Eczema, which runs with itching, redness, dryness and from time to time weeping, is a common skin disease that can seriously affect quality of life. It is not a single disease; it encompasses a group of skin conditions that run with similar symptoms. Eczema treatment requires correct diagnosis, the management of triggers and a holistic approach that supports the skin barrier. When managed correctly, the symptoms can largely be brought under control.
What is eczema?
Eczema (dermatitis) is a disease that runs with inflammation of the skin and in which itching is usually at the forefront. The weakening of the skin barrier leads to the skin losing its moisture and becoming more defenceless against external factors; this starts the vicious cycle of redness, dryness and itching.
Eczema has different types. Atopic eczema usually starts in childhood and is associated with an allergic predisposition. Contact eczema arises from the skin's contact with an irritating or allergic substance. Besides these, there are also different eczema types. Treatment varies according to the type of eczema.
Eczema is not a contagious disease. It can show a chronic course; it progresses with periods of flare-up and calming. For this reason treatment aims not only to clear the flare-up but also to protect the skin in the long term.
What are the symptoms?
- Intense itching (often the most bothersome symptom).
- Redness and an inflamed appearance.
- Dryness, flaking and cracks.
- Weeping and crusting in some periods.
- Thickening and hardening of the skin over time.
The location and severity of the symptoms vary according to the type of eczema and the person. Scratching the skin because of itching can worsen the symptoms further and increase the risk of infection. For this reason, bringing the itching under control is an important goal of treatment.
Causes and triggers
In eczema, genetic predisposition, the structural features of the skin barrier and immune-system responses play a role. When environmental triggers are added on top of this, the symptoms flare up. Determining the triggers is one of the most important steps of treatment.
Among the frequent triggers are harsh soaps and detergents, hot water, sudden changes of temperature and humidity, sweat, some fabrics (for example wool), stress and person-specific allergens. These triggers are not the same in everyone; for this reason a personalised evaluation is needed.
Avoiding triggers alone can provide a marked reduction in symptoms. That is why eczema management includes adjustments of lifestyle and skin care as much as medication.
How is it diagnosed?
Eczema is diagnosed by a detailed dermatological examination and the evaluation of the person's history. The distribution of the symptoms, the age of onset and the course are important. When contact eczema is suspected, further tests (such as a patch test) can come onto the agenda to determine the triggering substance.
Correct diagnosis directly affects treatment; because eczema can be confused with similar-looking diseases such as psoriasis and fungal infection. A wrong diagnosis can lead to wrong treatment and worsening of the symptoms. For this reason persistent itching and redness must definitely be evaluated.
The treatment approach
The basis of eczema treatment is repairing and protecting the skin barrier. For this reason regular and ample moisturising is an indispensable part of treatment. The correct use of a moisturiser reduces flare-ups and increases the skin's resistance.
During flare-up periods, topical treatments recommended by the physician can be used to bring the inflammation and itching under control. In severe cases additional treatments may be needed. Treatment is always planned according to the person, the type and severity of the eczema.
The aim of treatment is to bring flare-ups under control quickly, reduce itching and lengthen the time between flare-ups. Since eczema is a chronic disease, a long-term protection and care plan is of great importance.
In eczema a healthy skin barrier is the basis of everything; regular moisturising is most of the time the strongest treatment.
Skin care and lifestyle
The care of eczema skin should be gentle. Instead of harsh soaps, mild cleansers that do not dry the skin should be preferred; the bath should be with lukewarm water and kept short. Applying a moisturiser after the bath while the skin is still damp helps preserve the moisture.
Avoiding irritating fabrics, preferring cotton clothing and staying away from known triggers reduces flare-ups. Keeping the nails short helps prevent skin damage due to itching.
It is known that stress can trigger eczema; for this reason stress management also indirectly contributes to skin health. Eczema management requires a holistic lifestyle approach.
Frequently asked questions
Does eczema go away? In some types, especially childhood eczema, the symptoms can decrease over time. In chronic types, although the disease does not completely disappear, it can be kept under control for a long time with correct management and a comfortable skin can be achieved.
Is it contagious? No, eczema is not a contagious disease. However, secondary infections can develop in itchy and damaged skin; in this case additional treatment may be needed.
How often should I use a moisturiser? In eczema, moisturising should be continued regularly even when there is no flare-up. In most people, application at least several times a day and especially after the bath is recommended; the frequency is determined according to the condition of the skin.
Living with eczema: practical recommendations
Since eczema is a chronic disease, learning to manage it is an important part of treatment. Recognising the factors that trigger flare-ups and arranging the daily routine accordingly can markedly reduce the frequency and severity of symptoms. In this respect eczema management begins with the person getting to know their own skin.
Regularity is essential in daily skin care. Continuing moisturising not only during flare-up periods but also when the skin is well keeps the barrier strong and delays new flare-ups. In the choice of moisturiser, fragrance-free, additive-free, skin-soothing products should be preferred.
The choice of clothing is also important. Woollen and synthetic fabrics can increase itching in some people; cotton and breathable fabrics are usually more comfortable. Washing newly bought clothes before first use can prevent residual substances from irritating.
Bathing habits also make a difference in eczema. Very hot and long baths dry the skin; instead, lukewarm and short showers should be preferred. Applying a moisturiser after the bath while the skin is still damp, before it dries completely, helps trap the moisture in the skin.
Coping with itching is one of the most challenging issues in eczema. Although scratching provides momentary relief, it irritates the skin and feeds the vicious cycle. Keeping the nails short, applying a cold compress and using the treatments recommended by the physician regularly help in controlling the itching.
Seasonal changes also affect eczema. Dry and cold winter air and hot days with excessive sweating can lead to flare-ups in different people. Adapting skin care to the season provides a more balanced skin throughout the year.
All these measures give the best result when combined with medical treatment. When eczema is managed together with correct information and regular care, it can turn into a controlled condition that does not restrict daily life.
At the clinic of Dr. Burcu Çelen, eczema treatment is carried out with a personalised plan based on correct diagnosis, trigger management and support of the skin barrier. You can make an appointment to evaluate your itching and redness complaints.