Eczema is the common name for a group of conditions that cause itching and redness of the skin. It can resemble a rash. The most common form is atopic dermatitis (AD). Most eczema complications are itch-related. Scratching the itchy skin damages its surface. Eczema also causes invisible skin changes that increase the risk of infection.
What are the symptoms of atopic eczema?
Eczema is a condition that causes dry, scaly skin that itches.
Some people experience only small patches of dry skin, while others may suffer from generalized inflammation of the skin all over the body.
Inflamed skin can be red on white and dark-brown skin, purple or gray on brown and black skin. This means it can also be harder to see on brown and black skin.
Although atopic eczema can affect any part of the body, it most commonly affects the hands in adults, and the inside of elbows, back of knees, face and scalp in children. It can also affect the outside of elbows and the front of knees in children with brown or black skin.
People with atopic eczema generally experience periods when symptoms are less noticeable, as well as periods when symptoms become more severe (flare-ups).
What causes atopic eczema?
The exact cause of atopic eczema is unknown, but it is clear that it is not due to a single factor.
Atopic eczema often occurs in people who suffer from allergies. The term “atopic” means sensitivity to allergens.
Atopic eczema can be hereditary and often develops alongside other conditions, such as asthma and hay fever.
The symptoms of atopic eczema often have certain triggers, such as soaps, detergents, stress and climate.
Food allergies can sometimes play a role, especially in young children with severe eczema.
You may be asked to keep a food diary to try to determine whether a specific food aggravates your symptoms.
Can eczema cause complications?
Here are the 10 complications of eczema:
1- Bacterial infections
Signs of eczema infection include:
- Fever or general malaise
- Oozing
- Swelling and pain
- Yellow crust
- Yellow or white patches in the eczema
Your doctor may prescribe an antibiotic. If you have a boil, your doctor may have to open it up and drain it.
2- Cellulite
A bacterial infection that penetrates deep into the skin is called cellulitis. Symptoms include:
- Fever
- Redness
- Swelling
- Hot, sensitive skin
You’ll need an antibiotic to clear the infection. If the infection is severe, your doctor may admit you to hospital to administer intravenous medication.
3- Viral infections
Sometimes a virus is the cause of an infection.
a- Herpetic eczema
Herpetic eczema is caused by the same virus that causes herpes labialis (herpes simplex 1). More rarely, it is caused by the virus involved in genital herpes (herpes simplex 2). Symptoms include painful blisters that open up and form scabs. You may also experience fever and swollen lymph nodes. Genital herpes is treated with antiviral drugs.
b- Molluscum contagiosum
This viral infection is caused by a poxvirus. It manifests itself as white or flesh-colored lesions on the skin. These spots may have a hollow in the center. They may be itchy and swollen. Doctors sometimes suggest letting the body get rid of the condition on its own. But in the case of eczema, treatment may be the best solution. Options include
- Cryotherapy (freezing)
- Curettage (removal)
- Pulsed dye laser (burning the skin).
- Treatments to be applied to the skin, including acids and cantharidin.
Preventing infections
The following measures can help you prevent bacterial and viral infections:
- Always wash your hands before applying cream to your skin.
- Don’t dip your fingers into a jar of ointment or cream, as you risk contaminating it. Instead, use a spoon that you can wash each time.
- If your eczema is infected, don’t share towels, bedding or clothes.
- Avoid close contact with someone with a fever blister. Don’t share dishes, lip balm or anything else that has touched that person’s mouth.
4- Neurodermatitis
This condition, also known as lichen simplex chronicus, is the result of the itch-scratch cycle and can be triggered by eczema. It occurs when a spot is scratched so often that the skin becomes thick, dry and leathery. The spot may turn red, brown or gray.
It can occur anywhere, but the most common locations are as follows:
- Ankles
- Elbows
- Feet
- Hands
- Neck
- Scalp
- Shoulders
- Wrists
To treat neurodermatitis, your doctor will want to help your skin heal and stop the cycle of itching and scratching. Possible options include:
- Steroids
- Patches containing medication to numb the skin
- Bandages to cover the affected area
- Medication to help you avoid scratching while you sleep
5- Scars
Eczema can leave scars on your skin, particularly in areas that have been infected and then healed. Scars can be particularly noticeable if you have darker skin.
Many scars fade over time. But if they don’t, your doctor may recommend an ointment. You could undergo an operation to smooth out the damaged skin. Plastic surgery is another possibility.
6- Scalp problems
Seborrheic dermatitis is a distinct type of eczema that mainly affects the scalp. It can occur in addition to atopic dermatitis. A fungus called malassezia yeast, which lives on the surface of the skin, can cause inflammation.
In adults, it is often the cause of dandruff. In more severe cases, you may scratch your scalp to the point of damaging the hair follicles, which can lead to hair loss.
It can also affect the wings of the nose, forehead, chest, armpits and groin. In babies, the appearance of the scalp is sometimes called cradle cap.
Your doctor will probably recommend an antifungal cream or medicated shampoo to treat this condition. If your case is more serious, you may be able to take a steroid or another type of medication.
7- Sleep problems
Sleep disorders are common among eczema sufferers. Researchers don’t quite understand why, but the itching that wakes people up is one reason.
When your eczema is under control, you sleep better. You can also take other steps to improve your sleep, such as:
- Stick to a regular bedtime.
- Limit caffeine in the evening.
- Turn off screens well before bedtime.
- Sleep in a dark, quiet room.
- Your doctor may also recommend taking an antihistamine or melatonin supplement.
8- Effects on mental health
Research suggests that eczema can increase the risk of depression and anxiety. This can create a difficult cycle because your body’s physical reactions to stress can trigger eczema flare-ups.
If you’re feeling anxious or depressed, here are some steps you can take:
- Exercise or find other ways to relax.
- Find a support group.
- Talk to your doctor.