Eczema

Definition of eczema

The term eczema is a collective term for inflammatory skin diseases that can occur in various forms and are usually not contagious.
Eczema is also known as dermatitis or itchy rash .
What all eczema have in common is that the top layer of skin is more sensitive and has been damaged, for example, by dehydration or allergenic substances. The skin’s natural protective barrier is weakened and infectious agents can penetrate more easily.

Causes of Eczema

Eczema can be triggered by external (exogenous) or internal (endogenous) influences. If patients come into contact with certain substances, external, exogenous contact dermatitis can occur. These include allergic contact eczema , which causes a sensitivity reaction in the body to so-called allergy-triggering substances (allergens). The most common allergens include nickel, fragrances in cosmetics, food, preservatives and hair dyes.

In contrast, non-allergic contact eczema is not caused by a specific immunological reaction of the body, but rather the eczema is triggered by contact with harmful substances such as cleaning agents, alkalis, acids, moisture, heat or cold.

Endogenous eczema , on the other hand, is triggered by internal factors such as hereditary predisposition. Neurodermatitis is the most common endogenous eczema.

Factors that can cause or worsen eczema:

• Wet work and repeated contact with water and detergents
• Allergens such as nickel, chromium and latex
• Warm and cold temperatures as well as strong temperature fluctuations
• Sweat
• stress and sleep problems
• Exposure to certain chemicals: laundry detergent, perfume, makeup, soap
• Certain fabrics such as wool or synthetic fibers (e.g. polyester)
• Dry air
• Infections and various diseases

symptoms of eczema

Eczema can appear anywhere on the body, for example on the hands (hand eczema), feet (foot eczema) and in skin folds and eyelids. They are characterized by red, itchy, and dry skin that tends to peel.

In the acute phase of the disease , redness (erythema), nodules (papules) and fluid-filled blisters (vesicles) can occur. Scabs and crusts (crustae) can also form. Scratching can cause small bleeding wounds.

In the chronic phase of the disease , the skin can flake (desquamate) and thicken. Eczema can also be extremely drying and cause small cracks in the skin.

The most common types of eczema

• Atopic eczema (neurodermatitis): Neurodermatitis is a chronic, non-contagious skin disease that is usually associated with dry, scaly skin and severe itching. What exactly leads to the disease has not been finally clarified. Nevertheless, it is known that genetic factors as well as certain foods, nicotine consumption and stress promote neurodermatitis.
• Allergic contact eczema: Typical of contact eczema are red and itchy areas of skin with fluid-filled blisters. The skin irritation is caused by an allergic reaction of the body to contact with, for example, nickel or latex. As a rule, the symptoms only appear after repeated contact with the allergen. Certain occupational groups are particularly at risk of contracting contact dermatitis. These include, for example, hairdressers, painters, florists, bakers as well as doctors and nurses, as they often come into contact with allergenic substances. If there is a suspicion that the professional activity is the cause of the disease, a doctor should be contacted in any case, as an occupational disease may be present.
• Dyshidrotic eczema: This type of eczema usually presents as small itchy blisters on the hands and feet. After the blisters have dried, fine scaling may occur. The cause is an eczema reaction in areas rich in sweat glands, which is why the symptoms often occur at higher temperatures in the summer months.
• Hyperkeratotic hand and foot eczema: scaly, callus-like skin changes appear on the palms of the hands and feet. The disease is often chronic and there is usually no cause for the symptoms.
• Nummular Eczema: Nummular eczema causes red, itchy, coin-shaped patches on the back, upper arms, legs, and hands.
• Seborrheic dermatitis: Seborrheic eczema is triggered, among other things, by excessive sebum production. Men and infants up to the age of three months are particularly frequently affected. The scaly skin areas mostly appear on the scalp and face.

diagnosis of eczema

You can first contact your general practitioner with your complaints. If necessary, they can refer you to a specialist. The specialist for diseases of the skin is the skin doctor (dermatologist) .

In order to make the correct diagnosis, the doctor treating you will first ask you a few questions about your symptoms. In this anamnesis interview, he will ask you about the appearance, frequency and duration of the eczema. He will also ask you questions about your job and private habits, for example to rule out an allergic skin reaction.

This will be followed by a physical examination , during which the doctor will assess the eczema. The dermatologist will then carry out a so-called epicutaneous test (patch test) . Small test patches with possible allergens are stuck to the back and a reaction is awaited. If skin reddens, the allergen that triggers the eczema can be identified.

You can do this yourself for eczema

• Take good care of your skin. Moisturize your skin regularly. Special skin-friendly ointments, creams or lotions can be used for this. Depending on the skin condition, you can choose between ointments with a high fat content for dry, scaly eczema and watery lotions for weeping eczema.
• Don’t shower too often because water dries out your skin.
• Use pH-neutral, perfume-free soap with moisturizing substances.
• Wear skin-friendly materials like cotton, silk, and bamboo instead of wool and synthetics.
• Try not to scratch yourself. Scratching makes symptoms worse and bacteria can enter through the small wounds.
• When washing dishes, wear laundry gloves that protect your hands from water and dishwashing liquid.

treatment of eczema

It is important that triggering factors of eczema are avoided . This can mean giving up jewelry containing nickel or avoiding certain foods. Symptoms of contact eczema should improve after withdrawal of the triggering allergen. If the professional activity is suspected of causing the symptoms, changes in the work process or better protective clothing should be considered together with the doctor and the employer.

Anti- inflammatory ointments containing cortisone can also help locally. Cortisone ointments have been available in pharmacies without a prescription for some time, but the type and duration of use should be discussed with the doctor.

It is also possible to treat the eczematous skin areas with phototherapy using UV radiation . If the course is very severe, anti-inflammatory, systemic drugs can also be taken.

If atopic eczema is present, the treatment can be very lengthy. Most treatment options only reduce the severity and duration of the symptoms, but cannot cure them. There are various active ingredients available that can be applied to the skin, such as creams containing urea. In the case of acute attacks, antibiotics, calcineurin inhibitors and creams containing cortisone can also be used.

When to seek help for eczema

If the eczema occurs for the first time, a medical examination is always advisable in order to avoid the disease becoming chronic. Even if the symptoms get progressively worse despite ongoing treatment, you need to see a doctor again.

If work-related skin changes occur, the company doctor or dermatologist should be contacted. This informs the responsible trade association or accident insurance fund in order to clarify the existence of an occupational disease.

How can Med-Healths help?

Noticed a red, itchy patch of skin and not sure what it is? You can use the Med-Healths app to upload pictures of the eczema and talk to a doctor about your symptoms. The doctor can prescribe the right medication for you, issue a prescription and write you off sick if necessary. He can also refer you to an appropriate specialist if further examinations are necessary.