Eczema, also called dermatitis, refers to a cluster of skin conditions that have varying symptoms, the most common of which is dry skin. Normal skin produces oils that create a barrier to prevent water loss and stop irritants from penetrating the skin. If you have eczema, your skin does not do this as effectively.
Eczema is usually found on the hands, elbows, knees and lower legs, but it can affect the face, neck, upper chest and front of the shoulders as one gets older. Eczema can be very uncomfortable and look unpleasant. People with eczema are nearly always sensitive to triggers that cause flare-ups, and often need to take extra care with their skin.
It is important that the type of eczema be correctly diagnosed; the forms of eczema can look similar, but the causes may differ and thus require different treatments, which include a wide range of medical and behavioral therapies. Because each case is different, finding the right approach to healing your eczema may take time. You may want to work with a variety of experts, including a dermatologist, a behavioral therapist, a massage therapist, or a homeopath. You may simply want to keep track of your symptoms and solutions in your journal.
Listen to Your Body
Mild eczema can appear as dry skin that itches. It may come and go and never progress to the acute phase. More severe eczema can be red in appearance, feel hot and itchy, and become inflamed. It can also blister, scale and weep. When eczema becomes chronic, the skin’s functioning can begin to deteriorate and the epidermis may begin to thicken. Scales appear as cell turnover increases. The skin can become broken and cracked with fissures, and secondary thickening (lichenification) may appear from scratching.
Here are the various types with their symptoms:
- Atopic Eczema: Dryness, itchiness (pruritis), redness, inflammation. If infected, skin may crack and weep.
- Allergic Contact Dermatitis: Dry, itchy skin; redness, inflammation, rash, or blistering.
- Irritant Contact Dermatitis: Itchy, dry skin; rash—usually on hands
- Adult Seborrheic Eczema: Generally seen on scalp as mild dandruff; can spread to face, ears, and chest. Skin is red, inflamed, and flaky with yellowish-grey scales.
- Varicose (Asteatotic) Eczema: Affects the lower legs. Appears on the skin around the shins and ankles. Skin is itchy, inflamed and speckled. Ulcers can occur.
- Discoid (Nummular) Eczema: Coin-shaped, reddened area. Normally appears suddenly on lower legs or trunk. Can be itchy and weep fluid.
What Causes This
In atopic eczema, the most common form of eczema, the exact cause is unknown, but it is generally thought that people inherit a tendency toward the disorder. People with atopic eczema are generally sensitive to allergens in the environment that others find harmless. It is also closely linked with asthma and hay fever. The symptoms can be set off by a number of triggers.
In Allergic Contact Dermatitis, the immune system responds to a substance that comes in contact with the skin. Common allergens include poison ivy and oak, nickel and other metals, perfume, sunscreens, rubber.
In Irritant Contact Dermatitis, the cause is contact with everyday substances, such as bleaches, caustic detergents, chemicals, soap. Exposure to tar or certain plant juices, including celery, lime, and parsley, in conjunction with light can cause phototoxic reaction.
Adult Seborrheic Eczema is believed to be a reaction to a microbe growing on skin (Pityrosporum ovale); marked by excessive secretion from the sebaceous glands.
Varicose (Asteatotic) Eczema can be the result of poor venous circulation.
Discoid (Nummular) Eczema has no known cause and is associated with dry skin that worsens in dry weather.
As with dry skin, the first line of treatment against eczema is emollient therapy. When emollients are used correctly, mild to moderate symptoms of eczema can be controlled without having to resort to stronger measures, such as steroids.
Many doctors recommend steroids to control severe symptoms. While steroids can dramatically improve the condition, there can also be a rebound inflammatory response when they are discontinued. Hydrocortisone cream is a topical steroid that is available over the counter without a prescription. It is one of the weaker steroid creams. You may want to try this before resorting to prescription-strength steroids. I do not recommend steroid use for long periods of time.
Antihistamines can also help relieve itching and may help you get some sleep, but again, I do not recommend ongoing reliance on these. Some eczema sufferers have also successfully used light therapy. Ask your doctor if either of these are good short-term therapies for your eczema; caution should be exercised with exposure to light, as some dermatitic conditions are photosensitive.
The following are standard treatments for the various types of eczema:
- Atopic Eczema: Emollients, topical steroids, behavior modification.
- Allergic Contact Dermatitis: Prevent contact with allergen. Use topical ointments or steroid creams.
