The terms Eczema and Dermatitis are often used synonymously. Eczema implies an itchy rash while dermatitis simply means skin inflammation, but both terms are used to describe a range of dermal ailments. In most cases, eczema is characterized by redness, dryness, itchiness and swollen skin. More serious types of eczema may result in cracked skin, crusty scales or blisters that ooze fluid.
There are several types of eczema that arise from various causes. They can be singular instances, periodically re-occurring, or chronic in frequency and may happen at any stage of life. Since many things can irritate the skin, a doctor will try to narrow the diagnosis to a specific category of dermatitis to better treat it, and to avoid further or exacerbated outbreaks of it.
The Most Common Types of Eczema Include:
Contact dermatitis (which includes both allergic and irritant contacts) typically manifests as a pink or red itchy rash. Allergic contact dermatitis results from casual contact with plant sources (such as poison ivy), flowers, herbs, fruits, and vegetables. Other inorganic causes can include: fragrances, hair dyes, metals, rubber, formaldehyde (used as a preservative in many products), and skin care products. Irritant contact dermatitis is caused when a harsh substance aggravates the skin by repeatedly contacting it. Chemicals and soaps are frequently the culprits but ironically, the most common example of irritant dermatitis is dry, damaged skin due to over-washing. In this case, the irritant is the water that is drying out and damaging the skin with repeated exposure.
Atopic dermatitis is the most severe kind of eczema. Atopic dermatitis is a chronic disease that causes itchy, inflamed skin – usually in tender areas such as behind the knees, insides of the elbows and face, but it can occur anywhere on the body. It most often begins in early childhood or infancy. While the symptoms can fade during childhood, many people experience some form of atopic dermatitis throughout their entire life. Atopic dermatitis can also be accompanied by other allergic conditions such as asthma and hay fever. It tends to flare periodically and then subside. The cause of atopic dermatitis is not fully known, but it may result from a combination of inherited tendencies for sensitive skin and malfunction in the body’s immune system. People suffering from atopic dermatitis tend to have high staph levels on their skin, although atopic dermatitis is not contagious.
Dyshidrosis, also known as dyshidrotic eczema or pompholyx, is a skin condition more common in women. Small blisters appear on the palms of the hands, sides of the fingers and sometimes the soles of the feet. The fluid-filled blisters that occur in dyshidrotic eczema can persist for about three weeks and cause intense itching. Once the blisters of dyshidrosis dry, your skin may appear scaly.
Treatment for dyshidrotic eczema most often includes topical creams or ointments, but in severe cases your doctor may suggest corticosteroid pills such as prednisone, to be taken orally.
Nummular eczema consists of rounded red plaques that are most commonly seen on the legs, hands, arms, and torso. It is more common in men than in women, and the peak age of onset is between 55 and 65. Living in a dry, cold environment or taking frequent very hot showers can cause this condition. It is neither hereditary nor contagious.
Seborrheic dermatitis, (commonly called cradle cap in infants), consists of oily, yellowish or reddish scaling on the scalp, face, or genitals. When on the face, it is typically in or near the eyebrows, or along the sides of the nose. Seborrheic dermatitis is caused by a fungal infection and may be aggravated by stress. On the scalp of adults it is commonly known as dandruff. Seborrhea is oiliness of the skin, especially of the scalp and face, without redness or scaling. Seborrheic dermatitis has both redness and scaling.
While there are several over the counter (OTC) medications that help to relieve the symptoms of eczema, prescription topical steroids have been the standard treatment for the disease itself. Oral steroids may be prescribed for severe flare-ups. The FDA has also approved a new class of drugs called Topical Immunomodulators (TIMs) or calcineurin inhibitors. They are topical medications that can help control the symptoms of atopic dermatitis and reduce the need for topical steroids. They are gentler alternative for sensitive locations, such as the face and skin folds. They are generally effective and well tolerated. Topical anesthetics, antibiotics, antihistamines, antibacterial, antifungal and anti-inflammatory drugs are available in creams, gels, ointments, lotions and solutions. Most of these classes of drugs can also be administered orally.
For more information about Eczema/Dermatitis, or to schedule a Eczema/Dermatitis consultation, please contact Dr. Garramone’s office today at 239-482-1900.