Eczema - Causes, Symptoms, How To Treat?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Eczema: causes, symptoms, how to treat?

Content:

• Types of eczema
• Causes of eczema
• Symptoms of eczema
• Answers to popular questions
• How can a doctor help?
• How is eczema treated?

Eczema is a dermatological disease characterized by skin rashes in the form of papules with serous contents, edema and itching of the affected skin. It can take place in a dry and weeping form, it is characterized by polymorphism of manifestations in the form of a rash. The inflammatory process in eczema is of an allergic nature, but the causes of the disease can be different - prolonged contact of the skin with an allergen, metabolic disorders, pathologies of the nervous and endocrine systems. Therefore, in the treatment of eczema, complex therapy is used, which is prescribed by the doctor individually for each patient.

Eczema can take place in acute and chronic form, has a cyclical development with periods of remission, recurrence of the disease is often found. Skin rashes and associated discomfort not only spoil the patient's appearance and give him discomfort, but can significantly worsen his psychological state. Given the neuro-allergic nature of the disease, this only aggravates the pathological process, slowing down recovery. Treatment measures include different therapeutic areas, from which the most effective for each individual case are selected.

Types of eczema

Eczema belongs to idiopathic diseases, the causes and mechanism of its development are not fully understood, while there is a group of factors that can provoke a certain type of eczema. Diseases such as vegetative-vascular dystonia, varicose veins, diabetes mellitus, dysfunction of the thyroid gland, pathology of the digestive system against the background of psycho-emotional stress and hereditary predisposition can provoke eczema.

• Idiopathic or true eczema is characterized by spontaneous eruptions for no apparent reason, the trigger for the disease is contact with allergens, chemically aggressive substances against the background of increased sensitization of the body. For idiopathic eczema, such manifestations as papules with serous contents, weeping erosions, crusts and scales are characteristic, and all of them can be present on the skin at the same time, which is a characteristic symptom of this type of eczema. Another feature of true eczema is the symmetry of the rash (if one hand is affected, the same skin rash is usually present on the other). The disease is characterized by seasonality with exacerbations in the autumn-winter period.
• Children's eczema - the disease affects infants, begins with the face, from where it gradually passes to the neck, chest and limbs. It often affects infants who are bottle-fed and children who have a genetic predisposition to developing bronchial asthma and other atopic diseases.
• Seborrheic eczema - it is provoked by fungi that parasitize the scalp. In addition, seborrheic eczema can affect areas of the skin where a large number of sebaceous glands are located - the face, axillary region, shoulder blades. The disease proceeds without a weeping stage, characterized by nodular eruptions with scales, flaking and crusting (how is oily and dry seborrhea treated?).
• Atopic eczema is typical for people prone to allergic reactions. Manifestations in the form of bubbles, skin edema and hyperemia occur after contact with an allergen.

• Occupational eczema is common among workers in chemical plants, cleaners and those who are in constant contact with household chemicals, formaldehydes, and dyes. The disease begins with lesions of the skin of the hands, since it is most often exposed to chemical irritants, after which it moves to other parts of the body.
• Microbial eczema - occurs on areas of the skin with inflammatory processes that are the result of a microbial or fungal infection. The main focus of the disease is an area of the skin with wounds, trophic ulcers and fistulas, where greenish or yellow crusts are formed. If the crusts are damaged, a weeping red surface opens up, which can grow from the periphery.
• Varicose eczema - poor circulation and venous congestion in tissues can lead to skin rashes on the lower extremities. More often affects older women, people with cardiovascular pathologies, overweight. Other symptoms are darkening of the epidermis, red spots and irritations on the skin, the presence of non-healing wounds on the legs.

• Dyshidrotic eczema - occurs as a result of a violation of the activity of the sweat glands and neuroendocrine regulation. Often appear in people with hyperhidrosis of the feet and palms, as well as in those who, by virtue of their profession, constantly have contact with chemically aggressive substances. Rashes begin with the hands, appear on the lateral surfaces of the fingers, and then move to other parts of the body. They arise spontaneously after severe stress or in the hot season when the body overheats, spontaneously pass if there are no complications in the form of a secondary infection (for more details: dyshidrotic eczema on the fingers).

