Eczema

Eczema is a chronic, non-contagious skin condition that results from an inflammatory reaction. This leads to red flaky spots, bumps, swelling, fissures, or crusts. In some cases, the skin may become wet. Eczema is often accompanied by intense itching and is generally treated with eczema creams. 

The following factors and causes can contribute to eczema: 

• Predisposition (runs in the family) 
• Climate factors (dry or cold air) 
• Illness 
• Stress and tension 
• Skin bacteria 
• Chemicals in skincare products 
• Dishwashing detergents 
• Sweating 
• Certain textiles like wool or nylon 

There are several types of eczema, with the most common being: 

• Constitutional or atopic eczema 
• Seborrheic eczema 
• Contact eczema 
• Dyshidrosis (blisters of eczema) 
• Nummular eczema 
• Tylotic eczema 
• Eczema craquelé or asteatotic eczema 
• Hypostatic eczema 

The appearance and location of eczema symptoms vary depending on the type. Here are some key characteristics for different forms: 

Constitutional or atopic eczema:

This is the most common form and has a hereditary component. It can appear anywhere on the body, often causing extreme itching, redness, swelling, blisters, bumps, or scabs. In adults, it tends to occur on the hands, feet, elbow folds, and behind the knees. 

Seborrheic eczema:

Commonly affects men more than women and appears as itchy or yellowish flaky spots on areas like the face, nose, scalp, eyebrows, and around the ears. This type worsens with stress, cold, and dryness. 

Contact eczema:

Divided into allergic and irritant contact eczema, it can result from contact with allergens or irritants such as perfume, jewellery, or latex. Symptoms include red, itchy rashes that can flake, swell, or blister. 

Dyshidrosis (blisters of eczema):

Characterised by clear, itchy blisters on the hands, fingers, feet, or toes, it can sometimes be related to fungal infections. 

Nummular eczema:

This chronic form appears as coin-shaped red, flaky patches on the legs, often during cold months. 

Tylotic eczema:

A chronic hand eczema that features calluses and painful cracks, particularly on the palms and soles. 

Eczema craquelé (asteatotic eczema):

Commonly found in older individuals, this form involves small cracks and flaky skin on the lower legs. 

Hypostatic eczema:

Caused by poor blood flow in the legs, this type presents as a damp rash, with redness, scabs, and swelling. 

Eczema is not contagious, but there are some ways to help manage it: 

• Avoid scratching 
• Keep nails short 
• Maintain a diary for tracking flare-ups 
• Keep your skin moisturised and supple 
• Use unscented skincare products 
• Avoid long, hot baths or showers 
• Wear soft, airy clothing made of cotton 
• Manage stress effectively 

Consulting a doctor is essential for proper eczema treatment. Depending on the type and severity, treatments may include moisturisers, eczema creams, or ointments to restore the skin barrier and reduce symptoms like itching and redness. 

For mild eczema, non-medicated creams or ointments are often used to keep the skin hydrated. For more severe cases, topical corticosteroids may be prescribed. In some cases, corticosteroids are combined with non-medicated creams to reduce reliance on stronger medications. 

For seborrheic eczema, especially on the scalp or beard, medicated shampoos may help. In cases of contact eczema, identifying and avoiding the irritants is key. Compression stockings are often used to manage hypostatic eczema. 

If non-medicated treatments are insufficient, doctors may prescribe corticosteroids in varying strengths depending on the severity of the eczema. These medications help to reduce inflammation and are often used in short treatment courses. 

For seborrheic eczema, ketoconazole cream or selenium sulphide may be prescribed. 

Over-the-counter eczema creams containing chamomile, liquorice, or witch hazel may help reduce inflammation. Menthol ointment can have a cooling effect, providing relief from itching.  

Leading a healthy lifestyle can make a significant difference in managing eczema. Avoid stress, get plenty of sleep, eat well, and use skincare products that are gentle on the skin. 

Excessive scratching can lead to infections. Long-term use of corticosteroids may thin the skin or cause discolouration. These changes can affect a person’s confidence, leading to psychological stress. 

By following a consistent skincare routine, avoiding triggers, and using moisturising creams, you can reduce the risk of flare-ups. Consult your doctor if symptoms worsen or recur. 

huidarts.com (z.d.) dyshidrosis. (consulted on 25 April 2019). https://www.huidarts.com/huidaandoeningen/blaasjeseczeem-acrovesiculeus-eczeem/

huidarts.com (z.d.). seborrheic eczema. (consulted on 25 April 2019). https://www.huidarts.com/huidaandoeningen/seborrhoisch-eczeem-adulte-vorm/

huidinfo.nl (z.d.). Tylotic eczema. (consulted on 25 April 2019). https://www.huidinfo.nl/t/tylotisch-eczeem/ huidinfo.nl (z.d.). Hypostatic eczema (consulted on 25 April 2019). https://www.huidinfo.nl/h/hypostatisch-eczeem/

Huidfonds.nl (z.d.). Is there anything I can do myself about eczema? (consulted on 25 April 2019). https://huidfonds.nl/je- huid/huidaandoeningen/eczeem/

Mekkes, J.R. (03-06-2012) Nummular eczema. (consulted on 25 April 2019). https://www.huidziekten.nl/folders/nederlands/nummulair-eczeem.htm

Pharmacoterapeutic compass (s.d.) Seborrhagic, Contitutional, Contact eczema/treatment plan/medicines. (consulted on 25 April 2019). https://www.farmacotherapeutischkompas.nl/zoeken?domein=indicaties&alledomeinen_zoekterm=eczeem

Skin hospital dermicis (z.d.). Contact eczema. (consulted on 25 April 2019). https://www.dermicis.nl/nl/aandoeningen/eczeem/contacteczeem

Skin doctor (z.d.). Forms of eczema. (consulted on 25 April 2019). https://www.huidarts.com/huidaandoeningen/eczeem/ Tartuffel (2011) Eczema craquelé. (consulted on 25 April 2019). https://mens-en-gezondheid.infonu.nl/aandoeningen/79976- craquele-eczeem-asteatotisch-eczeem-symptomen-en-oorzaak.html