Eczema

Definition

Eczema (also called dermatitis) is a term that refers to several different types of skin swelling. Most types cause dry, itchy skin and rashes on the face, inside the elbows and behind the knees, and on the hands and feet. Scratching the skin can cause it to turn red, swell and itch even more.

The most common type of eczema is atopic dermatitis. It is most common in babies and children, but adults can have it too. As children who have atopic dermatitis grow older, this problem will either get better or go away completely. But sometimes the skin may stay dry and get irritated easily.

Black people are more likely to develop more severe forms of eczema than people of other ethnicities.

Eczema can cause darker brown, purple, or gray patches on Black skin with affected areas that may be swollen, warm, itchy, and dry or scaly.

Many Black people with eczema experience more extensive dryness and dark circles around their eyes than people from other racial backgrounds.

“Although African American adults are slightly less likely to have eczema compared to people of other races, 20% of Black children have eczema, which is almost double the rate found in white, Asian, Native American, and Hispanic children,” according to Healthgrades.

Eczema is not contagious.

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Causes

The cause of eczema is not known. However, it is likely caused by both genetic and environmental factors. 

Eczema is often associated with other allergic diseases such as asthma, hay fever, and food allergy. Children whose parents have asthma and allergies are more likely to develop atopic dermatitis than children of parents without allergic diseases. According to the National Institute of Allergy and Infectious Diseases, approximately 30 percent of children with atopic dermatitis have food allergies, and many develop asthma or respiratory allergies. People who live in cities or drier climates also appear more likely to develop the disease.

Your eczema condition can worsen if you are exposed to certain triggers, such as:

• Pollen, mold, dust mites, animals, and certain foods (for allergic individuals) 
• Cold and dry air 
• Colds or the flu 
• Skin contact with irritating chemicals 
• Skin contact with rough materials such as wool 
• Emotional factors such as stress 
• Fragrances or dyes added to skin lotions or soaps
• Taking too many baths or showers and not moisturizing your skin properly afterward

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Symptoms

Eczema can get better or worse over time, but it is often a long-lasting disease. People who have it may also develop hay fever and asthma.

Although atopic dermatitis (eczema) signs and symptoms vary from person to person, the most common symptoms include:

• Dry skin
• Itching, which may be severe, especially at night
• Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp
• Small, raised bumps, which may leak fluid and crust over when scratched
• Thickened, cracked, scaly skin
• Raw, sensitive, swollen skin from scratching
• Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.

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Complications

Because people with atopic dermatitis have skin that lacks infection-fighting proteins, they are more susceptible to skin infections caused by bacteria and viruses. Fungal infections are also common in people with atopic dermatitis.

Bacterial Infections

A major health risk associated with atopic dermatitis is skin colonization or infection by bacteria such as Staphylococcus aureus. Sixty to 90 percent of people with atopic dermatitis are likely to have staph bacteria on their skin, according to NAID. Many eventually develop an infection, which worsens the atopic dermatitis.

Viral Infections

People with atopic dermatitis are highly vulnerable to certain viral infections of the skin. For example, those that are infected with herpes simplex virus can develop a severe skin condition called atopic dermatitis with eczema herpeticum.

If you have atopic dermatitis, you should not receive the smallpox vaccine, even if you are in remission, because you are at risk of developing a severe infection called eczema vaccinatum. This infection is caused when the live vaccinia virus in the smallpox vaccine reproduces and spreads throughout the body. In addition, if you are in close contact with people who have atopic dermatitis or a history of the disease, you should not receive the smallpox vaccine because of the risk of transmitting the live vaccine virus to the person with atopic dermatitis.

Treatments and Prevention

Though there is no cure, the right treatment plan and medications may reduce your symptoms and help you control the condition.

Treatments for eczema may include medicines, skin creams, light therapy, and good skincare. You can prevent certain types of eczema by avoiding:

• Things that irritate your skin, such as certain soaps, fabrics, and lotions
• Stress
• Things you are allergic to, such as food, pollen, and animals

You should discuss the best treatment plan and medications for your atopic dermatitis with your doctor. However, taking care of your skin at home may reduce the need for prescription medications.

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