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Eczema symptoms

What are the eczema symptoms?

• Moderate-to-severely itching skin (this symptom separates eczema from other skin rashes)
• Recurring rash - dry, red, patchy or cracked skin. (In infants and toddlers, the rash usually appears on the face, elbows or knees. In older children and adults, the rash appears less often on the face, and more commonly on the hands, neck, inner elbows, backs of the knees and ankles)
• Skin weeping watery fluid
• Rough, "leathery," thick skin lesions which may be infected by bacteria or viruses.

What is eczema?

Eczema (atopic dermatitis) is a recurring, non-infectious, inflammatory skin condition affecting one in three Australians at some stage throughout their lives. The condition is most common in people with a family history of an atopic disorder, including asthma or hay fever.

Atopic eczema is the most common form of the disease among Australians. The skin becomes red, dry, itchy and scaly, and in severe cases, may weep, bleed and crust over, causing the sufferer much discomfort. Sometimes the skin may become infected. The condition can also flare and subside for no apparent reason.

Although eczema affects all ages, it usually appears in early childhood (in babies between two-to-six months of age) and disappears around six years of age. In fact, more than half of all eczema sufferers show signs within their first 12 months of life and 90 per cent of people develop eczema before the age of five.

Although most children grow out of the condition, a small percentage may experience eczema into adulthood. The condition can not only afflict the individual sufferer, but also their family, friends and health practitioners.

Babies and Children eczema

Atopic eczema (AE) or atopic dermatitis (AD) is a dry, itchy, inflammatory common skin condition affecting ten to twenty per cent of children. The exact cause of eczema is not known. However if there is a history of eczema, asthma or hay fever in the family, your child is more likely to develop one of these conditions.

The onset of eczema is usually before 12 months and it sometimes appears in the first few months after birth. Infants may develop red, oozing, crusted rashes on the face, scalp, diaper area, hands, arms, feet, or legs.

Approximately fifty per cent of children will no longer be troubled by eczema by two years of age and eighty five per cent will "grow out of" eczema before five years of age.

Unfortunately there is no cure for eczema, although there are many ways to keep it under control. If treated and managed well the disease has less impact on daily living and is less likely to have a negative effect on the quality of life for the child and family.

What areas of the body can it affect on the baby or child?

Eczema is a red, hot, dry and itchy rash that can affect one or many areas on the face and body and it can be mild, moderate or severe. Babies usually have a red, scaly rash on their face, which is very itchy. The rash is sometimes on their scalp, behind their ears, on their body or arms and legs.

There are often scratch marks on the skin because of the itch. These areas may become infected with bacteria and this can worsen the eczema.

When the rash begins in the first few months of life it normally affects the face. The cheeks and chin become red, dry, hot and itchy. This is made worse by dribbling, hands touching the face and mouth and saliva irritating the skin. The scalp and facial blood vessels are dilated quickly if baby is overheated. At this age eczema may also affect the trunk and limbs, but the changes in these areas are not usually as severe.

As the child becomes a toddler the eczema is less likely to affect the face and more likely to be present on the limbs and trunk. In toddlers and older children (school age) the eczema tends to affect the hot areas of the body. Such as the flexures of the neck, elbows, wrists, knees, ankles and buttocks.

     You will notice that at times your child's skin is good and at other times it gets worse. This is part of the eczema and is not necessarily caused by bad care.

General Eczema/Dermatitis

Contact Dermatitis

Contact dermatitis is inflammation caused by contact with a particular substance; the rash is confined to a specific area and often has clearly defined boundaries.

Substances can cause skin inflammation by one of two mechanisms—irritation (irritant contact dermatitis) or allergic reaction (allergic contact dermatitis). Even very mild soaps, detergents, and certain metals may irritate the skin after frequent contact. Sometimes repeated exposure, even to water, may dry out and irritate the skin. Strong irritants, such as acids, alkalis (such as cleaners), and some organic solvents (such as acetone in nail polish remover), may cause skin changes in a few minutes. 

With an allergic reaction, the first exposure to a particular substance (or in some cases, the first several exposures) doesn’t cause a reaction, but the next exposure may cause itching and dermatitis within 4 to 24 hours.

People may use (or be exposed to) substances for years without a problem, then suddenly develop an allergic reaction. Even ointments, creams, and lotions used to treat dermatitis can cause such a reaction. About 10 percent of women are allergic to nickel, the most common cause of dermatitis from jewellery. People may also develop dermatitis from any of the materials they touch while at work (occupational dermatitis).

When dermatitis results after a person touches certain substances and then exposes the skin to sunlight, the condition is called photoallergic or phototoxic contact dermatitis. Such substances include sunscreens, aftershave lotions, certain perfumes, antibiotics, coal tar, and oils.                          

The effects of contact dermatitis range from a mild, short-lived redness to severe swelling and blisters. Often, the rash contains tiny, itching blisters (vesicles). At first, the rash is limited to the contact site, but later it may spread. The rash area may be very small (for example, the earlobes if earrings cause dermatitis), or it may cover a large area of the body (for example, if a body lotion causes dermatitis).

If the substance causing the rash is removed, the redness usually disappears in a few days. Blisters may ooze and form crusts, but they soon dry. Residual scaling, itching, and temporary thickening of the skin may last for days or weeks. 

Dermatitis of Hands and Feet

Dermatitis of the hands and feet includes a group of disorders in which the hands and feet are frequently inflamed and irritated.

