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Eczema is inflammation of the skin characterized by dry, itchy, red, vesicular and crusting patches. It is usually localized and can lead to bleeding if scratched excessively. Atopic dermatitis is the most common form of eczema. This skin condition is non-contagious. It often starts during infancy and can continue through one’s adult life as well. Contact dermatitis is a type of eczema that occurs as a result of contact with irritants or allergens.
Causes and triggers
The cause of eczema is unknown but is thought to be a combination of genetic and environmental factors. Atopic dermatitis is linked with a dysfunctional immune response. It has a genetic cause too. History of atopic dermatitis amongst family members and allergy are considered to be two main causes of this disease. Urbanization and improved quality of life has caused an increased incidence of eczema. Exaggerated care/over-protection of children against dust can predispose them to develop this disease.
Various factors can aggravate the condition. Substances that irritate the skin are the most common triggers. Flares can also be triggered by certain conditions that affect the immune system and by actions and environments that irritate the skin. Some of the triggers are:
- Dry skin
- Excessive sweating
- Low humidity
- Solvents, soaps or detergents
- Quick changes in temperature
- Long, hot baths
- Certain foods such as eggs, milk, fish, soy or wheat, shell-fish, etc.
Eczema causes dryness and recurring skin rashes on any area of the skin, usually on the hands, neck, face, and legs. The cheeks and areas near the lips are affected first in infants. Later, it may get localized to the hands and legs. Some of the signs and symptoms are:
- redness of the skin
- intermittent itching that becomes worse by night
- abrasions and scaring due to vigorous scratching
- small, raised bumps which leak fluid and form crust when scratched
Eczema has often been associated with the following conditions:
- Viral (herpes simplex), bacterial and fungal infections
- Allergic conjunctivitis, eyelid dermatitis (blepharitis), etc.
- Early onset of atopic dermatitis in children makes them susceptible to allergic rhinitis or asthma at a later age.
There is no diagnostic test for eczema. Diagnosis is based on physical examination and visual inspection. Family history may also be elicited. Serum IgE levels may found to be elevated. Hence a blood test to check eosinophil cell count can help to support the diagnosis. Patch tests can be done to determine to the allergen in allergic contact dermatitis.
There is no complete cure for eczema. Treatment is aiming at reducing inflammation and relieving itching. A systemic, prolonged approach must be used to keep the disease in control.
- Avoid or eliminate aggravating factors. Monitor the diet and create a skincare regime.
- In mild cases, treatment is typically with moisturizers. A good moisturizer helps conserve the skin’s natural moisture and provides adequate hydration.
- In moderate to severe cases, steroids may be used along with moisturizers to control the flare.
- Topical immunosuppressants, calcineurin inhibitors, are used in the treatment of severe atopic dermatitis which does not respond to steroids.
- When the eczema is severe and does not respond to other treatments, oral immunosuppressant medications such as cyclosporine and methotrexate are used.
- Antibiotics may be used when a bacterial infection develops
- Light therapy using ultraviolet light may be used along with other modalities to treat moderate to severe eczema.
- Eczema is known as Vicharchika in Ayurveda. It is caused due to the impairment of all the three doshas – vata, pitta and kapha. The pitta impaired vicharchika due to impairment of digestion and aggravation of pitta dosha is the most common. There is accumulation of ama (toxins) which manifests in the skin and causes eczema. Treatment involves soothing pitta by enhancing the body’s digestion, and by cleansing the body of accumulated toxins. Several herbs are used to treat the symptoms. The underlying cause is treated with elaborate process to purify the blood. Some of the methods are Panchakarma (to improve the blood), Snehana (smoothen skin), Sarvang Abhanga (whole body oil massage), Swedana (induce sweating to remove toxins), Virechana (purgation) etc.1, 2
- Homeopathic remedies have been used to frequently relieve or eradicate eczema. They can help get to the seat of the problem and to deal with it. Various remedies are used depending on the symptoms. Some of the commonly used remedies are Sulfur, Arsenicum album, Calcarea Carbonica, etc.
- According to traditional Chinese medicine good health is a balance between the body’s internal systems and the outside environment. An imbalance between these energy results in diseases. Eczema is caused by wind, dampness and heat. It is treated with herbal medicines and acupuncture.
1. Pallavi Hegde, D T Hemanth, S V Emmi, M P Shilpa, Pradeep S Shindhe, Y M Santosh A case discussion on eczema Int J Ayurveda Res. 2010 Oct-Dec; 1(4): 268–270. doi: 10.4103/0974-7788.76792 PMCID: PMC3059451
2. Kaur M, Chandola H. Role of Virechana Karma in cure and prevention of recurrence of Vicharchika (Eczema). Ayu. 2012 Oct;33(4):505-10. doi: 10.4103/0974-8520.110526. PubMed PMID: 23723667; PubMed Central PMCID: PMC3665194.
3. Witt CM, Lüdtke R, Mengler N, Willich SN. How healthy are chronically ill patients after eight years of homeopathic treatment?–Results from a long term observational study. BMC Public Health. 2008 Dec 17;8:413. doi: 10.1186/1471-2458-8-413. PubMed PMID: 19091085; PubMed Central PMCID: PMC2630323.