Eczema – What Is It Really?

Eczema is a general term for dermatitis, a group of conditions that cause the skin to become inflamed, itchy and/or have a rash-like appearance. These rashes may appear red in lighter skin tones or grey/ashy in darker skin tones.

Types Of Eczema

1. Atopic dermatitis is the most common type of eczema which usually starts in childhood. It is part of the atopic triad with asthma and hay fever (allergic rhinitis). This type of eczema happens when the skin’s natural barrier is weakened, meaning that the skin is less able to protect you against irritants and allergens.
2. Contact dermatitis: this type of eczema manifests as irritated skin caused by a reaction to substances the skin came in contact with. There are two types: Allergic contact dermatitis – an immune system reaction to an irritant. Irritant contact dermatitis – when chemical or other irritants irritate the skin.
3. Nummular eczema (or discoid eczema): chronic well-defined coin-shaped rashes on the skin. It can be triggered by a reaction to an insect bite or an allergic reaction to metals or chemicals. Dry skin during cold weather can also cause it.

Below is a before and after of our client at Skin101 center, Abuja who presented with contact dermatitis following the use of an organic skincare product. These photos were taken 2 weeks apart.

4. Dyshidrotic eczema: In this type of eczema, blisters develop on the soles of the feet and/or the palms of the hands and fingers. It is twice as common in women as it is in men.
5. Seborrheic dermatitis: This is a chronic form of eczema that appears on the body where there are a lot of oil-producing glands (sebaceous glands), eg. scalp, nose, etc. Unlike many other types of eczema, it is not the result of an allergy. The exact cause is unknown, however, genes, hormones and microorganisms that live on the skin naturally play a role. People of any age can develop seborrheic dermatitis including infants (known as “cradle cap”). 
6. Neurodermatitis (lichen simplex chronicus): This type of eczema causes thick, scaly patches to appear on the skin. Chronic scratching causes itchy patches of skin to become dry, leathery and thickened. This is called lichenification.
7. Stasis dermatitis (also called gravitational dermatitis, venous eczema or venous stasis dermatitis): This type of eczema happens when there is a problem with blood flow which causes fluid to leak out of weakened veins into the skin (usually lower legs).

In Nigeria and most parts of the world, fungal infections and many scaly skin lesions are often mistaken for Eczema. Many people do not actually know what eczema is. Eczema is not contagious, you cannot “catch it” from someone who has it. 

Common Skin Conditions Mistaken For Eczema

• Tinea/Dermatophytosis also known as Ringworm
• Psoriasis
• Pityriasis Versicolor
• Rosacea

*Read: Difference Between Sensitive And Sensitized Skin

Common Symptoms For All Types Of Eczema

• redness
• dry, scaly skin
• itching (may be intense)

Common Triggers For Eczema

• Some food and drinks e.g. Fish, Egg, Peanuts, etc
• Skincare products and makeup
• Soaps and detergents
• Physical activities, exercise, swimming in a chlorinated pool
• Duration of baths or showers and the temperature of the water used
• Stress
• Allergens (usually pollens or animal dander)

Treatment Of Eczema

Eczema comes and goes however there are treatment options depending on the type of eczema and clinical presentation.

• Corticosteroid creams or ointments
• Antihistamines
• Antibiotics (when there is a superimposed infection)
• Tacrolimus (Calcineurin inhibitor)
• Keratolytics
• Emollients

*Note that sometimes, people can have more than one type of eczema on their body at the same time. This is the reason seeing a professional is necessary to make a correct diagnosis and treat appropriately.

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