Causes of eczema

Due to the fact that eczema is an idiopathic disease, it is difficult to indicate the exact cause of its occurrence. However, there are a number of predisposing factors, including:

Endogenous causes of eczema:

• Digestive disorders (pancreatitis, flatulence, dysbiosis, hepatitis) and evacuation (diarrhea, constipation);
• Kidney dysfunction, nephrosis;
• Hereditary predisposition to atopic diseases;
• Angiovegetative neuroses;
• Neuroendocrine pathologies, and many others.

Exogenous causes of eczema:

• Skin exposure to allergens, synthetic and harsh chemicals such as oil products, acids, alcohols, phenols and other irritants;
• Exposure to ultraviolet radiation, hypothermia, overheating and other climatic changes;
• Injury to the skin and, in particular, peripheral nerves;
• Allergic reaction to pharmaceuticals such as benzylpenicillin, novocaine and others.

All these factors create a situation in which the skin becomes hypersensitive to the effects of physical, chemical and other irritants.

Often the following pathologies also contribute to the occurrence of eczema:

• Lack of omega-6, omega-3 polyunsaturated fatty acids;
• Renal dysfunction;
• Avitaminosis, in particular - vitamin B6 deficiency;
• Parasitic infestations - in children, helminthic infestations with pinworms are often found, while in adults, disorders of vitamin absorption and sensitization occur due to infection with pinworms.
• Inflammatory diseases of the pancreas and gallbladder;
• Immunity disorders, both congenital and acquired (AIDS).

Eczema most often appears on the skin for no apparent external cause. This phenomenon provides a functional and metabolic connection between the skin and internal organs. With food, many toxins enter the body, which are normally excreted in the feces or processed by the liver. If these organs fail, the skin takes over the excretion of metabolites. Over time, poisons constantly passing through the integument destructively affect the epithelium, which is expressed in the form of eczema.

Symptoms of eczema

This skin disease is characterized by the following general symptoms:

• Erythema - redness of the skin that determines the affected area.
• Papules are pink-red nodules that rise above the surface of the erythema.
• Vesicles - papules in the process of inflammation are filled with serous fluid.
• Pustules are vesicles, the contents of which become cloudy and accumulate pus.
• Erosion (depressions) arising at the site of burst pustules and vesicles.
• Hair loss in erythematous areas.
• The appearance of dry crusts at the site of dried erosion.
• Exfoliation of crusts and covering of new, pathologically restored skin with scales and dry plates from the stratum corneum of the epithelium.

Symptoms of the different types of eczema:

The rashes are located on areas of the body not covered by clothing - arms, neck, face. The main difference from other types is the symmetry of the location of papular and vesicular rashes. The acute stage of the disease begins with the appearance of small vesicles, which, as the pathology progresses, can merge with each other or burst, leading first to point erosion, and then to skin lichenification.

The first stage of the pathological process is characterized by swelling and hyperemia of the skin, after which bubble rashes appear on the affected areas. After the rupture of the bubbles, the third stage of the disease begins - weeping eczema. Further, the skin around the areas with rashes peels off, becomes dry and becomes covered with crusts and scales. During the transition to the chronic stage, the main symptom that worries patients is severe itching.

At an early stage of the disease, all negative manifestations affect only the areas of the body exposed to the irritating factor, after which the rash spreads to other areas of the skin. Most of the symptoms are similar to those of true or idiopathic eczema.

The disease is provoked by excessive multiplication of microorganisms in the area of non-healing wounds on the skin surface. Localization of skin rashes - around burns, ulcers and wound surfaces. At an early stage of the disease, the affected area begins to peel off and flake off with scales on one side, accumulation of exudate and the formation of crusts is possible. Moreover, this form of eczema is not characterized by the presence of pronounced itching.

This variety is localized on the palms and soles, characterized by itching, burning, the appearance of dense bubbles in the thickness of the epithelium, and very weak erythema. The accession of a fungal or bacterial infection also causes an increase in the nearby lymph nodes (for more details: symptoms of dyshidrotic eczema on the fingers).

A coin-shaped variety of eczema, so named due to the fact that the redness has a well-defined round shape. In these erythematous areas, scales, papules, vesicles and other characteristic manifestations of eczema may appear.

A form of microbial eczema that affects various skin folds: inguinal, axillary, under the mammary glands and others. It differs from other forms in strong redness and cracks in the depths of the folds.

It is localized mainly in areas with dense sebaceous glands - the scalp, face (chin and under the nose), armpits, groin. It manifests itself in the form of multiple small and large plaques of a pale yellow color (in more detail: treatment of seborrhea at home - 6 most effective recipes).

