ECZEMA
Whether you’ve just been diagnosed or worry that you could have eczema, you’re probably nervous, confused, or just plain uncomfortable. That’s normal, and everyone featured on Health and Wellness Associates with this condition felt like you do now. You know what they say, though: knowledge is power. On this page alone, you’ll discover the realities and challenges of the condition, but also the best treatments, helpful lifestyle changes, where to find your eczema community, and all the crucial information to help you not just manage—but thrive. We’re sure you’ve got a lot of questions…and we’re here to answer them.
What Is Eczema, Exactly?
Let’s start with the 30-second trailer version: Eczema—a chronic inflammatory skin condition—is red, raw, and itchy. In some cases, ridiculously so; it’s an itch that begs to be scratched. Maybe you’ve scratched until your skin swelled. Or bled. Or maybe your child is the one suffering and itching. Odds are strong on the latter as eczema is more likely to impact infants and young kids. In fact, nine million children in the U.S. have it.
And like a movie sequel that nobody wanted, the condition can return. Eczema affects more than seven percent of adults, according to the National Eczema Society. And one in four people report adult-onset of symptoms, having never experienced them as a child.
Experts say the prevalence of eczema is like a U-shaped curve: high in children and teens, low in young and middle-aged adults, and high again in those in their 70s, per a recent study published in the Annals of Internal Medicine.
Eczema is frequently referred to as atopic dermatitis, the most common form that starts in children. There is a possibility that it will go away in adulthood. “Eczema” and “atopic dermatitis” are used interchangeably by physicians.
But there are other types of eczema:
- Contact dermatitis: A red, itchy skin reaction to something you touch: say, nickel in jewelry or laundry detergent.
- Dyshidrotic eczema: More common in women, this type forms small blisters and bumps on hands and feet.
- Hand eczema: Just what it sounds like—this version only affects the hands.
- Neurodermatitis: Like atopic dermatitis, this forms scaly patches on skin. Only difference is that the patches here are noticeably thicker.
- Nummular eczema: With this type, round coin-sized spots pop up on skin, and they itch even more than other types of eczema.
- Stasis dermatitis: This appears when fluid seeps out of veins into skin, leading to painful swelling.
- Congenital dermatitis: Mother may be the carrier. Allergens while pregnant can cause babies to have eczema at birth, or shortly after birth. This is the most serious condition of dermatitis that must be treated immediately, and there are two patients.
While there is no cure for eczema, there are periods when symptoms worsen (flares), and periods where they disappear entirely (remission).
What Causes Eczema in the First Place?
Researchers don’t know the exact cause of eczema, but they know what drives it—a getaway car-combo of genes and environmental factors. If you have a family history of eczema, you’re more likely to develop the condition. One study published in Nature Genetics found that some people with eczema lack the proper proteins to build a strong barrier on the outermost layer of the skin, the epidermis.
This allows critical moisture to escape and rolls out a welcome mat for allergens, aka triggers. When people with eczema are exposed to these triggers (be it certain soaps or emotional stress), their bodies produce inflammatory signals to their immune system. Enter: flares.
If you have been diagnosed with eczema, then your symptoms can worsen if you’re exposed to triggers, including:
- Too-cold or too-dry environments. These can strip your skin of moisture, causing it to become brittle and scaly and leading to an eczema flare. But there can also be the wrong kind of moisture….
- Excessive sweating. This can irritate your skin, especially when you’re in the middle of a flare and in areas where sweat can get trapped, like in the crooks of your elbows, knees, and neck.
- Stress or anxiety. When you’re tense, your nervous system takes the pilot’s seat (hello, “fight or flight”), instructing your body to shield itself by pumping out stress hormones, including cortisol. Cortisol regulates the immune system, but when it whooshes out during stressful situations, an imbalance occurs—inflammation-promoting cells and allergic antibodies produce at a rapid clip. Plus, when we’re in freak-out mode, white blood cells release itch-inducing histamines and our blood vessels dilate, adding a little more histamine to the mix. In a nutshell: A bad, no-good party.
- Airborne allergens. Allergens and allergies are not one in the same and eczema is not an allergy. Allergens are essentially triggers, and eczema flares when those triggers—dust mites, pollen, and pet dander—enter the skin and your immune system plays defense. You might itch, swell, or get hives. Again, this is not an “allergic” reaction; it is an immune system response. Removing the allergen is a must! Children with eczema are more likely to develop severe cases of Asthma if not treated correctly.
- What about food allergies and eczema? There’s still plenty of research to be done, but the general consensus is that kids—less so for adults—with eczema are more likely to be allergic to foods (peanuts, milk, and eggs are the big ones), but food allergies don’t necessarily cause eczema or flares. In other words, a food allergy might make an eczema symptom worse, but it’s not likely going to directly make you flare like an airborne allergen can. That said, because eczema is an inflammatory condition, many people find relief when they monitor their diets and eat anti-inflammatory foods like fish and vegetables.
- Other irritants. Exposure to certain chemicals, including fragrance and sulfates found in soaps, detergents, perfumes, and cosmetics, can irritate already sensitive skin, opening the door for an inflammatory response. Look for the National Eczema Association seal on everything from lotion to laundry detergent labels.
