Eczema and dermatitis are the terms used interchangeably for a very common skin inflammation. Atopic dermatitis is most common and often present from childhood. It tends to occur in the first weeks or months of life in genetically prone individuals. Often the first signs appear with introduction of solid foods but can start a lot earlier than that. It can settle in childhood but it can also persist into adulthood. Even children that out grow it often tend to have dry, sensitive skin in adulthood with episodic flare ups. Other types include seborrhoeic, asteatotic, pompholyx, and stasis eczema plus allergic contact dermatitis irritant contact dermatitis.
You may be born with an increased likelihood of developing eczema, which you inherit from your parents. You may be a carrier of the Fillagrin gene deficiency. In this gene deficiency there is an increase in palmar creasing.
When you are exposed to environmental factors, such as house dust mite, food allergens, cat and dog dander or pollen, you may experience your condition getting worse. There are several triggers that can make your symptoms worse including any ill health, teething, hormonal changes, stress, exercise and irritants.
Itching, dryness, redness, crusting, flaking, blistering, cracking, oozing, or bleeding is commonly associated with eczema. There may be some areas of skin discolouration too (increased or decreased pigmentation) which may appear due to skin inflammation, but the scarring is exceptionally rare.
It is important to establish the type of eczema. More than one type of eczema can exist in the same patient. Identifying triggers for flare-ups is also very important to treat eczema effectively. Often the treatment plan consists of a regime for flare-ups and another regime as a maintenance therapy. Topical treatments include soap substitute, emollient, barrier cream and treatment creams. Your dermatologist will establish the most suitable regime for your based on your skin type, form/s of eczema and convenience of the treatment for you.
If any allergies are established (based on allergy blood tests or skin prick tests) they should be excluded as much as it is possible and your dermatologist will be able to guide you on this. When needed you will be referred to a dietician too. Occasionally a course of phototherapy may be needed or systemic therapies for more severe cases.