Eczema is an inflammation of the skin that causes the skin to become dry, red and often itchy. You may get eczema if the skin’s outer protective layer has weakened or damaged. For example, it may be due to dry skin, abrasion or that you have come into contact with substances that irritate the skin or that you are allergic to. Eczema is not contagious.
How an eczema looks and where on the body it sits depends on the type of eczema you have.
Different types of eczema
The most common types of eczema are the following:
- Atopic dermatitis, also known as flexural eczema.
- Milk eczema, also called seborrheic eczema.
- Contact eczema, which can be either allergic or non-allergic.
- Coin-shaped eczema, also called nummular eczema.
- Leg Eczema.
Eczema is very common in young children, but the problems usually decrease with age. Most people get eczema at some point in their lives. The most common type is milk dermatitis, but contact eczema is also very common. The risk of getting eczema increases if someone close relative has or has had it.
Symptoms of eczema
It is common for the skin to first become red, dry and itchy. The red is better seen on light skin than on dark skin. The red may not be visible on dark skin at all. You may get small blisters and bumps if eczema worsens. The blisters and bumps can crack and fluid and then you get wounds and scabs on the skin.
It can be difficult to avoid itching for eczema and it can cause you to get sores and bleeding. Eczema may become infected. Then the wound fluid can become cloudy and the scabs thicker and yellowish, but it is not always noticeable.
You can get cracks in the skin that hurt. Your skin will become coarser and fold if you have long-term problems.
In the case of atopic dermatitis, the skin becomes dry and scaly. You get rashes that are red, dry, scaly, bumpy and that itch.
In many, eczema begins during the first year of life. The rashes usually get on the cheeks first. Then they can spread to other parts of the body, such as the neck, chest, abdomen and diaper area. Eczema can also be found on the outside of the arms and legs.
It usually scratches a lot, especially at night.
From about two years of age, eczema usually settles more in the kneecaps, arm wrinkles and around the wrists and wrists. The eczema is therefore usually called flexural eczema.
Milk eczema appears as red and scaly skin in places where there are many sebaceous glands. The most common is that the eczema is on the scalp. Other common places are around and in the ears, in the eyebrows, on the nose wings, and on the chest. Sometimes the milk dermatitis can get into the skin folds, such as the armpits and groins. Usually, it does not itch much, sometimes not at all.
Milk eczema can sometimes be difficult to distinguish from psoriasis.
In infants, the spleen may easily be mistaken for atopic dermatitis, but the spleen usually does not itch as much.
Scabies – a type of milk dermatitis in infants
Scabies is common in infants and usually occur during the baby’s first months.
Scab looks like oily, yellow-brown scales in the scalp. It can form yellow-white crusts or coatings if the child has a lot of scarves that are not treated.
In contact eczema, it is common for the skin to redden and itch while forming fluid-filled blisters.
Non-allergic contact eczema usually sits on your hands. It is also called hand eczema or irritant eczema.
Allergic contact dermatitis occurs on the part of the skin that has been in contact with something you are allergic to. The eczema is mostly on the hands. Symptoms on the face and especially around the eyes are common if the substance you are allergic to comes through the air. You can get the substance on your hands and transfer it to the face or other parts of the body.
Coin format eczema
Coin-shaped eczema usually appears on arms and legs as blushing, itchy and scaly patches. The knockouts are round and about the same size as a coin. It is usually people over 50 who get this type of eczema. Eczema is more common in men than in women.
Lower leg eczema is common in varicose veins or leg ulcers. The eczema itches and scales easily. Sometimes the skin may become reddish-brown where the eczema is present. The legs are often swollen. Lower leg eczema is more common in older people.
Things that make eczema worse
There are several things that can aggravate eczema. For example, it could be any of the following:
- Sweating due to hot clothes or physical activity.
- Chemicals such as detergent and soap.
- Dusty environments.
- Water, especially water with chlorine in it.
- Dry and cold winter weather.
- Reduced humidity indoors when the house is heated.
- Stress and poor sleep.
- Diseases, such as colds or an eczema infection.
What can I do for myself?
Lubricate your skin regularly with, for example, a softening cream if you have dry and sensitive skin that easily itches. This reduces the risk of an eczema flare-up.
It is important to lubricate with plasticizers even if eczema has already flared up.