The rash appears on the inside of the arms and legs. Has the following features. Small nodules and blisters that itch do not open without lichenification of the skin against the background of scratching.

It is widespread in women during menopause. Symptoms: thickening (hyperkeratosis) of the skin of the palms and heels, painful deep and superficial cracks, itching. Wetness, severe redness, vesicles practically do not occur with horny eczema.

Occurs in cases of varicose veins, complicated by the formation of trophic ulcers or skin hardening. Symptoms are lower leg lesions that resemble classic microbial eczema.

It is accompanied by itching and periodic wetness, manifests itself on the skin of the hands or nails in the presence of a fungus, it is observed on the feet.

Appear after a nipple injury during breastfeeding or due to scabies. Symptoms: redness, the presence of crusts, scales, cracks and wet areas (on the topic: 10 mistakes that nursing mothers make during breastfeeding).

The manifestation of the first symptom is a temporary period from 3 to 6 months of the child's development. This is true, seborrheic or microbial eczema. Symptoms: symmetry of the lesion, indistinctness of the borders, reddened, weeping skin, the presence of crusts and scales at first. From the beginning, the lesion is local in the cheeks and forehead area, then spreads to the scalp, limbs and trunk. It is observed up to two years after which it regresses or transforms into folded or other eczema. Scientists agree that the development of childhood eczema is affected by a change in the flora of the child's intestines.

Answers to popular questions

What treatment can a doctor prescribe?

First of all, it is necessary to clearly understand that eczema can be treated only after a complete medical diagnosis of the patient's condition. This is due to the fact that several other severe skin diseases have similar symptoms. Incorrect self-diagnosis often leads to the fact that patients with eczema independently begin to take medications and carry out procedures that only aggravate their condition.

Based on the current situation, the doctor can decide on the sequential treatment of the symptoms and the cause of the disease, or a simultaneous complex effect. Most often, they begin with symptomatic therapy, as this gives time for the most accurate determination of the cause of the disease and improves the moral and physical condition of the patient.

• Anti-allergic medications are prescribed for itching;
• To slow down the development of eczema and eliminate foci of skin lesions on the extremities, compresses with boric acid are used;
• B vitamins help the skin to regenerate, therefore, contribute to a speedy recovery and are almost always prescribed as part of a complex therapy for eczema;
• To accelerate the filtration of blood (if one of the causes of eczema is a specific toxicant substance, or littering with various salts), diuretics are widely used.
• If eczema causes complications, such as an excessive increase in the area of skin lesions, acute painful sensations during natural movements or lack of response to treatment, systemic agents are used - corticosteroids in tablets or injections and cytostatics.

What can the patient do himself?

Patients with eczema can independently determine the circumstances in which negative symptoms of the disease are aggravated - this may be the intake of certain foods, contact with pets, dust pollution, pollen, household chemicals, etc.

In order to prevent varicose eczema, it is necessary to carefully monitor any wounds, abrasions, ulcers on the skin. Wearing compression underwear, physiotherapy exercises and any measures aimed at strengthening blood vessels also help prevent exacerbations of varicose eczema.

It is recommended to use medicinal cosmetics and moisturizers during daily skin care, which restore the barrier properties of the epidermis and reduce sensitization.

Since in most cases eczema develops against a background of nervous disorders, it is necessary to observe the daily regimen and, if possible, avoid stressful situations and psychoemotional stress.

Good results as a part of complex therapy are provided by spa treatment, visiting mud springs, halotherapy, thalassotherapy. In some cases, laser therapy, herbal medicine and folk recipes help to achieve improvement.

What should you abstain from?

People with eczema should follow a special diet, limiting themselves to foods that can trigger an allergic reaction. These include baked goods, cream cakes, fatty meats, red berries (raspberries, strawberries, cherries), and vegetables. Allergic reactions often occur after ingestion of citrus fruits, chocolate, honey, canned food and pickles.

The diet of a patient with eczema should contain unprocessed cereals, plant foods rich in fiber, kefir and other low-fat fermented milk products. Take food in fractional portions at least five times a day. The amount of liquid per day should not exceed two liters, it is recommended to drink alkaline mineral waters and vegetable juices.

Good results in exacerbations of eczema are given by fasting days, fasting for two days and a salt-free diet for three days.

