Eczema - symptoms, causes and treatment
Dr. Anja Loose-Roland
Updated on 02. November 2023
Eczema, also called dermatitis in medicine, is a collective term for various diseases of the epidermis. Almost every adult suffers from this inflammatory skin disease at some point in his or her life. Eczema is not contagious, but the intense itching makes it unpleasant for the patient.
Eczema Brief overview:
- Causes: Stress, contact with allergenic substances
- Symptoms: Redness, itching, oozing
- Prevention: Avoidance of triggers
- Treatment: Cream, medicines
How do I recognise eczema?
Eczema is caused by inflammation of the skin. Although the condition has different causes, many common symptoms are seen. Characteristic signs are:
- Redness and inflammation
- Severe itching
- Skin forms scales or crusts
- Oozing
- Dry skin with cracks
- Red, itchy bumps
Some forms of dermatitis only occur on certain areas of the body, like eczema on the hand. However, dermatitis can also appear anywhere on the body.
What are the different types of eczema?
Different types of eczema can occur. The distinction lies in the cause and the appearance.
- Atopic eczema (neurodermatitis): A chronic disease manifested by itchy, red and scaly skin. Neurodermatitis often occurs in conjunction with allergies such as hay fever.
- Contact dermatitis (allergic eczema): A reaction of the skin to a certain substance or materials, such as nickel, perfume or certain chemicals.
- Dyshidrotic eczema (hand and foot dermatitis): This skin condition manifests itself as itchy blisters on the hands, feet and arms. It accompanies other skin diseases and occurs in contact with aggressive substances or high humidity.
- Nummular eczema (nummular dermatitis): A chronic disease manifested by round, itchy, red and scaly skin rashes. The cause of the disease is unclear. People with hay fever or asthma unfortunately suffer more often from this eczema.
- Seborrhoeic eczema (gneiss): A condition manifested by [dry\]\(/dry-skin/), scaly and itchy skin on the scalp, face and chest area. The cause is thought to be excessive production of fat, which is accompanied by fungal infection. This dermatitis is often chronic.
- Stasis dermatitis (stasis dermatitis): This skin disease is manifested by itchy, red and scaly skin on the legs in patients with circulatory disorders.
What is the cause of eczema?
The causes of eczema are very diverse and for several forms of dermatitis the cause is not yet known. Known triggers for some eczema are:
- Contact with allergenic substances such as chemicals, detergents, disinfectants, jewellery or oils but also mites as in post-scabial eczema internal link to scabiosis.
- Stress and related poor nutrition can take away the elasticity of the skin. This makes it more susceptible to germs and allergens.
- Too much moisture due to air-impermeable clothing, heavy sweating or excessive hygiene leads to softening of the skin. Protective oils are washed away and the skin becomes more susceptible to germs.
- Too long contact with water, not drinking enough, dry heating air or extensive sunbathing can dry out the skin. The skin barrier loses its natural protection and germs can penetrate.
Which risk groups are more affected by eczema?
Eczema can occur in anyone, regardless of age. Some risk groups are more likely to develop dermatitis. These include:
- Hereditary predisposition: If eczema occurred several times in the past within the family, one's risk of dermatitis is increased. This often applies to atopic eczema.
- Allergy sufferers: If there is an intolerance to certain substances such as nickel, the body reacts with eczema on contact. At the same time, if there is an allergy such as hay fever, the body and therefore the skin is weakened. Then eczema like neurodermatitis can spread.
- Immunocompromised people: Infections, stress and taking immunodepressants weaken the body's defence system. This makes the skin more susceptible to irritation and inflammation as well as eczema.
- Chronically ill people: A number of chronic, inflammatory diseases such as diabetes mellitus and Parkinson's disease can weaken the body's defence system. Often, the necessary medication attacks the skin's balance, providing the basis for eczema.
- Contact with critical substances: In their professional lives, many people are in constant contact with substances that can trigger eczema. Contact allergies are particularly common among medical staff, cleaners, hairdressers and beauticians.
How is eczema treated?
Most eczema is easily treatable. Unfortunately, some of these conditions are chronic and cannot be cured. The treatment of eczema depends on the type and severity of the condition. Eczema on the skin caused by jewellery containing nickel can be cured quickly by leaving it out. If the cause of the dermatitis is unknown, a doctor should be consulted for:
- Severe and long-lasting itching
- Infestation of sensitive areas such as eczema on the eyelid or in the ear
- Extensive dermatitis
- Inflammation of the affected areas
- Eczema on the foot, when discomfort occurs when walking
- Recurrent dermatitis
Eczema on the face often causes a lot of distress, so it is a good idea to see a doctor. In children, the diagnosis should be initiated early because many medications can only be used in smaller doses or not at all in children.
What medicines can help with eczema?
In most cases, ointments with anti-inflammatory and anti-itching agents are used for eczema. These locally applied medications against skin eczema contain corticosteroids that suppress the immune system. Antihistamines, which are often available over-the-counter at pharmacies, are used to relieve itching. If large areas of the body are affected or if the eczema is already far advanced, systemic therapy with tablets becomes necessary. This may also be necessary for eczema on the scalp, as the hair makes it difficult to apply creams. The therapy can only be prescribed by a doctor. If the areas of dermatitis have already become inflamed, antibiotics are used to treat the infection. Seborrhoeic eczema on the scalp plays a special role in the treatment of dermatitis. Treatment is carried out with shampoo that contains an antimycotic as the active ingredient against fungal infections.
What measures can support the healing of eczema?
Various methods can be used to support the treatment of dermatitis. These differ depending on the type of eczema.
- Phototherapy: By irradiating the skin with UV light, cells that are relevant to the skin disease are killed. This method is mainly used for neurodermatitis.
- Avoidance of triggers: Whether it is day cream, nickel earrings or aggressive cleaning agents, the triggers for eczema should be avoided immediately.
- Proper clothing: Loose-fitting cotton clothing is breathable and allows air to reach the body. This prevents heat build-up and helps eczema heal better.
- Physiotherapy: If you have stasis eczema, physiotherapy can improve blood flow to the veins in your legs. This will improve the symptoms.
- No scratching: Scratching the affected areas causes additional damage to the skin. Bacteria and germs can get in and cause an infection. Fingernails should be kept short. Tight-fitting gloves often help with small children.
How can I support the treatment of eczema with home remedies?
When treating with home remedies, the rule is: moist on moist and fat on dry. Gels and watery solutions can help with weeping eczema. Greasy creams and ointments are used for dry dermatitis. Suitable home remedies are:
- Itching: Cooling compresses can be used to stop the itching for the time of application. Alternatively, products containing tannins such as black tea or [witch hazel\]\(/witch hazel/) are used as compresses.
- Infection: If an infection has spread on the eczema, compresses and ointments based on chamomile flowers help. These contain anti-inflammatory, wound-healing and antibacterial active substances and thus support the healing of the skin.
- Weeping eczema: Camomile and calendula support the healing of the skin. Oak bark and witch hazel have an anti-itching, anti-inflammatory and wound-healing effect. The home remedies can be used as moist compresses, gels, watery infusions and baths.
- Dry, chronic eczema: Ointments with a high fat content and extracts of calendula or camomile are suitable for the care and healing of dry and inflamed skin. Alternatively, various oils from evening primrose, olive or St. John's wort can be applied. To moisturise the skin, the affected areas are treated with glycerine cream.
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