Lubricating the skin relieves the itching and helps the skin maintain its natural protection against external influences. Examples of external effects may be that the skin is exposed to water, abrasion or chemicals such as detergent and soap.
Avoid drying out the skin
Avoid excessive washing with water and soap. Many who have dry skin cannot tolerate bathing or showering more than every other day. Use a mild soap and avoid too much-perfumed products. At the pharmacy, you will find wash cream and shower oil for dry and sensitive skin. Hair spray and hair gel can make it itchy on the scalp.
Avoid substances that irritate the skin
Use unscented detergent and avoid rinse aid. Do not overdose on detergents. It is good to find out if the water is hard or soft where you live to know how to dose. You can inquire at your municipality or search the municipality’s website.
It is also good to wash new clothes before using them so that any chemicals disappear.
Avoid substances that may have triggered eczemas, such as detergents or jewelry containing nickel. You can use plastic gloves when washing dishes or do anything else where you have a lot of contact with water if you have eczema on your hands. You can have cotton mittens underneath to keep your hands dry.
Rinse thoroughly and dry under bracelets and rings after washing your hands. So, soap residues that can irritate the skin disappear.
Don’t be too warm indoors
It’s good not to have too warm indoors. Humidity often decreases when the air in the houses is heated during the winter. Dry and cold winter weather usually causes more problems with eczema.
It can be good to have a cool bed in the bedroom and to use a thin blanket.
Taking cool baths can make it itchy less.
Avoid warm clothing
Avoid dressing too hot as sweating can make it itchy. Woolen clothing can irritate and itch and synthetic clothing can make you sweat easier. Preferably wear cotton clothing closest to the body. There are also other materials that can work well, such as silk and bamboo.
Eczema often gets better from the sun, but you should keep in mind to sunbathe carefully and avoid burning yourself. Skin with eczema is extra sensitive and easily becomes dry and thin.
Try not to itch
It is difficult to avoid itching, and it quickly becomes a habit. But itching causes more itching, makes eczema worse and increases the risk of infection, so it is important to try not to.
Gently pat or massage with skin lotion instead of tearing your nails when itching. Cotton gloves can prevent you from scratching eczema while you sleep. It is also good to keep your nails short cut.
Try non-prescription cortisone
Often treatment with cortisone is needed, which suppresses inflammation and relieves itching. You can try lubricating the skin with non-prescription cream or ointment with cortisone for a week. Cortisone should not be used in children under two years without a doctor’s prescription.
When and where should I seek care?
Contact a health care center if any of the following is true of you:
- You have not improved after a week of treatment for eczema with non-prescription cortisone.
- You have eczema that spreads or looks different, such as fluids.
- Your eczema does not get better by the treatment that usually helps.
- You have eczema around your eyes.
- You have eczema on the lower leg.
- You have a lot of trouble with milk dermatitis.
You can contact many receptions by logging in.
Contact a childcare center, BVC, if a child under the age of six gets eczema.
Eczema can flare up quickly, often in connection with an infection. Then you should seek care directly at a health center or on-call reception. You can get a referral to a skin specialist if needed.
As a patient, according to the Patient Act, you have the opportunity to influence your care.
You can seek care at any medical center or open specialist clinic you want throughout the country. Sometimes a referral to the open specialized care is required.
You should understand the information
In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. For example, you should receive information about treatment options and how long you may have to wait for care and treatment for eczema.
Children should also be involved in their care. The older the child, the more important it is.
If you need tools, you should get information about what is available and how to get it.
Treatment of eczema
All treatment of eczema is to curb inflammation and heal the skin so that it becomes whole and supple again. Then the skin gets back its protection against abrasion, dehydration and irritants and allergenic substances.
The treatment you receive depends on the type of eczema you have, how old you are, where on the body the eczema is and how much trouble you have.
Here you can read about the drug treatment of eczema.
In the case of lower leg eczema, the cause of the eczema is treated
In the case of lower leg eczema, the cause of eczema is mainly treated. If you have ulcers, you will receive treatment for them. Swollen legs are wrapped with specialties or specially tested support socks. You may need to have varicose veins operated.
Your job can affect
Sometimes, eczema can be caused or worsened by the job you have. Then you may need professional advice and possibly the help of a specialist in so-called professional dermatology, to investigate your workplace. Occupational health care can often refer to so-called occupational medical clinics at university hospitals in larger cities.
