Eczema can also become pervasive and severe. In very serious cases, it can cover a large percentage of the skin’s surface. Each case is unique and therefore different. Several variables can influence the severity of your case. These factors include:
- the sensitivity of your skin,
- the length of exposure to the irritant(s) and
- the class and efficacy of the treatment(s).
If your eczema shows signs of scabing, oozing, cracking and/or bleeding it is time to seek medical attention. The worse the condition, the more likely it becomes that an infection will take hold. As eczema spreads, the chances that the skin will break or crack increases.
Treatment and Outcomes
Dermatologists and clinics that specialize in skin care are uniquely qualified to treat psoriasis and eczema. Since these two skin conditions result from different causes, it should come as no surprise that treating them uses different techniques. There may be some similarities in treating the symptoms, but the overall objective of treatment and therefore therapeutic modalities used, will be distinct.
Similarly to psoriasis, medical professionals will likely first recommend a topical corticosteroid cream to treat eczema. There may also be over-the-counter creams that can help treat the itching. Additionally, there are some effective treatments that involve using a cream as a barrier to protect the skin from irritants and infections. This can give the skin time to heal.
Topical creams can be used in conjunction with wet bandages. This technique requires medical supervision. In some severe cases, it is performed in the hospital under constant monitoring.
More serious cases of eczema may require stronger antibiotic creams or systemic prescription medications such as oral corticosteroids (prednisone). There are potential serious side effects so they can not be used long term.
Counseling can also be used to help people avoid scratching the affected areas. People also find that talking about their condition with others who have it, can help them from feeling isolated and embarrassed.
Eczema on the Legs
Eczema likes to grow in the folds of the body. On the legs, this means in the creases at the back of the knee or the front of the ankle. Sweat and other irritants from clothing and the air can get trapped in these folds, causing prolonged exposure. On top of this, the skin at the joints rub together frequently, further causing irritation. This creates the perfect environment for atopic dermatitis to take hold.
If not quickly treated effectively, eczema on the backs of the knees can become very difficult to remedy. Because of its location, it tends to be very irritating and painful. It is not uncommon that irritation and friction from clothing will cause significant discharges of blood and pus. These cases also have a high risk of infection.
Psoriasis and Dry Skin
Although many cases of psoriasis present with patches of dry or scaly skin, this is not always the case. Sometimes the large red patches show no signs of scales. With time, the red patches of psoriasis can build up a layer of dead skin cells, producing visible scales and peeling.
If you do have scales on your skin, do not pick or pull at them. They should be allowed to fall off on their own. If removed with force, the skin may break, bleed and become infected. You can however, use the palm of your hand to gently brush the area, removing small pieces of loose skin.
In some cases, the patches may develop a very thick layer of white, dead cells before beginning to shed scales.
Eczema and Dry Skin
Patches of dry skin is one of the hallmarks of eczema. The skin can become extremely dry. As the skin dries, it becomes fragile making it prone to cracking. As the skin starts to peel, it may look like a peeling callus, blister, or a sunburn. The cracks and peeling skin need to be treated carefully to avoid infection.
Removing the skin may or may not expose raw skin or open wounds. They need to be handled with care to minimize the risk of introducing a bacterial or viral infection.
Symptoms of Eczema
- Your skin will become itchy (almost always) before a rash appears from eczema.
- You may notice patches of dry, itchy skin on any part of your body, but usually on the hands, face and neck, or legs. Skin may feel thicker.
- Severely dry patches of skin may develop open sores with crusts and become infected if scratched.
Causes of Eczema
The exact cause of eczema is not known. The most common type of eczema, which is atopic dermatitis, resembles an allergy, but the skin irritation is not an allergic reaction. It is seen in children more often than in adults. The current consensus is that the cause is a combination of factors, including:
- Genetic factors
- Immune system abnormalities
- Harsh environments
- Activities that cause skin to become sensitive
- Defects in the skin barrier that allow moisture out and germs in
What We Do Know About the Causes of Eczema
Eczema is not contagious. You can’t catch eczema by coming in contact with someone who has it.
Eczema often occurs in families. This implies a genetic role in the cause. A major risk factor is having relatives who had or have:
- Seasonal allergies (hay fever, pollen allergies, etc)
Mother’s age at time of birth has effect. It has been observed that children born to older women are more likely to develop eczema than children born to younger women, although it is not clear why.
Environment has a role. Children are more likely to develop eczema if:
- They are in a higher social class
- Live in colder climates
- Live in urban areas with higher levels of pollution
Eczema is not an allergic reaction. Even so, a large number of children who have eczema also have food allergies. In fact, doctors also know that a large percentage of children with severe eczema will develop asthma or other allergies later. But this does not mean that certain foods that are common food allergens (such as dairy, eggs, and nuts) cause eczema or make it worse. Before removing any foods from your child’s diet, consult your child’s doctor to be sure nutritional needs will be met.
What Triggers Eczema?
There are things that, although they do not cause eczema, will make an irritation or rash occur or become worse. Certain fibers such as wool and some man-made fibers are prime examples.
Symptoms of eczema:
There are many different types of eczema, and they cause different symptoms, which include:
- Redness. The affected skin may be blotchy or red, and may even bleed.
- Itching . Itching can often be so intense that it will sometimes cause a person to damage their skin by scratching it.
- Scaling. Due to surface skin can flaking off, skin can appear rough and scaly.
- Blisters. Blisters may form and become crusty or ooze fluid.
- Cracking. Extreme cases can cause the skin to develop fissures, which are painful deep cracks.
Eczema can flare up and cause sudden, severe symptoms, or can be a chronic problem with less severe symptoms.
Types of Eczema:
Eczema Treatments Eczema Causes
Atopic dermatitis, the most common form of eczema, affects people who also have:
- Pollen allergies such as hay fever
- Family history of eczema, asthma, or hay fever
- Defects in the skin’s barrier, allowing moisture out and germs in
This type usually begins during childhood or even infancy, but can occur at any age.
Most often, it affects skin on the:
- Hands and feet
- Inner elbows
- Back of the knees
Over time, scratching the skin can cause it to become thicker and inflamed. Scratching can also cause infections in the raw area.
Irritants that can make symptoms of atopic dermatitis worse include:
- Rough clothing or irritating fabric
- Household chemicals
Other allergy triggers such as certain foods and dust mites can also make symptoms worse.
Eczema Treatments Eczema Causes
Treatments of eczema include:
- Products to moisturize the skin
- Steroid creams
- Drugs that control the immune system including dupilumab (Dupixent), which is given as an injection every two weeks, and crisaborole (Eucrisa), a non-steroid ointment that is applied twice a day
- Antibiotics (if infection is present)
- Ultraviolet light, sometimes with a drug called psoralen
- See your Podiatrist