Dermatitis of the hands results from repetitive tasks and contact with chemicals. Dermatitis of the feet results from the warm, moist conditions in socks and shoes. Dermatitis may make the skin of the hands and feet itch or hurt.

Contact dermatitis, one type of Dermatitis of the hands, usually results from irritation by chemicals (such as soaps) or by rubber gloves.

Pompholyx, a long-lasting condition that produces itchy blisters on the palms and sides of the fingers, can also appear on the soles of the feet. The blisters are often scaly, red, and oozing. Pompholyx is sometimes called dyshidrosis, which means “abnormal sweating,” but the condition has nothing to do with sweating.

Fungal infection is a common cause of an eruption on the feet, especially tiny blisters or deep red rashes. Sometimes, a person who has a chronic fungal infection on the feet develops dermatitis on the hands because of an allergic reaction to the fungus.

Atopic Dermatitis

Atopic dermatitis is a chronic, itchy inflammation of the upper layers of the skin that often develops in people who have hay fever or asthma and in people who have family members with these conditions.

People with atopic dermatitis usually have many other allergic disorders.

Many conditions can make atopic dermatitis worse, including emotional stress, changes in temperature or humidity, bacterial skin infections, and contact with irritating clothing (especially wool). In some infants, food allergies may provoke atopic dermatitis.

Atopic dermatitis sometimes appears in the first few months after birth. Infants may develop red, oozing, crusted rashes on the face, scalp, diaper area, hands, arms, feet, or legs. Often, the dermatitis clears up by age 3 or 4, although it commonly recurs.  In older children and adults, the rash often occurs (and recurs) in only one or a few spots, especially on the upper arms, in front of the elbows, or behind the knees.

Although the colour, intensity, and location of the dermatitis may vary the rash always itches. The itching often leads to uncontrollable scratching, triggering a cycle of itching-scratching-rash-itching that makes the problem worse. Scratching and rubbing can also tear the skin, leaving an opening for bacteria to enter and cause infections.

For unknown reasons, people with long-term atopic dermatitis sometimes develop cataracts in their 20s or 30s. In people with atopic dermatitis, herpes simplex, which usually affects a small area and is mild, may produce a serious illness with eczema and high fever.

Nummular Dermatitis

Nummular dermatitis is a persistent, usually itchy rash and inflammation characterized by coin shaped spots with tiny blisters, scabs and scales.

The cause isn’t known. Nummular dermatitis usually affects middle-aged people occurs along with dry skin, and is most common in winter. However, the rash may come and go without any apparent reason.

The round spots start as itchy patches of pimples and blisters that later ooze and form crusts. The rash may be widespread. Often, spots are more obvious on the backs of the arms or legs and on the buttocks, but they also appear on the torso.

Seborrheic Dermatitis

Seborrheic dermatitis is an inflammation of the upper layers of the skin, causing scales on the scalp, face, and occasionally on other areas. Seborrheic dermatitis often runs in families, and cold weather usually makes it worse.

Seborrheic dermatitis usually begins gradually, causing dry or greasy scaling of the scalp (dandruff), sometimes with itching but without hair loss. In more severe cases, yellowish to reddish scaly pimples appear along the hairline, behind the ears, in the ear canal, on the eyebrows, on the bridge of the nose, around the nose, and on the chest. In newborns less than one month old, seborrheic dermatitis may produce a thick, yellow, crusted scalp rash (cradle cap) and sometimes yellow scaling behind the ears and red pimples on the face. Frequently, a stubborn diaper rash accompanies the scalp rash. Older children may develop a thick, tenacious, scaly rash with large flakes of skin.

Stasis Dermatitis

Stasis dermatitis is a chronic redness, scaling, warmth and swelling (inflammation) on the lower culminating in dark brown skin.

Statis dermatitis results from pooling of blood and fluid under the skin, so it tends to occur in people who have varicose veins and swelling (edema)

Statis dermatitis usually occurs on the ankles. At first, the skin becomes reddened and mildly scaly. Over several weeks or months, the skin turns dark brown. The underlying pooling of blood often is ignored for long periods, during which the swelling increases as does the possibility of infection and eventual severe skin damage (ulceration).

Localized Scratch Dermatitis

Localized scratch dermatitis (lichen simplex chronicus, neurodermatitis) is a chronic, itchy inflammation of the top layer of the skin. It causes dryness, scaling, and dark, thickened patches that have oval, irregular, or angular shapes.

The cause is unknown, but psychological factors may play a role. The condition doesn’t seem to be allergic. More women than men have localized scratch dermatitis, and it’s common among Asians and Native Americans. It usually develops between ages 20 and 50.

Localized scratch dermatitis can occur anywhere on the body, including the anus (pruritus ani) and the vagina (pruritus vulvae). In the early stages the skin looks normal, but it itches. Later, dryness, scaling, and dark patches develop as a result of the scratching and rubbing.

Tips to control dermatitis / Eczema

Use mild herbal products on the skin

Harsh chemicals like detergents cause allergies and dermatitis may occur in the process. It is always advisable to treat the skin gently and use only mild herbal products for the skin. Look closely at commercial washing powders, shampoos and skin care products. Many of these products contain petrochemicals, and artificial aroma agents. Many baby products are bases on petroleum.

Avoid scratching the skin

Scratching the skin whenever it itches sets up a vicious cycle of scratch and itch. It is best to control violent itching by the application of a soothing lotion. Vigorous scratching may lead to tear or breakage of the skin which then paves the way for further bacterial infection. 

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