- Irritant Contact Dermatitis: Avoid irritants, keep skin moisturized.
- Adult Seborrheic Eczema: Anti-fungal shampoos and creams.
- Varicose (Asteatotic) Eczema: Emollients, steroid creams.
- Discoid (Nummular) Eczema: Emollients, steroid creams.
Spiritual and Holistic Options
Various complementary and homeopathic therapies exist for eczema, including aromatherapy, relaxation, and Chinese herbs. If you decide to explore holistic remedies, make sure the practitioner you choose is properly qualified to treat your condition. Remember, what works for one person may not work for another, so you may need to do some trial-and-error work here. Also, be certain to keep you doctor informed of any natural therapies you are using in conjunction with medical treatments.
Many factors can trigger eczema. It is often a good idea to keep a journal, that so you can identify your triggers and avoid them. Here is list of possible triggers:
- Irritants in the Home or Work Place: People with eczema are more likely to react to dust mites; animal fur; certain plants; dry, overheated air; low humidity; wool; and synthetic materials.
- Foods: Certain foods may trigger eczema. Food additives, colorings, and preservatives such as parabens E214 and E218, sodium benzoate E211, and sorbic acid E200 are common reactants.
- Industrial or chemical irritants: Detergents, biological washing agents, and chlorine, among others, can trigger eczema.
- Climatological conditions: There is some evidence that the symptoms of eczema generally improve at high altitudes, at the seashore, and in humid regions. Symptoms tend to worsen in the fall, when central heating is more widely used and cold temperatures also lead to a reduction in relative humidity indoors and outside. Whereas exposure to light can help some types, it exacerbates photosensitive forms.
- Stress: Eczema is aggravated by negative psychological factors. Stress reduction modalities can help. You may want to try relaxation therapy or massage therapy using emollients.
Eczema and dermatitis, like other skin concerns, have both physical and psychological components. When we have skin symptoms such as eczema, it is often an indication that something else is going on and our skin is trying to feel our emotions for us. That is why dermatologists often realize that, in order to get the best results, patients need simultaneous treatment for their skin as well as their minds and emotions.
Skin symptoms will usually resolve themselves when the person acknowledges whatever is going on underneath the surface. In other words, identify what is “getting under your skin.” Eczema can be your body’s way of creating an “armor” against the perceived criticism of others. I remember hearing a story about a woman who had a persistent rash on her ring finger. It became so severe that she had to have her wedding ring cut off. However, the woman was able to wear similar rings on her other fingers without problem. When her dermatologist asked the woman what was going on in her life, he found out that she had been caring for an infant with little help.
The location of a skin problem can also be indicative of the emotional issues underlying it. One of my readers developed such severe eczema on her hands that her dermatologist thought she might have lupus. It turned out that she was under a great deal of stress related to caring for her elderly mother. She was not sure she could “handle it.” The problem eventually resolved itself when she hired outside help.
Learning to experience your emotions in your heart can do a lot for your skin. The first course of action is to learn to feel the thing that you need to feel. Often there is unresolved or unacknowledged anger. Skin symptoms can also be a way of crying out for more love. In severe situations, psychotherapy that specifically focuses on exploring and dealing effectively with situations that trigger skin symptoms can be useful.
Here are some steps you can take to make the condition less aggravating:
- Keep a positive attitude: Negative emotions start a hormonal cascade that can trigger or worsen your symptoms. Because skin is our boundary between our inner and outer selves, a good “skin health” affirmation is this: “I am safe and protected at all times. I relax into my essential self, which is positive and loving.”
- Wear natural fabrics: Cotton and other soft, natural fabrics can limit irritation. Avoid wool and synthetic fabrics.
- Do not scratch: Scratching can lead to infection.
- Reduce household irritants: Try to get rid of dust, dust mites, fur and dander from pets by vacuuming often, using air filters and keeping your house clean. You may also want to use anti-allergenic bedding.
- Use gentle washing powders: Avoid harsh detergents and scented cleansers.
- Try relaxation therapy: Relaxation therapy and massage therapy modalities can help by reducing muscle tension. This can lead to less aggravation and other detrimental psychological factors that contribute to flare ups.
- Keep your bedroom cool: Overheating aggravates itching. So does dry air. You may want to use a humidifier or keep a saucer of water in each room to keep moisture in the air. If you heat with a woodstove, place a kettle of water on top to release steam and check it often.