Eczema

Eczema, also known as dermatitis, is a general term for inflammatory conditions that affect the outermost layers of the skin, known as the epidermis (top layer) and dermis (second layer). These conditions are typically characterized by itching, redness, swelling of the skin, small bumps/lesions, flaking, cracks, and dryness.

There are many types of eczema that can occur at any age and can be triggered by a variety of factors. For example, diaper dermatitis is triggered by tight and wet diapers in infants, contact dermatitis is triggered when the skin comes into contact with something it is sensitive to, and atopic eczema, is a hereditary, chronic skin condition.

In general, eczema is categorized based on whether it is triggered by an external factor (exogenous) or an internal factor (endogenous), as well as its appearance and characteristics. Often, the development of eczema is influenced by a combination of factors both inside and outside the body. Some types of eczema have unknown causes and are classified as having an unknown origin.

The symptoms vary slightly depending on the type of eczema and its severity. Generally, with eczema, one can experience red, irritated skin, itching, small bumps, boils, or pimples on the skin, sores from scratching, and dry, flaky, and cracked skin.

Eczema develops because inflammation in the skin weakens the skin barrier, resulting in water loss through the skin and making it more difficult for the body to protect itself against irritants and allergens.

This is often a combination of factors within the body that affect the composition of the skin and factors in the external environment (such as water, soap, perfume, foods, chemicals, etc.) that trigger the development of eczema. In some types of eczema, genetics also play an important role.

It can be challenging to identify the exact underlying cause that triggered eczema, and often, there is more than one reason. A doctor will ask several questions to determine the type of eczema and then examine the skin. If the type of eczema is clear, a diagnosis can be made, and the appropriate treatment can be initiated. Sometimes, additional tests (such as a bacterial culture from eczema, blood tests, or allergy tests) or a consultation with a dermatologist may be necessary if there is uncertainty. At times, it may be necessary to try different treatments and observe what works best.

It is important to remove potential triggers of eczema if possible. This can be done through trial and error or by undergoing an allergy test. You can read more about how the test is conducted here.

Subsequently, a steroid cream can be used to reduce inflammation in the skin. There are different creams available with varying strengths, and the choice of cream and strength will depend on the location and severity of eczema, as assessed by the doctor. Often, a strong cream is initially prescribed and then gradually reduced as eczema improves. Initially, the affected areas are typically applied with the cream once or twice daily for several weeks, and then the frequency can be reduced to 2-3 times per week.

It is important to always apply a good and moisturizing cream simultaneously when using steroid creams, even during periods when the eczema is better and there is no need for steroid cream.

Is eczema contagious?

• No, eczema is not contagious. However, if a person has a skin infection that causes a rash, the infection itself can be contagious through direct contact with the skin (e.g., chickenpox, impetigo, scabies).

Is eczema hereditary?

• Often, yes, some forms of eczema, such as atopic dermatitis and psoriasis, can have a genetic component. However, eczema caused by diaper rash or infection-related rashes is not hereditary.

Is there any treatment for eczema other than creams?

• For certain types of eczema, oral medication may be prescribed, but it is typically reserved for severe cases. For the majority of eczema cases, steroid creams and a good moisturizer are the primary treatment options.

Can eczema be influenced by what I eat?

• Yes, it can. Some people may develop eczema if they eat something they are intolerant to, for example.

What can I do to avoid getting eczema?

• It is important to avoid factors that are known to trigger eczema, such as food items that one is intolerant to or allergens from animals, etc.
• Furthermore, it is recommended to use mild and allergy-friendly detergents, use a gentle shower gel/oil, avoid showering or bathing too frequently, and apply a good and moisturizing cream in the morning and evening.
• During winter, it is advisable to avoid direct contact of wool with the skin as it can also trigger eczema.
• If you notice that eczema is starting to flare up, it is important to start treatment early to prevent it from becoming severe and more difficult to manage.

Author: Doctor Martine Hallin Henriksen

Last updated: 21.10.2020

Reading time: approximately 3-4 minutes

References:

• Andersen K.E., Lomholt H.B., Thestrup-Pedersen K., Wulf H.C. (2018), Klinisk dermatologi og venerologi, Oslo, Gyldendal Norsk Forlag AS, side 33-36
• Norsk Elektronisk Legehåndbok, (2020), Utslett, generalisert, (online), tilgjengelig fra: https://legehandboka.no/handboken/kliniske-kapitler/hud/symptomer-og-tegn/symptomdokument/utslett-generalisert/, hentet den 20.10.2020.

Forfatter: lege Martine Hallin Henriksen

Sist oppdatert: 21.10.2020

Lesetid: ca 3-4 minutter