Eczema is a chronic inflammatory condition of the skin that is characterised by itching, redness and lesions/eruptions on the skin. Being fairly common, this affects almost 20% of children and 1-2 % of adults worldwide. Eczema can affect people belonging to any age group though it's more commonly seen in infants. In case of infants, the condition usually resolves by the age of 3 years but may continue into adulthood in few cases. This is no particular gender predilection seen in cases.
Eczema is not a life-threatening disease but it can have a significant impact on the life of the patient. The discomfort caused by the condition, an altered self image that the patient develops, anxiety about the nature of the disease, etc. are additional issues that the treating physician has to tackle besides the condition itself.
The disease itself has phases during which the symptoms get worse, then get better or resolve by themselves - thus it runs an unpredictable course in many people. However, timely detection and treatment can save a lot of trouble for the patients rather than ignoring the initial presenting symptoms.
Numerous factors have been suggested as a cause for eczema (dermatitis/ skin allergy) but no exact origin and mechanism has been pin-pointed for this condition. Most of the studies simply speculate as to what can trigger this condition and a combination of genetic as well as environmental factors has been strongly implicated.
An abnormal function of the immune system (allergy/ allergic response) is seen in most cases where the body reacts abnormally to external impressions which otherwise don’t have an impact on healthy individuals.
Some of the triggers for eczema include but are not limited to:
- Environmental allergens: House dust, sand, smoke, animal dander, pollen, molds, etc.
- Dietary allergens: Milk & milk products, soy, fish, eggs, peanuts, etc.
- Contact with irritant substances such as soaps, detergents, cleaning products, cosmetics, perfumes, etc. Even contact with certain forms of clothing, rubber, watches, jewelry, some metals such as nickel, etc, can trigger it off.
- Changes in temperature and humidity
- Dry climate and excessively cold temperature
- Psychological stress - This has been advocated as a cause in a large number of cases. How stress triggers off the altered immune response is not clearly understood.
- Impaired blood circulation especially in the legs - leads to stasis dermatitis
- Genetic factor: This has been strongly implicated as a cause for developing eczema. Often, patients with eczema are seen to be having some form of family history of allergies, asthma, hay fever or other forms of allergic diseases.
- Unknown factors trigger certain forms of dermatitis such as seborrheic dermatitis, atopic dermatitis, etc.
Varied in its presentation, eczema can show up in diverse forms in different individuals. Some key features that are common to most forms of eczema are as follows:
- Dry itchy skin
- Redness, heat and swelling of the affected part
- Skin eruptions - usually multiple small ones
- Occasionally there may be oozing of thin watery fluid from the eruptions
- Chronic scratching may lead to thickening of the skin in the affected area
- Darkening of the skin in long standing cases
- Crust formation may be seen
The lesions may appear on any part of the body but are commonly seen to affect:
- Knees, elbows, ankles - especially inner sides
- Face and neck
- Arms and legs
- Folds of skin
In children, nappy region, scalp, face and neck and forearms are commonly affected.
Sometimes the symptoms may exist for a short period of time (less than 4 weeks) and then disappear completely, this is called acute eczema. However, in most cases, the features persist for a long period and tend to be recurring in nature leading to 'Chronic eczema'.
There aThere are different kinds of presentations of eczema and it is important to know your type to understand the treatability of the same. Discussed here are some common types:
1) Atopic dermatitis:
This is also commonly known as infantile eczema since it develops during the first year after birth in most cases. 90% of atopic dermatitis patients develop symptoms before the age of five.
Symptoms largely include reddish, dry or oozing scaly eruptions at the bend of elbows, back of knees, neck, face, etc. The skin is extremely dry and very itchy. Infants usually find it very difficult to control the itching and excessive scratching may lead to secondary infection.
The condition develops as an allergic reaction to a number of things such as foods, environmental allergens, etc. (see causes of eczema for details). The condition tends to be hereditary and often family history of some form of allergy, asthma, hay fever, etc. is seen in such cases. Atopic dermatitis is often accompanied by other allergic and hypersensitive conditions like rhinitis, asthma, etc. In certain cases, the two conditions may alternate with each other i.e. one flares up when the other subsides.
