Eczema

Eczema

Eczema (pronounced eg-zuh-ma) is basically a group of various conditions which make the skin red, itchy, hot, dry and inflamed. There are many types of eczema that cause distinctive reaction patterns in the skin, which can be either acute or chronic and due to a number of causes.

The condition is very common but it is not contagious. Often, it is used synonymously with the term “dermatitis” which is a superficial inflammation of the epidermis (skin) that can be acute and chronic; owing to a number of causes. This is why another commonly used term to define eczema would be atopic dermatitis.

Eczema can manifest on any part of the body. It is also a condition that can be seen in infants. However, in infants, it usually occurs on the forehead, cheeks, forearms, legs, scalp and neck. The regions affected by the condition are dry, thickened or scalp in appearance. One may also see some hyperpigmentation. In kids and in adults, eczema generally manifests on the forehead, cheeks, forearms, legs, scalp and neck. The itchy rash could also show oozing and crusting. The repeated scratching can give a leathery texture to the skin due to thickening (lichenification).

Types of Eczema

There are two groups of eczemas: Exogenous and endogenous.
While overlap between the two groups is common, distinction between them is critical for treatment because avoidance of incriminating contactants takes precedence over other measures in the management of exogenous eczema.

Classification of Eczema

Exogenous

• Contact Dermatitis – Primary Irritant or Allergic Contact
• Photodermatitis
• Phytodermatitis
• Photophytodermatitis
• Hypostatic Or Varicose Eczema
• Lichen Simplex
• Autosensitization Dermatitis

Endogenous

  • Atopic
  • Seborrheic
  • Discoid
  • Asteatotic
  • Gravitational
  • Localized neurodermatitis
  • Pompholyx

Symptoms of Eczema

  • In the former, there is no secretion whereas in the latter, the patches may “weep,” either by scratching or without it
  • Redness and swelling, usually with ill-defined margin
  • Papules, vesicles and more rarely, large blisters
  • Exudation and cracking
  • Scaling
  • Lichenification, a dry leathery thickening with increased skin markings, is secondary to rubbing and scratching
  • Fissures and scratch marks
  • Pigmentation

Some of the related manifestations of eczema are:

  • Keratosis pilaris: Small, rough bumps like “chicken skin” on the surface of the arms, buttocks and anterior portion of thighs
  • Ichthyosis vulgaris: Fish-like scales, especially on the legs; thickened skin with increased visible lines on the palms and soles
  • Keratoconus: Cornea becomes cone-shaped in severe cases, usually in the later years
  • Dennie-Morgan line: Prominent skin folds below the eyes
  • Fissures form on the palms, soles and fingers
  • Red patches on the face
  • Pale area around the mouth (perioral pallor)
  • Dryness of skin
  • Recurrent, asymptomatic, hypopigmented scaly lesions on the face and shoulders

Causes of Eczema

It is difficult to pinpoint exact eczema causes as each of the varied types have their own causes. By and large, the cause of atopic (endogenous) eczema is genetic. Atopy is generally inherited and can be seen in families with a history of related disorders like asthma, hay fever, urticaria, food allergies, etc. A person with atopic eczema has a higher tendency to develop allergies to other things as well. Studies are being conducted to identify the causes of certain types of eczema, particularly the link between eczema and stress and environmental factors.

Essentially, the causes of eczema can be understood as:
1. Hereditary factors (makes one prone to eczema)
2. Environmental factors (triggers and sustains eczema)

The causes for exogenous eczema are also many with a few of the common ones being:
Direct or indirect contact with soaps, perfumes, dyes, cosmetics (deodorants, makeup, nail polish, etc.), metal compounds (nickel, mercury, etc.), rubber, leather, resins, etc. Exposure to sunlight can also be one of the causative factors.

The exact cause of other types of eczema such as infantile and adult seborrheic eczema, and discoid eczema, the causes remain unknown.

Eczema experienced in the silver years of life can be due to poor blood circulation in the legs (stasis dermatitis).

Stress and related negative emotions like grief, anxiety, guilt, frustration and suppressed emotions can affect the working of the hypothalamus and the adrenal glands which have a negative impact on your immunity. When the body’s immunity is lowered, the skin becomes more prone to such conditions.

Ayurveda and Eczema

According to Ayurveda, eczema or vicharchika can be primarily attributed to a poor diet and lifestyle which impairs digestion and aggravates Pitta dosha (biohumor representing Fire and Water). Pitta shows up in the skin as blisters and breakouts due to the accumulation of internally heating toxins called ama. When these toxins enter the deeper layers of the bodily tissues they contaminate them to cause this condition.
However, eczema may also be caused due to an imbalance of the other doshas. Here is a look at the different manifestations of the condition based on the dosha that is aggravated.
Vata dosha: This eczema is characterized by extreme dryness, scaling, itching and lots of pain and throbbing.
Pitta dosha: Pitta-type eczema shows up as red, blistery, bleeding, burning sensation and infections. Pitta people may be susceptible to seborrheic and contact dermatitis due to excess heat, particularly in the armpits and on the scalp.
Kapha dosha: Kaphic eczema itches, oozes and causes thickening of the skin. Kapha individuals may be prone to seborrheic eczema, especially in between rolls of fats as well as other moist sweaty areas.
Tridoshic eczema may show symptoms of all three types of eczema. This is commonly seen in most chronic cases.

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