The terms dermatitis and eczema are often used interchangeably and refers to a group of inflammatory conditions that affects the outer layer of the skin. Dermatitis is common, results from a variety of different causes and has various patterns. It may present as a single episode or can be a chronic recurrent condition. The treatment plan depends on the specific type and severity of eczema.
Types of Eczema
- Atopic dermatitis in children and adults with atopic backgrounds (eg family history of dermatitis or asthma)
- Irritant contact dermatitis is provoked by handling water, chemicals and friction. Common in atopic dermatitis.
- Nappy dermatitis
- Allergic contact dermatitis due to skin contact with substances that most people don't react to eg nickel, hair dye or preservatives. Patch testing helpful
- Nummular dermatitis are persistent, scattered coin-shaped irritable patches
- Seborrhoeic dermatitis and dandruff of the scalp and face
- Venous stasis dermatitis on the lower legs of the elderly, due to swelling and varricose veins.
- Unclassified eczema
Mimickers of eczema
- Infections (Ringworm, syphilis, scabies)
- Drug reactions
- Systemic conditions
What is the treatment for eczema?
- Bathing Once a day, using lukewarm water and a soap substitute
- Clothing Wear soft, smooth, cool clothes
- Irritants Protect your skin from water and chemicals
- Emollients Apply liberally and often, particularly after bathing
- Topical steroids Apply to the itchy patches
- Calcineurin inhibitors New anti-inflammatory treatment
- Antibiotics or Antivirals if infection is complicating the dermatitis
- Systemic treatment as second line treatment
Dermatitis is often a chronic problem. If you see the dermatologist during the acute phase of eczema, a follow-up appointment is usually advised to review and discuss the maintenance plan.