What's That Scratch? An Overview of Eczema

Edited by Adam Da Costa Gomes

Has your skin been irritating you? Is it red and itchy? If yes, there is a good chance you may be experiencing eczema. This condition, sometimes referred to as atopic eczema or atopic dermatitis, is a common, long-term skin condition that primarily presents as an extremely itchy rash. Symptoms of eczema include:

Itchy rash that causes skin to turn red
Swelling
Skin dryness
Oozing and crusting of the skin
Rough, leathery appearing skin

Another common characteristic of eczema is that symptoms often occur in inconsistent waves. There may be periods of relief, followed by “flare-ups” where symptoms worsen.

Eczema is known as one of the most common health condition affecting young children in many regions of the world. While eczema mainly affects children, it can also be seen in adults. This being said, areas of the skin affected by eczema can vary depending on age. In babies, eczema patches are most commonly found on the cheeks as well as the outer surfaces of the arms and legs. However, in children, teenagers, and adults with eczema, patches are typically found on the backs of the knees, inside the elbows, and the back of the neck. Eczema rarely affects the face at these ages.

Types of Eczema

Eczema can be described as one of three types: mild, moderate and severe. The different types help to describe how each case of eczema affects day to day activities. Eczema is considered mild if the dry skin is not very itchy and has little impact on day-to-day life and sleep quality. Moderate eczema presents with more frequent itching than mild, and sleep quality starts to worsen. Finally, severe eczema consists of many areas of red, dry, inflamed skin, constant itching, and a major impact on day-to-day-life.

What can cause eczema?

The specific cause of eczema is currently unknown. However, it is believed that eczema is inherited from parents to children and may be linked to both allergies and asthma. While the exact cause is unknown, there are many factors that are believed to cause flare-ups. Some of these triggers include:

Long-term exposure to dry air, extreme cold, or extreme heat
Certain soaps and bath products
Fabrics such as wool or polyester in clothes or sheets
Certain cleaners and disinfectants
Fragrances from candles
Metal materials (especially nickel)
Certain chemicals including formaldehyde, isothiazolinone, cocamidopropyl betaine, and paraphenylene-diamine

If you are affected by eczema, it is important to document your triggers as you figure out what they are and be sure to stay clear of them. Also, remember that triggers are individual; what causes the onset of someone else’s flare-up may not cause yours, and vice-versa.

The Seal of Acceptance

The Seal of Acceptance was created by the Eczema Society of Canada as a way to help Canadians with sensitive skin conditions identify potentially safe products.

Products with the Seal have been researched through a formal scientific review that verifies that the products are made with ingredients at concentrations that are generally safe to be used for those with sensitive skin. This seal can be found on certain skin care products, over the counter products, and laundry products. Some brands that offer products with the Seal of Acceptance include Aveeno, Eucerin, and Tide.

Treatment

While eczema can not be cured, there are different products that can be used to help manage the symptoms during a flare-up. Moisturizers are a key component of eczema treatment.

These products help to keep the skin hydrated during flare-ups and periods of remission. Preferred moisturizers are thick creams that have a low water content or ointments with no water content. Some examples include Aveeno Eczema Care Moisturizing Cream, Cetaphil PRO Restoraderm Eczema Soothing Moisturizer, and Eucerin Eczema Relief Moisturizing Body Cream for Eczema-Prone Skin.

Topical corticosteroids are also often used in eczema treatment. Corticosteroids help reduce inflammation and itchiness to help promote skin healing. While low-strength topical corticosteroids can be purchased over the counter, these products do have side effects such as thinning of the skin, so it is important to get the advice of a healthcare professional on when to start and stop corticosteroid treatment.

Other strategies can be used to treat eczema flare-ups as well, including covering damp skin with a thick lotion or cream, avoiding harsh soaps, and taking lukewarm baths or showers.

Eczema is a very common skin condition affecting many children and adults. Due to the chronic nature of eczema with no cure, controlling itchiness and dryness is the main focus. If you are unable to manage your eczema with over-the-counter products, consult your family doctor for prescription medication options.

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References

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Sugerman DT. Atopic Eczema. JAMA. 2014;311(6):636. doi:10.1001/jama.2013.280498
Howe W. Treatment of apoptotic dermatitis (eczema). In: Up to Date. Updated June 13, 2022. https://www.uptodate.com/contents/treatment-of-atopic-dermatitis-eczema?search=eczema&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
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What is eczema? National Eczema Association. Published April 29, 2022. Accessed July 19, 2022. https://nationaleczema.org/eczema/
Seal of acceptance products. The Eczema Society of Canada. Published March 10, 2022. Accessed July 19, 2022. https://eczemahelp.ca/seal-products/
Available Eczema Treatment. The National Eczema Association. Accessed July 19, 2022. https://nationaleczema.org/eczema/treatment/