Eczema: Causes, Symptoms, Types & Tests

Eczema is a term often used to describe a group of conditions that cause the skin to become inflamed, itchy, and irritated. Affecting millions of people worldwide, eczema can range from mild patches to severe flare-ups that significantly impact daily life. While it is not contagious, eczema can be persistent and distressing. Understanding its triggers, types, and the diagnostic process can help manage symptoms more effectively and improve skin health.

What is Eczema?

Eczema, also known as atopic dermatitis (the most common type), is a chronic inflammatory skin condition characterized by dry, itchy, and inflamed patches of skin. The word "eczema" comes from the Greek word meaning "to boil over," reflecting the red, irritated appearance the skin often takes on. Eczema usually begins in childhood, but it can appear at any age. The condition often follows a relapsing-remitting course, where periods of flare-ups are followed by periods of improvement. Eczema can affect any part of the body but is most common on the face, hands, feet, and behind the knees or elbows.

Causes of Eczema

The exact cause of eczema isn’t fully understood, but it is believed to be a combination of genetic and environmental factors that disrupt the skin’s barrier function and trigger inflammation.

Common contributing factors include:

• Genetics: A family history of eczema, asthma, or hay fever increases risk.
• Immune system response: Overactivity can cause the skin to react strongly to irritants and allergens.
• Skin barrier defects: Reduced production of natural oils can lead to dry skin and make it easier for irritants and microbes to penetrate.
• Environmental triggers: Cold, dry weather, pollution, dust mites, and pet dander can provoke flare-ups.
• Irritants: Soaps, detergents, fragrances, and chemicals can worsen symptoms.
• Stress: Emotional stress is a common trigger for flare-ups.
• Microbial factors: Bacterial, viral, or fungal infections can exacerbate eczema.

While these factors may not cause eczema directly, they can significantly worsen symptoms in those predisposed to the condition.

Symptoms of Eczema

Eczema symptoms vary depending on age, severity, and type, but common features include:

• Intense itching: Often worse at night, leading to scratching.
• Red or brownish patches: Especially on hands, feet, ankles, wrists, neck, chest, eyelids, and inside elbows or knees.
• Dry, cracked skin: May appear scaly or thickened over time.
• Small raised bumps: These may leak fluid when scratched.
• Swelling: Especially during flare-ups.
• Raw, sensitive skin: Caused by repeated scratching.

Children often develop eczema on the face and scalp, while adults might see it more on hands and areas with frequent skin contact.

Types of Eczema

Eczema isn’t a single condition but includes several types:

1. Atopic Dermatitis:
The most common form, usually starting in childhood. Often associated with allergies, asthma, or hay fever.

2. Contact Dermatitis:
Occurs when skin reacts to irritants or allergens. Divided into:

• Irritant contact dermatitis
• Allergic contact dermatitis

3. Dyshidrotic Eczema:
Causes small, itchy blisters, usually on hands and feet.

4. Nummular Eczema:
Characterized by round, coin-shaped patches, often after skin injuries.

5. Seborrheic Dermatitis:
Commonly affects oily areas like the scalp and face, causing flaky, greasy scales.

6. Stasis Dermatitis:
Develops in people with poor circulation, usually on the lower legs.

Each type requires slightly different management, making accurate diagnosis essential.

Tests Used to Detect Eczema

Diagnosis usually relies on clinical examination and medical history. However, certain tests may be used to rule out other conditions or identify triggers:

• Physical examination: A dermatologist examines the skin and asks about symptoms and triggers.
• Allergy testing: Skin prick or patch testing to identify potential allergens.
• Skin biopsy: A small sample may be taken to rule out other skin conditions.
• Blood tests: Sometimes used to measure IgE levels or check for underlying conditions.

Doctors may also ask about family history, lifestyle, diet, and exposure to irritants to guide treatment.

Conclusion

Eczema can be challenging, both physically and emotionally. While it cannot be cured, understanding the condition helps patients manage symptoms effectively. Treatment often includes moisturizing, avoiding known triggers, using prescribed medications like topical corticosteroids or immunomodulators, and sometimes phototherapy. Lifestyle changes also help—choosing fragrance-free products, wearing breathable fabrics, managing stress, and keeping the skin hydrated. Early diagnosis and consistent care can significantly reduce flare-ups and improve quality of life.

Frequently Asked Questions (FAQ’s)

What is eczema?

Eczema is a chronic inflammatory skin condition causing itchy, dry, and red patches.

Is eczema contagious?

No, eczema cannot be spread from person to person.

What causes eczema flare-ups?

Triggers include stress, dry weather, allergens, certain soaps, and fabrics.

Can eczema go away completely?

Some children outgrow it, but for many, it’s a lifelong condition managed with treatment.

Which type of eczema is most common?

Atopic dermatitis is the most common form.

How is eczema diagnosed?

Mostly through physical examination, medical history, and sometimes allergy tests.

Does diet affect eczema?

For some, certain foods may trigger symptoms, though this varies individually.

What helps prevent eczema flare-ups?

Regular moisturizing, avoiding irritants, managing stress, and following medical advice.