The doctor usually examines the skin and you get to answer questions. It is usually enough for the doctor to be able to make a diagnosis, but sometimes more examinations are needed.
There are several different methods to test if you have an allergy.
A patch test shows if you are hypersensitive to certain substances that your skin comes into contact with. The test is also called an epidemic test.
Children with atopic dermatitis may also have allergies that cause respiratory problems, such as tingling and asthma. Then the child may need to be examined for allergies to, for example, different types of food, fur animals or pollen. It is often done with blood tests and so-called dot tests, where the allergic reaction in the skin is tested.
The doctor usually takes a small sample from eczema using a cotton swab if eczema appears to have been infected by bacteria. The sample is sent to a laboratory for cultivation.
What happens in the skin?
The skin acts as protection for the body and helps to maintain the body temperature at the right level. It consists of three layers of skin; the epidermis, leather skin and subcutaneous skin.
The epidermis is the outermost layer of skin and should prevent, among other things, dirt, bacteria, and viruses from entering the body. The epidermis protects against abrasion by preserving moisture and fat that keeps the skin supple. The epidermis forms a skin barrier to the environment.
Under the epidermis is the leather skin where there are blood vessels that supply oxygen and nutrients. Blood circulation in the leather skin is also important for the body to maintain the right temperature. The leather skin also contains connective tissue, lymphatic vessels, sensory bodies, nerves, hair follicles, sebaceous glands, and sweat glands.
Under the skin, there are fat cells that act as protection for the body. The fatty tissue in the subcutaneous tissue helps to keep warm and protects against bumps.
Inflammation is the body’s defense
You can get eczema if the skin barrier has dried out, cracked or worn out. This causes inflammation of the skin. Inflammation is the body’s way of defending itself against an injury or attack by, for example, bacteria.
The skin scales
At the top of the epidermis lies the horn layer, which consists of dead skin cells. New skin cells are constantly being formed from below. A skin cell lives for about a month before it dies and is rejected. In eczema, the skin cells are renewed faster than they should. Then, supporting skin cells accumulate on the skin surface and skin scales.
What does eczema depend on?
The different types of eczema have different causes.
It is not entirely known why some get atopic dermatitis, but inheritance and environment play a role.
Some who get atopic dermatitis have a worse skin barrier right from the start. Then the skin loses lighter moisture and fat and is, therefore, more susceptible to, for example, abrasion. The skin also responds more to irritants. The skin may also have less of some fats that bind water and prevent the skin from getting dry and scaly.
It is not quite clear what causes milk dermatitis. One reason may be that the body reacts to a yeast fungus found on the skin and scalp.
Some eczema is because you are allergic to any substance that the skin comes into contact with. Common substances that can cause allergic eczema are, for example, nickel, chromium, rubber, latex, rosin and certain preservatives in skincare products.
In non-allergic contact eczema, skin protection has worn off while the number of inflammatory cells in the skin has increased. It is common to have this type of eczema on your hands, for example, you often wash or use strong detergents.
Coin format eczema
Coin-shaped eczema can occur if you have dry skin and have bathed or showered a lot. It is usually not associated with allergies.
The bones can become swollen and you can get varicose veins and leg ulcers if the blood is difficult to pump from the bones to the heart. The skin often becomes brittle and thin and you can easily get eczema.
How is life affected by having eczema?
It is usually a relief to get a diagnosis so you can start treatment and relieve your complaints. You will learn to become an expert on your own skin and to treat yourself. It is important that children get involved in the treatment as soon as possible.
You can have various problems
Having eczema means you have to lubricate yourself regularly. It may take some time each day.
You may have trouble sleeping if your eczema is itching a lot. It can cause you to get tired during the day and find it difficult to concentrate at school or at work.
Some people find it embarrassing that others see eczema. It can be extra sensitive for children and young people, for example in sports at school.
You often need to think about avoiding what can trigger the trouble. Having eczema can also affect what career choice you can make.
Eczema associated with pregnancy
Eczema can be affected by pregnancy. In some, eczema gets worse. You can usually use cortisone when you are pregnant if you use it in a limited area of the skin, but you should consult a doctor first.
It is good to make sure that hand eczema is well treated before the baby is born. Caring for young children involves a lot of contact with water, which can worsen eczema.