Eczema (Atopic, Nummular, or Steatotic Eczema)

Eczema refers to a wide variety of skin conditions. In general, lesions that are red, blistering, oozing, scaly, brownish, thickened, and itchy may all be considered eczema. The term is often used interchangeably with dermatitis, which causes similar lesions, but unlike eczema, dermatitis usually has an identifiable external cause.

Eczema afflicts people of all ages, but certain forms of the disorder are more prevalent during specific life stages. For example, atopic eczema, sometimes referred to as infantile eczema, occurs mostly in babies, children, and young adults. Nummular, or discoid, eczema occurs mostly in adults. It's red, coin-shaped patches -- which may become swollen, blistered, or crusty -- sometimes itch and often ooze or thicken.

Some elderly people develop a condition called steatotic eczema, in which the skin becomes dry and scaly. Doctors think this is due to the loss of skin lipids that occurs with aging.. Allergies and eczema appear to be related, and both conditions tend to run in families. Stress can trigger a flare-up.

Diagnostic Studies and Procedures

The appearance of the skin patches usually forms the basis of a diagnosis. To distinguish eczema from allergic, or contact, dermatitis, a doctor will ask about substances to which the skin has been exposed; he may then order skin tests to identify possible allergens. Skin scrapings may also be studied under a microscope to rule out bacterial or fungal skin infections.

Medical Treatments

Anti-inflammatory medications are often prescribed to be taken by mouth or applied to the skin lesions. The most commonly prescribed topical medications are coal tar and cortisone cream. Mild eczema may respond to hydrocortisone in a non-prescription strength of 0.5 or 1 percent, but the prescription strength of 2.5 percent is usually needed. In certain cases, a doctor will recommend applying a liberal coating of hydrocortisone to affected areas at night and then covering them with plastic wrap or other occlusive dressing.

Oral antihistamines are often used to reduce itching and thus break the itch-scratch-itch cycle. If bacterial infection has already developed as a result of scratching, antibiotics may be prescribed. Oral cortisone, sedatives, or tranquilizers can help severe itching.

Alternative Therapies

Herbal Medicine. Creams or ointments containing duckweed, stinging nettle, or heartsease (tricolored sweet violets) are herbal remedies said to alleviate the itchiness and oozing lesions of eczema. For adults, some herbalists also recommend systemic treatments with various teas or tinctures, especially burdock or stinging nettle.

Naturopathy and Nutrition Therapy. A naturopath may recommend taking supplements of zinc, bioflavonoids, and vitamins A, E, and C, as well as two to four capsules of evening primrose oil three times a day, and 1 teaspoon of flaxseed oil once a day.

A food allergy can trigger eczema, especially in a young child. To identify the allergy, nutrition therapists often recommend eliminating such foods as milk products, eggs, tomatoes, and citrus fruits. If the eczema improves, the foods are then reintroduced one at a lime; a flare-up may indicate an allergy and avoiding that food in the future should solve the problem.

Relaxation Techniques. Excessive stress frequently aggravates eczema. Meditation, yoga, self-hypnosis, or visualization can improve one's ability to cope with periods of stress.

Self-Treatment

Many of the remedies used for dry skin can alleviate eczema too. It is also a good idea to use hypoallergenic skin products that are formulated especially for dry skin.

Adding 1 cup of Aveeno powder or other colloidal oatmeal product, or 1/2 cup of baking soda, to a tepid bath may help to reduce itching. An over-the-counter antihistamine taken at bedtime can reduce itching and promote sleep.

After bathing or showering, apply a moisturizing cream, gel, or skin medication recommended by a doctor. As much as possible, wear soft cotton clothing next to your skin.

If you live in a dry climate, you may benefit from a central humidifier, conversely, if heat and humidity seem to intensify itching, try using a dehumidifier and air conditioning. And avoid rapid changes of temperature, which can also aggravate eczema.

Brief exposure to the sun's ultraviolet rays can help heal eczema, but it is important not to get sunburned -- this can worsen the disorder, in addition to damaging skin and increasing the risk of developing skin cancer later.

If you nave severe eczema, you should eschew activities that provoke sweating. Instead of jogging or doing aerobics, for example, try swimming.

Other Causes of Itchy Skin Rashes

Many conditions can cause rashes and itching similar to those of eczema. These include an adverse reaction to medication, hives, prickly heat, diaper rash, scabies, insect bites, and skin infections, especially impetigo, a bacterial infection, and ringworm, caused by a fungal infection.