Grades of Eczema

• Acute eczema is not severe eczema. It is a rapid onset of reddened and inflamed eczema flares. Moreover, this may possibly cause blisters.
• Chronic eczema means long-lasting eczema. Once the initial phase reduces, the skin that has been infected for a while remains thickened and flakey.
• Infected eczema is regular eczema but with pus-filled blisters.

Different Types of Eczema

• Atopic eczema: It occurs due to genetic and environmental factors, or even a mild immune disorder. This leads to hypersensitivity. As a result, this increases itching.
• Discoid eczema: It appears as discrete islands of infection on a background of normal skin.
• Allergic contact eczema: It occurs due to contact with something the immune system identifies as foreign, like poison ivy.
• Irritant contact eczema: It occurs due to contact with skin irritants. These could be acids and other chemicals.
• Dyshidrotic eczema: It occurs on areas of the body that sweat, especially hands and feet.
• Neurodermatitis: It is localised, commonly due to an insect bite.
• Seborrheic eczema: It occurs due to increased secretion of sebum. As a result, this leads to yellowish, oily, scaly patches on the scalp, face and other body parts.
• Stasis dermatitis: It occurs because of issues in the body’s blood circulation process, and commonly seen on the lower legs.

Treatment for Eczema

There is no cure for Eczema. It can recur from time to time. Therefore, one must keep the triggers of eczema under control. If you suffer from eczema, you must 

• Know your triggers
• Maintain a regular bathing and moisturizing routine
• Use your regular OTC or prescription medication consistently 
• Be careful of any signs of infection on the skin. These could include pus-filled bumps, pain or redness.

Despite all these efforts, eczema can still flare. Eczema can be an unpredictable disease.  There are multiple treatment modalities for eczema.  Most of the treatments are topical, but in severe cases, even oral medicines can be prescribed.  These medications should only be taken under prescription as steroidal treatments may cause side effects like skin thinning or stretch marks.

There are several treatment modalities for Eczema: 

• OTC treatments 

Different OTC products work in different ways. Some help to moisturize skin. While some help skin symptoms such as rash, redness and itch. Lastly, some are for gently cleaning skin to prevent infection.

• Moisturising 

Moisturisers are one of the most important aspects of managing eczema. When your skin is dry, it can get irritated. As a result, eczema can flare. Moreover, wind, low humidity, cold temperatures, harsh soaps and too much washing without the use of a moisturizer can cause dry skin. It’s important to know how and when to properly moisturize bathe. In fact, it is important to use only those products which are best to use for eczema.

• Topical corticosteroid creams and ointments 

These are a type of anti-inflammatory medication. They help to relieve skin inflammation and itchiness. One must apply them directly onto the skin. However, make sure you consult with your dermatologist. Do not use any creams without a dermatologist’s prescription. 

• Systemic corticosteroids 

Dermatologists may prescribe systemic corticosteroids when topical treatments don’t work. These are either injected or oral medication. Moreover, one must use them only for short periods of time. These steroids are used only in cases of severe eczema as they may have serious side effects.

• Phototherapy

This includes UV light therapy and PUVA therapy. By exposing the affected areas to UV rays, this treatment aims to reduce itching and inflammation, increase vitamin D production and defence systems in the skin. 

• Systematic Medications (Immunosuppressants) 

Medicine does not know the exact cause of eczema. However, researchers do know that eczema and immune system are related. In eczema, the immune system overreacts and produces inflammation. As a result, the skin starts to itch, turns red and has skin barrier problems.

In case of severe eczema, your doctor may prescribe you an immunosuppressant. An immunosuppressant drug helps control the immune system. As a result, the symptoms of severe eczema can be controlled.  Pimecrolimus and tacrolimus are immunosuppressants, used for moderate-to-severe eczema. However, they may increase the risk of skin cancer.

• NSAID ointment

These are non-steroidal, anti-inflammatory ointments. They help ease rashes, redness and itching. In fact, they are ideal for mild-to-moderate forms of eczema. 

• Antihistamines

Histamine is the substance in the skin that causes itching. Antihistamines block the action of histamine and help relieve itching. Sedative preparations are prescribed to those in whom sleep disturbance is a major symptom. 

• Antibiotics

 Excessive scratching may damage the skin, allowing bacteria to get in and cause infections. Therefore, antibiotics are used to treat these infections.

• Biologics 

Biologic drugs contain genetically engineered proteins. They help to treat atopic eczema internally. Dermatologists administer them intravenously. They target the specific parts of the immune system that trigger inflammation. 

• Wet dressings 

This involves covering the affected skin with topical corticosteroids and wet bandages.