Do I Have Eczema Symptoms?
- Babies tend to get eczema on places they can reach and scratch like their cheeks, belly or scalp.
- Young kids, as they become more mobile, get it in areas of the body that come into contact with surfaces.
- Adults are more likely than kids to develop a ring of eczema around their eyes when they’re exposed to allergens or irritants, or in the nooks and crannies of their bodies, such as the back of their knees and elbows. If you’ve had eczema for many years, your skin can also be thicker, more leathery and darker, due to longtime scratching.
No matter the age, many eczema sufferers experience intense itching. Unfortunately, this can cause something known as the “itch-scratch cycle,” where the itching leads to scratching, resulting in the release of more inflammatory chemicals that worsen eczema by initiating the cascade that leads to inflammation and dry skin. If you don’t treat it, and keep scratching, you can get a bacterial skin infection.
Other symptoms of eczema include:
- Thick, scaly skin
- A darkening of the skin around your eyes. You may also see an extra fold of skin under them.
Self-care is critical. If you have eczema—any kind—get yourself a ceramide-rich moisturizer. We can’t underscore this enough. It’s a thirst trap for eczema, creating a barrier that helps prevent water loss and keeps out germs that could infect raw, inflamed skin, and it also replenishes lost moisture. Apply it immediately after a bath or shower.
Speaking of that shower, as amazing as hot water feels (it might even temporarily quell some of the itching), you want to stick with lukewarm water (too hot and you’ll dry out skin) and bathe for under 15 minutes. Use a gentle, unscented cleanser, not a sudsy bar of soap. The National Eczema Society also recommends either a ten-minute bleach bath—yes, bleach! Use a half-cup of household bleach for a full tub of water to kill bacteria and reduce the risk of infections or inflammation. Another expert-approved way to indulge your skin is to use a store-bought oatmeal bath product two to three times a week to help with the itching.
Does Eczema Have Serious Complications?
When we talk about eczema, we talk about the surface—raw, itchy, inflamed skin. But eczema’s impact can reach deep into the bones—literally. Some of the risks:
Staph infections: Since your skin may lack infection-fighting proteins, you’re more at risk of bacterial infections like staph. If the areas of eczema on your skin begin to appear swollen and red, or on dark skin, appear swollen and grey, call your doctor right away.
Bone fractures: Recent research has also linked severe eczema to a higher risk of fractures—hip, back, and spine. Experts say this is in part due to chronic inflammation linked to eczema.
Heart disease: People with severe eczema have up to a 50 percent greater risk of heart attack and death from heart disease than those without the condition, according to a May 2018 study published in the British Medical Journal. Researchers don’t yet know if the conditions are directly linked, or if eczema treatments might play a role. But if you have severe eczema it’s yet another good reason to get screened for heart disease and its risk factors like hypertension and high cholesterol.
Congenital Eczema: People who are born with eczema will have a shorter life span if not treated. Mothers of these people must be treated also, as they are a carrier. Again, there is no pill one can take, it takes a lifestyle change. Conditions to watch for are Juvenile Arthritis, diabetes, retinal problems, muscular and tendon problems to name a few. Important to have an appropriate doctor : pediatric infectious control physician.
What’s Life Like for People With Eczema?
Is it a life-threatening disease? In most cases, no, unless left untreated correctly. Is it a life-restricting disease? If not treated or controlled, yes. Adults with eczema are up to three times more likely to experience depression or anxiety than those who don’t have the disease, with about half going undiagnosed, perhaps because these emotions are new and not immediately connected to skin. And there are other ways eczema can dampen a person’s life:
Social life/dating: Almost a fifth of those with even just mild eczema say they avoid socializing because of it, while almost a quarter of eczema patients limit anything that might involve face-to-face interactions, according to a September 2018 study published in the Annals of Allergy, Asthma & Immunology.
Work: Eczema is not career-friendly: 20 percent of people say it’s hard to hold down a job because of it, with some saying that they’ve actually switched careers so they didn’t have to interface with people.
Sleep: Nearly half people with the condition say that their zzz time has been negatively impacted by their eczema. If you’re really itchy, you may have trouble sleeping, which can impact your mood and also make it harder for you to concentrate during the day.
Sex: An October 2017 French study discovered that more than 80 percent of people living with the condition found it hurt their libido. Eczema’s physical manifestations—red, itchy rash—may be hard to ignore. And if that rash appears in creases around your genital region, under breasts, or the folds between the backs of thighs and bum, sex may actually be an unpleasant experience.
Even if your libido is fine, your sex life may suffer due to your self-consciousness about your eczema. The best way to deal with this is to be up front. Let your partner know that you have eczema and that it’s not contagious. That simple exchange can help relieve your or someone else’s anxiety. And if you feel confident, but the act itself is uncomfortable, talk to your partner about possible tweaks to make you feel better physically—if sweat during sex is an issue, crack a window; if your skin is thin and sensitive in spots from treatments point them out to your S.O; or switch up positions to avoid skin-irritating chaffing.
We are in this Together!
Health and Wellness Associates
EHS Telehealth
Dr Patricia Carrothers
REVIEWED BY DR “J” JARANSON
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