In today's world, an incredibly large number of people live with this sensitive condition. And there is one more thing they share beyond the condition itself — nobody wants to talk about it. Let us explore the most important aspects of eczema in a clear, structured way.
What Is Eczema
Eczema is a medical condition characterised by chronic inflammation of the upper layer of the skin (the epidermis). When this barrier is compromised, the skin loses its ability to retain moisture and becomes highly permeable to external irritants, which prompts the immune system to react with inflammation. Eczema can appear anywhere on the body, but most commonly affects the face, hands, legs and the inner side of the elbows. Eczema is not contagious.
Types of Eczema
For proper care it is important to identify the exact type of eczema, as each has its own specific characteristics:
Atopic Dermatitis
This is the most common form of eczema, which often begins in early childhood. It has a strong hereditary character and is frequently linked to immune hypersensitivity. It is caused by a genetic deficiency of the protein filaggrin, which makes the skin unable to retain hydration and leaves it vulnerable. It presents as dry, intensely itchy red plaques, often localised in the folds of the elbows, behind the knees and on the cheeks.
Eczema vs Dermatitis: What Is the Difference?
The terms "eczema" and "dermatitis" are sometimes used interchangeably, but there is a subtle difference. Dermatitis is a broader term encompassing various forms of skin inflammation, including eczema. Eczema, on the other hand, is a specific type of dermatitis with its own unique characteristics and triggering factors.
Contact Dermatitis
This occurs when the skin reacts after direct contact with a specific substance. It is divided into two subtypes: Allergic (an immune response to metals such as nickel, fragrances or cosmetics) and Irritant (inflammation following exposure to aggressive chemicals, acids or harsh cleaning agents). Symptoms are usually confined to the area of contact and include redness, burning and sometimes blisters.
Dyshidrotic Eczema
This type primarily affects the hands and feet. Its hallmark is the appearance of small, deeply situated and intensely itchy blisters that resemble tapioca pearls. Once the blisters dry out, the skin begins to peel and remains painfully red and dry. It often flares up during seasonal stress, in humid conditions or following contact with certain metals.
Seborrhoeic Dermatitis
This is a chronic condition that affects areas with a high concentration of sebaceous glands. In babies it is known as "cradle cap", while in adults it affects the scalp, eyebrows, sides of the nose and chest. It presents as greasy, yellowish scales (dandruff) on a strongly reddened base. It is often triggered by a specific type of yeast that feeds on the skin's sebum.
Nummular (Discoid) Eczema
This type is easily recognised by its characteristic coin-shaped patches. These areas are clearly defined, intensely itchy and can become "weepy". It most commonly appears on the legs and arms following skin injury, burns or extreme winter dryness.
Causes of Eczema
Eczema is a multifactorial condition in which internal and external factors intertwine. The main causes include:
- Genetic predisposition: If parents have eczema, asthma or hay fever, the risk for their children is significantly higher. This is often linked to a mutation in the filaggrin gene.
- Impaired immune response: In those with eczema, the immune system reacts excessively to otherwise harmless substances (such as dust or pollen).
- Disrupted lipid barrier: The skin does not produce enough natural fats. This allows moisture to evaporate quickly.
- Environmental factors: Air pollution, hard water, sudden temperature changes or dry air.
- Stress: Raises cortisol levels, which weakens the immune response and leads to severe flare-ups.
Symptoms of Eczema
- Intense itching (Pruritus): The most prominent symptom, which often causes sleeplessness.
- Redness and inflammation: The skin appears "inflamed" and feels warm to the touch.
- Extreme dryness: The surface becomes rough and flaky.
- Cracking (Fissures): Painful cracks that may bleed.
- Vesicles: Small blisters that release a clear fluid.
How to Care for Eczema-Prone Skin
Keeping the skin hydrated is the single most important step. Avoid hot showers and replace harsh soaps with cleansing oils. Apply emollients immediately after bathing onto slightly damp skin.
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Frequently Asked Questions
❓ Can eczema be completely cured?
Eczema is a chronic condition. With proper care and by avoiding triggers, symptom-free periods can last for years.
❓ Why is the itching worse at night?
Cortisol levels drop in the evening, and the absence of external stimuli makes us more focused on the discomfort.
❓ What foods should I avoid?
Dairy products, gluten and sugar often worsen inflammation in sensitive individuals.
5 Golden Rules for Eczema-Prone Skin
- 👉 Fabrics: Cotton or silk only. Avoid wool.
- 👉 Laundry: Rinse clothes twice, avoid strong fabric softeners.
- 👉 Bathing: Lukewarm water for 5–10 minutes.
- 👉 Nails: Keep them short for safety.
- 👉 Relaxation: Manage stress through breathing exercises or yoga.
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