Eczema or atopic dermatitis is a chronic skin condition that caused skin to become dry, itchy, red and bumpy. It is highly prevalent skin disease affecting 1 in 10 people in their lifetime. It is very common in infancy with age of onset as early as in the first 2 months of life. 60% of patient will have it in the first year of life, 30% by age of 5 and 10% between the age of 6 and 20 years. Rarely atopic dermatitis has on adult onset. Some children get improvement of their eczema as they grow but some may continue to suffer eczema throughout their adult life.
The cause of eczema are multifactorial involving genetic, immune system and environmental factors that cause disruption of the skin barrier. Other external factor such as seasonal change (worse in winter, better in summer), clothing (wool), emotional stress, pets, carpets, smoke, dust, pollens and bedding (from house dust mites) can also trigger eczema. Food allergies are also very common in younger eczema patient especially to highly allergenic foods such as eggs, dairy, nuts and soy.
Eczema is related to atopy, in which your body have the tendency to produce an exaggerated immune response to otherwise harmless substance in the environment. It is related to other hypersensitivity disorders such as allergic rhinitis (hay fever), asthma and allergic conjunctivitis.
Clinical pictures of skin with eczema are dry, reddish, scaling and sometimes with crusts and painful cracks ('fissures'). Long term, the skin can become thickened ('lichenification'). Skin of eczema patient often easily infected due to constant scratching and broken skin barrier by infections such as Staphylococcus Aureus and Herpes which then precipitate severe eczema flare. Active infection can lead to much difficulties to keep the eczema under control and severe night time itchiness.
Mainstay of treatment are regular and liberals use of emollients, topical steroids and calcineurin inhibitors, UV phototherapy, immunosuppressive therapy and antibiotic when indicated in the case of secondary bacterial infection. Long term eczema can cause psyhological issue such as depression and poor self-esteem. Eczema is often debilitating to young children’s affecting their growth, developmental milestones, impairing their sleep and school performance if not managed well.
If you or someone you know, suffer from eczema, talk to our doctor today to discuss on the right treatment.