prevalent.
Symptoms for hay fever usually include:
- An itchy nose, mouth, eyes or skin
- A runny nose and/or stuffy nose
- Watery eyes
- Sore throat
According to researchers, up to 15% of children ages three to 18 months diagnosed with atopic dermatitis have an allergy to one or more types of food. The most common food allergies in children are milk, eggs, peanuts, wheat and soy.
Symptoms of food allergy include:
- Itchy mouth and swelling of the lips
- Vomiting, diarrhea, painful stomach cramps
- Hives, rash or reddening of the skin
- Blood pressure drop
- Food allergy symptoms appear within the first 30 minutes of eating or breathing in the food allergen.
Food allergies are a comorbid condition of atopic dermatitis. Science suggests that food allergies are not a trigger for atopic dermatitis.
For participants, all investigational medication (or inactive placebo), study-related tests, and study doctor’s visits will be provided at no cost for the duration of the study, up to 37 weeks. Participation is voluntary and you may withdraw at any time.