What is eczema and what causes eczema, how to treat this condition

Eczema is an cronic inflammation in the skin, mostly confined to the upper layer or the epidermis. There are two main cathegories of eczema, atopic eczema with internal causes and topic eczema caused by allergy from some external irritant.

Eczema is most common in children. However, also adults may get eczema and often in a more severe type that childhood eczema. The condition can become cronic and persist for months and years.


THE SYMPTOMS OF ECZEMA

The symptoms of eczema are: redness, edema, itching, small papules and small vesicles. The vesicles develop into small or larger superficial sores that cause weeping, oozing and crusting.

Dryness in the skin is actually two different factors that can occur alone or togeather: Lack of oily substances and lack of water. Lack of oily substances can however cause the water to diffuse out of the skin too rapidly, and therefore also cause the lack of moisture.

Later these symptoms can occure: Scaling, lichenifications and pigmentation.


ATOPIC ECZEMA

Atopic eczema , or atopic dermatitis has internal causes that are poorly understood. Heridity pays a role.

Common symptoms of atopic eczema is dry, red and itchy skin. Later on the other symptoms listed above can occur.

Atopic eczema is the most common type of eczema in children, it is also called child eczema or winter eczema. It often starts with intense itching. The reason that the skin becomes dry is that it produces too little fat.

Babies may have atopic eczema anywhere on the skin surface, but seldome on the buttocks. The rash often coours as spots a couple of inches wide. The affected areas are dry, red and flaky. The rash is often seeping fluid if the area gets infected too.

Older infants' and adults' rash look the same, but for older infants the rash is not so often divided in sharp spots. Now folds or angles at the joints are most often attacked. Most common are rashes on the neck, the elbow inide, wrist, the back of the knees and the ankles.

If the rash is often scratched due to iching, the rash will typically thicken.

Humans with atopic dermatitis are often afflicted with allergic disorders such as asthma, hay fever and food allergies. Therefore there may be some allergic mechanism behind this variant, but the allergy is not agsinst an overt substance in contact with the skin.

15 percent of children have atopic dermatitis in shorter or longer periods of childhood. Most often the disease stops by itself, but two percent of the population keeps the disease in adulthood. The incidence of atopic eczema has increased dramatically in the last 30 years.

Discoid eczema ( nummular eczema., exudative eczema., microbial eczema.) is a variant that gives round spots of oozing or dry rash, with distinct boundaries, often on lower legs. It is usually worse in winter. The cause is unknown, and the condition tends to come and go.


ALLERGIC OR TOPIC ECZEMA

Topic or allergic eczema is caused by allergy, often to food, such as milk, fish and eggs or to substances in contact with the skin.

There are many types of allergic eczema or eczema caused by irritants. Here are three variants:

- Contact dermatitis is caused by exposure of the skin to irritant substances or substances that the skin reacts allergic against.

- Xerotic eczema (Also called aka asteatotic, craquele, craquelatum, winter itch, pruritus hiemalis) begins with dry skin and turns gradualy into eczema. It most often occur on limbs and the truck It is common in dry winter weather. The condition gives dry, hardened and cracked skin areas. Old people are most often affected.

- Seborrhoeic dermatitis begins with dry or greasy skin and develops into an eczema with dry or greasy scaling. The skin can by dry becasue of lack of water and greasy at the same time. It occurs in the scalp and wyebrows or adjacent areas. Infants and even newborns are often affected.

- Dyshidrosis (dyshidrotic eczema., pompholyx, vesicular palmoplantar dermatitis, housewife’s eczema) is seen on palms, soles, and sides of fingers and toes. Tiny opaque bumps vesicles, thickening, and itching which worsens at night are the symptoms

- Venous eczema (gravitational eczema, stasis dermatitis, varicose e.) occurs in people with impaired circulation, varicose veins and edema, and is particularly common in the ankle area of people over 50. There is redness, scaling, darkening of the skin and itching. The disorder predisposes to leg ulcers.

- Dermatitis herpetiformis (Duhring’s Disease) causes intensely itchy and typically symmetrical rash on arms, thighs, knees, and back. It is directly related to celiac disease and can often be put into remission with appropriate diet.

- Neurodermatitis (lichen simplex chronicus, localized scratch dermatitis) is an itchy area of thickened, pigmented eczema patch caused by an habbit of rubbing and scratching.

- Autoeczematization (id reaction, autosensitization) is an eczematous reaction to an infection with parasites, fungi, bacteria or viruses and is cured together with the infection.


SUN-INDUCED ECZMA OR SUNRASH

Sunrash or sun allergy or polymorphous sun rash can occur after a lot of sun exposure on the skin of sensitive people, especially on the chest, arms and legs.

The condition is characterized by red and inflamed skin with knobs, blisters or nodules in the outer layers and is followed usually by intense itching. Is not considered the same as sunburn. A dose of sun ray that is too low to cause sunburn, can still often cause sunrash.

The condition is usually over after a few days without sun exposure. By scratching the rash the skin can be infected so that more serious ulcers with deeper damage can occur.

Sunrash seems to occur as an allergic reaction to substances that are formed in the skin through a chemical reaction when your skin is irradiated by UVA and UVB rays. Sunrash therefore seems to be a special kind of allergic eczema.