In addition to hygienic purposes, water procedures are contraindicated for patients with eczema; situations in which the body overheats, for example, going to the sauna, should also be avoided.

How can a doctor help?

If you find any signs of eczema, see your dermatologist right away. It is difficult to make an accurate diagnosis of eczema as its manifestations are very similar to those of other diseases.

Eczema can be confused with contact dermatitis. Contact dermatitis is a reaction of the skin to external stimuli such as perfume or cream.

When you come to the doctor, he will ask simple questions: what have you been ill with before, what are your complaints?

Your doctor can also help you identify sources of irritation, as often the same symptoms can appear when using a new shower gel or soap.

Don't be surprised if a dermatologist asks you about your emotional state or your relationships with others at work or at home, as excitement and stress can also lead to eczema.

How is eczema treated?

Treatment of eczema is a long-term process, as the disease often goes from an acute form to a chronic one and tends to relapse and exacerbate. The composition of complex therapy for eczema depends on the individual characteristics of the patient, his age and the effectiveness of previous treatment, as well as on the type of eczema, the magnitude and severity of the inflammation.

For the treatment of eczema, pathogenetic therapy means are used - a set of therapeutic measures aimed at restoring the normal function of damaged organs, increasing immune reactivity and the body's resistance to the effects of negative environmental factors. In addition, medical procedures are prescribed to reduce the sensitization of the body, these include blood transfusion, hirudotherapy, autohemotherapy and others. The doctor can prescribe a course of biostimulants injections, the most common drugs are the placenta and aloe extract.

A severe form of eczema is treatable with plasmapheresis, hemosorption and enterosorption.

If the neurological component of the disease is strongly pronounced, the doctor prescribes drugs that correct the disorders - herbal sedatives (Persen, Sedasen, Novopassit, Valerian), sodium bromide and bromcamphor for internal use, tranquilizers in a small dosage (Chlozepid, Phenozepam) for up to 10 days.

Enterosorbents

For the treatment of eczema, enterosorbents are used - drugs that reduce the intoxication of the body by absorbing and binding toxic substances. Popular means of this group are Polysorb, Multisorb, Atoxil, Enterosgel and Polyphepan, the course of their intake is 10 days.

Calcium chloride and sodium thiosulfate are prescribed intravenously, calcium gluconate - by intramuscular injections;

Mycotic eczema is treated with a solution of hexamethylenetetramine.

Hormone therapy

Hormonal agents are used with caution, in short courses and only under the supervision of a doctor, since uncontrolled use leads to serious complications - an aggravation of the inflammatory process, a decrease in immune defense, an exacerbation of chronic diseases, an infectious process.

For minor skin lesions with eczema, hormonal ointments and other topical agents can be dispensed with. Oral drugs are prescribed for a generalized inflammatory process for a course of 10 to 15 days - dexamethasone, corticotropin, triamcinolone, prednisolone.

Vitamin therapy

Vitamins can be used in the treatment of any type of eczema, as they prevent the development of allergic reactions and reduce inflammation, help accelerate the regeneration of damaged skin. Vitamin E oil solution has an antioxidant effect, improving the absorption of omega-3 and omega-6 fatty acids, metabolic disorders of which can provoke eczema.

Vitamin therapy also includes folic, ascorbic and niacin, injections of B vitamins.

Antihistamines

Antihistamines can be used for any type of eczema; the formulation and form of administration varies depending on the course of the disease. In the acute stage of eczema, promethazine, chloropyramine and diphenhydramine are prescribed. When the inflammation decreases and the disease becomes less severe, the same drugs are taken in tablet form.

In addition, the following antihistamines are used in the treatment of eczema - Ketotifen, Clarisens, Cetrin, Kestin, Lordestin, Zodak.

Immunomodulators

When eczema passes from an acute form to a chronic one, patients with impaired immunity can take immunomodulatory agents under the supervision of the attending physician. Immunomodulators are taken with caution to avoid complications; they cannot be used in the acute stage of the disease.

The drugs in this group are phagocytosis stimulants (Likopid, Polyoxidonium), Timomitetics (Timalin, Immunofan), as well as Plazmol, humisol solution and placenta extract.

With dysbacteriosis, indigestion

With inflammation of the pancreas, gastroduodenitis and other pathologies of the digestive system, the doctor prescribes enzyme preparations, bile salts, pepsin (Enzistal, Creon, Pancreatin, Gastenorm and others) as part of complex therapy, as well as drugs that restore intestinal normal flora (Lactobacterin, Bifiform, Khilak Forte).