2) Contact dermatitis:
As the name itself suggests, this type is marked by symptoms of eczema that develop in localized regions where the skin comes into direct contact with an allergen (allergic contact dermatitis) or an irritant (irritant contact dermatitis).
Irritants take longer period and increased amount of contact to trigger an eczematous reaction as compared to allergens (food allergens, environmental allergens). Even a brief exposure to a small amount of allergen can trigger a fast eczematous response.
One ofOne of the commonest forms of Contact dermatitis is the allergy that is caused by contact with nickel (which is a component of artificial jewellery). Contact with watches, ear rings, rings, chains or other items of this kind causes red, itchy rashes followed by tiny blisters and peeling of skin.
3) Seborrheic dermatitis:
Commonly seen to affect the scalp, margins of the head and area behind the ears, this condition is characterised by reddish rashes with yellowish, oily scales. This is common in people who have an oily skin and scalp and it varies according to seasons. When seborrheic dermatitis occurs in infants, it is known as 'cradle cap'.
4) Exfoliative dermatitis:
A great amount of scaling and flaking is typically seen in this type of eczema.
5) Stasis dermatitis:
This type of eczema occurs in the portions of the body where the blood circulation is poor (like the area around the ankles) and it has a tendency to form ulcers. It is often associated with some circulatory disorder like varicose veins, etc.
6) Nummular dermatitis:
The eruptions are coin shaped in this type of eczema.
This is characterised by eruptions which show close relation to psycho-somatic stress. The patient usually develops an intensively itchy skin especially when the person is resting or relaxed. A vicious itch-scratch-itch cycle develops. This type of eczema usually limits itself to areas that are easily accessible to the person such as lower legs, ankles, back and sides of the neck, wrists, forearms, and genitals.
8) Dyshidrotic dermatitis:
Small fluid-filled and itchy blisters appear on the hands and feet. These are most common along the edges of the fingers, toes, palms and soles and tend to appear during certain times of the year. The blisters cause intense itching and thickening of the skin after excessive scratching.
In April 2003, a clinical trial was concluded in Obitsu Sankei Hospital, Saitama, Japan. The trial carried out over the previous two years, involved a group of patients diagnosed as suffering from intractable atopic dermatitis (IAD). IAD is a form of eczema (atopic dermatitis) which has not responded to any medication so far. These patients were put on homeopathic medication for an average period of two years. Subsequently the study was concluded with the following report:
88% of the patients reported reduction in itching
77% of the patients reported improvement in sleep due to overall improvement in IAD
75% patients reported increased overall satisfaction in life
63.5% patients reported increased sense of work fulfillment
71.5% patients reported improved satisfaction in human relations
These results astonished the doctors carrying out the trial especially since it occurred in a group of patients who had not responded to any medication earlier. The fact that nearly 75-80% of these patients were now better with homeopathic medicines was an eye-opener to the doctors at the institute and for the entire world.
Additionally, the study clearly showed that not only was the primary complaint of atopic dermatitis relieved, but overall too, the patients experienced greater satisfaction resulting from the treatment, proving conclusively that homeopathic treatment is truly holistic in nature.
At Dr. Batra's, with our experience of successfully treating thousands of cases of eczema over the last 35 years, we are in possession of the experience and expertise to handle the cases with utmost care. The reason why our medication scores over conventional medication (like steroidal ointments used for treating eczema) is that it corrects the deviated immune process, which is the root cause of eczema or the skin allergy. The medication works to restore this deviated immunity to give rise to a series of repeated and increasingly prolonged remissions in the symptoms, which eventually proceeds to a good control of the disease.
At the same time, side-effects (as those seen with steroids) like thinning of the skin, atrophy of skin, secondary fungal and bacterial infections of the skin are completely avoided here.
It must be borne in mind that treatment duration varies from case to case and depends on many factors such as duration of the eczema, its extent and severity, and the previous treatment taken. However, the treatment has multiple benefits to offer to every patient of eczema and hence is strongly suggested for all cases.