Most people are exposed to sun-rash. Therefore a sun-mediated induction can be a component in the total cause or many cases of eczema.


THE DISEASE MECHANISMS OF ECZEMA

An important mechanism of this disease is inflammation. The inflammatory reaction occurs in the uppermost layer of the skin and the area right beneath the upper leyer.

An important component of this inflammation mechanism is realease of the substanse histamine from certain cells in the skin and also the release of other tissue hormones. This reaction takes place because there are anti-bodies against certain substances in the skin that react with the substances and make a chemical complex. This chemical complex then stimulate the cells containing histamine and other tissue hormons to release these.

The exact mechanism of this triggering is very complex. The anti-bodies can be free floating, they can be situated at the cells that release histamine or they can be situated at the surface of special controle cells. The complex produced when the anti-bodies are coupled to the substance ( the anti-gen) will then trigger the histamine-containing cells either directly or indirectly through controle cells or throug a chain of reactions in a group of helper substances called complement..

The released substances stimulates the skin to react by the early symptoms of eczema.

Histamine and similar compunds make blood vessels relax and make the wessel waals easier for fluid to penetrate into the rooms between the cells. This reaction and the penetration of fluid gives such symptoms as redness and swelling of the skin and it contributes to symptoms like oozing and itching.

The walls also get easier to penetrate for immune cells like lymphocytes and for more anti-bodies. The complexes formed, the helper cells and the helper substances also attract more immune cells to the area, and these cells produce a more detailled reaction that gives many of the other symptoms.

The substances that the immune system react against can be produced by the body itself. Then the eczema is of the atopic type. The reaction can be against substances coming from the outside, and one then gets a topic eczema like contact eczema or reactive eczema or allergic eczema.

After some time there will be coagulations caused by rfibrine or other substances in the fluid that oozes or accumulates in the upper skin layer, and then the skin gets dry and harsh.

The primary reactions can later on trigger other cells in the skin to react in certain ways. The epitelial cells can be stimulated to divide so that the epidermis get thicker and with a thicker horny layer. The connective tissue underneath the epidermis can be stimulated to produce more fibres. These activities also make the skin appear dryer, thicker and rougher.

Skin affected by eczema more easily breaks or tears apart at certain places than normal skin. These injuries causes oozing and bleeding. Bacteria and fungi can come in and infect the skin. Substances produced by the microorganisms can also make the skin react even more by an inflammatory process, so that the eczema itself also worsens.


THE TREATMENT OF ECZEMA

By eczema caused by allergy or irritation from a substance, removal of exposure to that substance is an important measure that can cure the condition. This may sometimes be difficult because the substance is a part of the environment or because it is not allways quite clear what substances that is causing the condition.

Dotors can often test solutions of the most common allergens on the skin, and thereby detect the causing agent. However, often one must try out removing several factors one is exposed to before there is a positive result.

Try to remove or change out soaps and cosmetics used on your skin. Also try to take away or exchange washing media used on interior surroundings and furniture.

Try to cut out fore some period these food types one after the other: Milk and dairy products, wheat products, acidic fruits, eggs, nuts and seafood, Also try to avoid food containing chemical additives, preservatives and colorings.

A more rigorous cleanng of your clothes and inside your home can take away mites, moulds and dust that your skin react against.

If yo use special chemicals in your work and are exposed to those, install measures so that the cemicals will not come in contact with your skin or do not come out in the air that you breath.

If the surroundings in your daily life is unnormally dry, unnormally humid, cold, warm or full of sun-shine, try to change these conditions. If that is not possible, creams to protect your skin can be of help.

You can find creams and lotions to help against eczema by excerting many simultaeous actions: softening the skin, protecting the skin from external impacts, reducing inflammation, moisturizing the skin, reducing itching, killing bacteria or fungi and induce healing of sores and damages.

Some of the topical remedies are wholly composed of natural ingredients, others can contain natural and synthetic ingrediets in combination. Oils of several types are important effectors in these creams that gives many of the listed effects simultanously. Analgesic (pain killing ingredients) and antibacterial substances can also be ingredients in these products. They can further contain herbal ingredients that accelarate tissue growth and thereby help healing. Squalan is also more robust against oxydation by the air oxygen.

Squalane is a type of oil, a hydrocarbone with the formula C30H62, that often works well against eczema. This is a saturated oil found naturally in the skin and fat of humans and animals and in many plant oils. Squalane can be used topically alone and it is also an ingredient in many topical creams used against skin problems. Squalan is not the same as squalene. Squalene is a related compound with many good properties that is also used in topical skin treatment products, but squalane is perhaps the most well suited for treatment against eczema.

There are also oral pills made of natural ingredients available in the market to treat eczema. The oil is very fluid and goes well into the structures in the skin and makes it smooth and elastic. Such pills work by reducing inflammation, stimulating the healing and the building up of a better skin integrity and supplying materials for skin healing and regrowth. Ingredients found in such pills can be: selenium, zinc, Omega-3-oils, Artichoke extract, Grape Seed Extract, Milk Thistle, Olive Leaf Extract, gamma linolenic acid, collagen Type II, hylaronic acid and chondrotin Sulfate.

By severe eczema that cannot be remedied by milder means creams containing steroids and anti-histaminic oral drugs can be useful for some time. However, prolonged treatment by steroids can cause skin athrophy or other damages.