With microbial eczema

Microbial eczema is treated by destroying its pathogen, so it is best to take a smear before starting the appropriate therapy to determine the type, strain and degree of resistance of the microbe to antibiotics. Armed with this information, the doctor will most likely prescribe the correct treatment the first time, and the drugs used by the patient from the series of macrolides, cephalosporins, aminoglycosides and fluoroquinolones will stop the spread of eczema.

Laboratory testing can also show the presence of fungal organisms. To get rid of them, antifungal ointments and topical creams or tablets of appropriate drugs are prescribed.

Local drug therapy of microbial eczema includes a wide range of drugs of various dosage forms: powders, solutions, pastes, creams, ointments. The choice of the necessary medication is carried out by the doctor based on the type of eczema, the degree of spread, localization and severity of the skin lesion.

Various cortical formations and pustules are covered with such means:

• Dyes: brilliant green, methyl violet, gentian violet.
• Aerosols and creams: panthenol, polcortolone, levovinisole.
• Lotions with solutions of resorcinol or ethacaridine lactate.

Limiting the area of damage to eczema of certain parts of the body allows the use of more concentrated and potent drugs that can quickly stop itching and stop the development of the disease.

They are fixed on the skin with lotions and bandages:

• Lead water;
• Resorcinol solution 1%;
• Copper or zinc sulfate (sulfate) 0.1%;
• Burov's fluid;
• Silver nitrate 0.25%;
• Menthol solution 0.5-1%;
• Citric acid 1%;
• Diphenhydramine paste;
• Specialized anti-eczema podophyllin ointment for hands.

Eczema in the acute stage is stopped with the help of various powders:

• White clay powder;
• Zinc oxide;
• Wheat starch.

They contribute to the subsiding of the pathological process, after which the time comes for the use of the above-mentioned external agents, as well as additional ointments and pastes:

• Zinc paste;
• Lassar pasta;
• Naftalan paste
• Ichthyol and boron-zinc pastes.

For specific indications and a doctor's prescription, corticosteroid ointments can be used:

• Elokom;
• Skin Cap (contains a powerful corticosteroid, although this is not mentioned in the instructions);
• Advantan;
• Flucinar;
• Celestoderm.

With regard to microbial eczema, the best option would be to use hormonal ointments with antifungal agents, antibiotics and antiseptics in the composition:

• Trimistin;
• Travocort;
• Kremgen;
• Celestoderm with garamycin;
• Lorinden S.

On the subject: Treatment of eczema with folk remedies - 7 effective remedies

Physiotherapy procedures

There are many different types of physiotherapy that are used to treat eczema.

With their help, the most significant effect in the treatment process is achieved, although for each case you have to look for the most suitable of the tested methods:

• Paraffin applications;
• Reflexology with needles;
• Laser correction;
• Ozone therapy - injections, ozone chambers;
• Mud baths;
• Sunbathing (UV radiation);
• Ultrasonic treatment;
• Galvanization;
• Electrosleep;
• Diadynamic therapy;
• Radon and mineral baths;
• Aerotherapy;
• Inhalation with diphenhydramine.

Diet therapy

A diet for eczema is necessary in the process of treatment and for prevention, since there are a number of studies proving the direct involvement of the digestive system in provoking this disease (more about the diet for eczema).

According to many modern doctors, constant irritation of the stomach and intestines affects the health of the skin, so a patient with eczema needs to deny himself fried, spicy, smoked and spicy foods, high protein foods (including egg), canned food, sausage products as well as chocolate, coffee and, of course, alcohol.

Patients with eczema note that when switching to a diet of vegetable and fermented milk products (cereals, vegetables, fruits, herbs, cottage cheese, milk, cream), there is a significant weakening of the symptoms of the disease.

Anti-relapse treatment and prevention of exacerbations

When remission is achieved, eczema treatment does not stop. Additionally, a course of histoglobulins is prescribed, as well as emphasis on observing individual hygiene. It is also important to respond quickly to the appearance of intercurrent diseases, the surgical treatment of which is necessary to prevent the recurrence of eczema. The remission of the disease is prolonged by diet, and it is imperative to protect damaged skin from the effects of ultraviolet radiation, frost, moisture, harsh chemicals and injury.

The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist

Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).