Eczema
Damages the barrier function
| Download this episode | It starts with an itching that won’t go away and soon develops into a red, dry, bumpy area on your skin. Eczema, known clinically as atopic dermatitis, damages the body’s skin barrier function. This loss of barrier function makes your skin more sensitive and more prone to infection and dryness. Eczema originates from the Greek word “ekzein” which means to “boil over” or “break out.” An estimated 31 million Americans have some form of eczema, according to the National Eczema Association. More than 16 million adults in this country have eczema that initially began at around two years of age. That doesn’t mean it’s solely a disease of childhood onset. One in four adults reported having their initial symptoms later in life. Luckily, eczema doesn’t harm your body, it doesn’t mean that your skin is dirty or infected, and it’s not contagious. It commonly shows up on the face, inside of the elbows or behind the knees, but it can appear anywhere on the body. | Eczema, or atopic dermatitis, is caused by a combination of immune system activation, genetics, environmental triggers and stress. If you have eczema, your immune system overreacts to small irritants or allergens. This overreaction can inflame your skin. The chance of developing atopic dermatitis is higher if there is a family history of the disease, which suggests that genetics may play a role in the cause. Recently researchers found changes to genes that control a specific protein and help our bodies maintain a healthy layer of skin. Without the normal levels of this protein, the skin barrier changes, allowing moisture to escape and exposing the skin immune system to the environment, leading to atopic dermatitis. Environmental factors, such as exposure to tobacco smoke or certain air pollutants, may trigger the immune system to change the protective barrier of the skin allowing more moisture to escape, which can lead to eczema. | The most common symptom of eczema is itching, which can be severe at times. Other symptoms include red, dry patches of skin, rashes that may ooze, weep clear fluid or bleed when scratched, and thickening or hardening of the skin. Eczema most often begins before the age of five and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years. It can also cause an extra fold of skin under the eye, known as a Dennie-Morgan fold, or extra skin creases on the palms of the hands and soles of the feet. Eczema can lead to depression or anxiety and sleep loss, which ultimately can cause behavior issues in children. If you think you or your child has eczema, you should consult with your health-care provider, who will discuss any symptoms you are experiencing. You may be asked to undergo an allergy skin test or a blood test to rule out any other causes for the rash. | When it comes to treating eczema, Dr. Joshua Kennedy with UAMS’ Allergy and Immunology Clinic says it’s important to identify the location and type of rash you have and the severity of itching it causes. It’s also important to determine any triggers that are unique to you or your child and how to prevent exposure to them. Your doctor may prescribe a corticosteroid ointment to apply to your rash. This will help reduce itching and calm inflammation. Antihistamines like cetirizine or hydroxyzine also reduce itching. Dr. Kennedy recommends moisturizing your skin with ointments. These emollients leave an oily layer over the skin to trap in moisture-lotions don’t do this as well. Use mild soaps and other products that are free of perfumes, dyes and alcohol. Look for products labeled fragrance free or hypoallergenic. Try not to scratch the irritated area on your skin, even if it itches. Scratching can break the skin and lead to an infection. | If you have eczema, it’s a good idea to establish a skin care routine for keeping your skin healthy. This includes wearing gloves for jobs that involve putting your hands in water. Try wearing cotton gloves under plastic gloves to absorb sweat, and wear gloves outside, especially during the winter months. Take baths or showers using lukewarm water rather than hot. Use a mild soap for your bath or shower and pat your skin dry instead of rubbing it. Apply a moisturizing ointment or emollient immediately after patting dry your skin to help seal in the moisture. Learn to recognize stress in your life and how to manage it. Regular aerobic exercise, hobbies and stress-management techniques, such as meditation or yoga, might help. Wear loose clothes made of cotton and other natural materials and always wash any new clothing before wearing it. Try to avoid getting too hot and drink at least eight glasses of water each day, as water helps keep your skin moist.
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Can inflame your skin
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Itching can be severe at times
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Identify location, type of rash
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Follow a good skin care routine
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