What’s the Deal with My Moody Skin? Eczema Explained

Eczema in dictionary Eczema in dictionary

Understanding exactly what’s going on with your skin can be so frustrating, especially when research confirms that you either have a simple rash, are suffering from eczema or are dying of a rare airborne flesh-eating disease. We can’t really speak to rare diseases, but we do know a thing or two about eczema, which impacts quality of life for as many as 10% of adults and 16% of children worldwide.*

It’s all Greek to me.

Much of the confusion surrounding eczema is due to the fact that it’s a super-general term for a slew of skin conditions that cause red, irritated and inflamed skin. Even the Greek word from which eczema stems proves vague, meaning, “to boil over.” In essence, it’s like using the word “tree,” which doesn’t tell you a whole heck of a lot. What type of tree is it? What’s its common name? Is it evergreen? Fruit bearing? That said, when most people throw around the term “eczema” they’re referring to genetic condition called atopic dermatitis. (Yep, it stems from the good ol’ family tree.)

‘Tis but thy name that is my enemy. (aka Who cares what it’s called, what is it?)

Hey, Shakespeare said it best. Basically, it doesn’t really matter what you call it, what the heck is it? Atopic dermatitis (let’s just stick to calling it “eczema” like everybody else) causes a hyperactive immune response when the skin is exposed to allergens and other irritants. Why? If you’ve got eczema, your genetic makeup gives you the short end of the stick when it comes to having enough filaggrin. This protein acts like a skin-shield and a deficiency leaves your skin more porous and vulnerable to irritants that can breach the surface. This open-door policy makes the immune system work overtime, and like a diligent bouncer at a rowdy club, it gets all puffed up in its attempts to strong-arm irritants out — i.e. inflamed.

How can I get more of this f’in thing? (filaggrin, people, it’s called filaggrin.)

At this point, the next logical question is, “Why can’t an eczema sufferer simply pop a filaggrin pill and be done with it?” Wish it were that easy. There are some preliminary studies looking at whether taking daily oral proteinogenic amino acid supplementation called L-histidine can prompt filaggrin formation. Results seem promising in mitigating some of the symptoms, but it’s still murky as to whether it only helps those with certain gene mutations; more research needs to be done. And while eczema can be effectively treated and controlled, there is no cure for this maddening, embarrassing and often relentless skin condition. That leaves those of us with the condition confused about what can be done in the meantime. Especially since even those with dormant cases are susceptible to internal and external triggers. It’s a personal journey so being aware of and avoiding individual eczema triggers as well as following a daily skincare regime is vital to managing symptoms.

How do I know if I have it?

In short, unless you studied the nuances of epidermal epidemiology in medical school, you don’t. That’s why scheduling an appointment with a dermatologist proves much more telling than a sesh with Dr. Google. That said, we understand that when your skin feels like it’s on fire, you want a little instant gratification in getting some answers. Here are a few of the signs that could point to eczema until you can get an appointment with a medical professional.

Flare and Compare

  1. Itchiness The most prominent symptom of eczema is itchiness. It can range anywhere from minor to severe. People living with the condition will often scratch flare-ups to the point of drawing blood; a no-no that dermatologists refer to as the itch-scratch cycle.
  2. Inflamed Skin Look for red to brownish-gray patches that tend to crop up on the hands, feet, ankles, wrists, upper chest and neck
  3. Rough, Leathery Patches Developing a thick skin to awkward stares is one thing, but thickened, hardened patches of skin that may appear cracked or scaly could be signs of eczema.
  4. Small Raised Bumps Think goose bumps gone rogue. They will often leak fluid and crust over when scratched.
  5. Areas of Swelling Swelling near the point of flare-up, often exacerbated by scratching, can indicate inflammation caused by eczema.

Where does it crop up?

Eczema can appear anywhere on your body, but it does tend to have favorite go-to locations — especially when factoring your age. Infants are most likely to have flare-ups on their face, cheeks and scalp. Babies (6 to 12 months) tend to have flare-ups on their knees and elbows (areas inadvertently scratched when crawling or scooting around). Children (5 years and older) get flare-ups on their hands, elbows and knees. And in adults, eczema makes regular appearances around the eyes and on the back of the knees and elbows.

Is it contagious?

Feel like people recoil from a handshake during an outbreak? You can say with the utmost confidence that eczema is not contagious. However, eczema flare-ups are susceptible to bacteria, fungus and virus, so it is important to monitor breakouts for signs of further infection.

Mystery solved. Now what?

Ok, you cracked the case: It’s eczema. Your dermatologist can help you devise a treatment plan and we’re here to let you know that there are steps you can take to help crack down on flare-ups in the future. Here are a few that can help reduce the number and severity of outbreaks.

  • Moisturize daily. Seaweed based moisturizers have proven especially effective in preventing flare-ups and trouble spots.
  • Avoid temperature extremes.Think warm showers not hot.
  • Reduce stress.
  • Avoid harsh chemicals like those often found in cleaning products, hand soap, etc.
  • Avoid eczema trigger foods. Stave the crave.

Remember that even if you got your system locked down and seem to be doing everything right, eczema can still break out from time to time. Don’t scratch and try not to fret. It’s an ailment that’s been largely demystified so management is within reach.

Resources:
https://www.ncbi.nlm.nih.gov/pubmed/29042806

Regarding daily oral l-histidine supplementation
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634381/

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