Causes And Risk Factors Of Eczema
Skin affected by eczema is unable to retain moisture well, possibly because of low production of fats and oils. It is also caused by a disrupted skin barrier, allowing whatever moisture the skin has to freely evaporate into the air. This causes it to become dry and lose its protective properties.
It’s not clear what causes certain people to develop eczema, specifically atopic dermatitis.
Children are more likely to develop eczema if other allergic diseases such as hay fever and asthma run in the family, which suggests that there may be a genetic component to the condition. Read more about conditions related to eczema below.
Though dermatologists dont necessarily consider eczema an autoimmune disorder, the symptoms of atopic dermatitis are thought to be the result of an immune system overreaction or dysfunction.
Indian Journal of Dermatology
In addition to genetic and immune system factors, environmental factors also play a role in worsening or triggering eczema.
Eczema And Skin Pigmentation: What You Need To Know
Have you ever noticed that your eczema has created patches of skin that are darkeror lighterthan your usual skin tone? Depending on how much melanin you have, your eczema can appear purple, brown, gray, red, or pink. And the skin around it can be impacted too: scratching and lichenification can cause eczema skin discoloration. While changes to skin pigment can occur in all skin types, its most common and most noticeable in skin of color. Heres what you need to know about the ways eczema can impact your pigment-and how reducing itch and inflammation can help minimize discoloration.
Eczema And Your Surroundings
Specific materials and products in your surroundings can trigger eczema. Usually, these triggers cause contact dermatitis. This form of eczema is especially common for those who work in professions with many triggers, such as hairstylists, mechanics and custodians. Whether you work in these professions or not, your surroundings may be causing your eczema to flare-up after touching specific dyes, cleaning products and other chemicals.
Your environment can also trigger eczema flare-ups, especially if you live somewhere known for environmental extremes. Folks who live in extremely cold and damp places or hot and swampy places may be at a higher risk of eczema. This can also be true for certain seasons. If summers where you live are particularly hot and sweaty, you may experience more eczema flare-ups in summer than in fall, winter or spring.
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Understanding Different Kinds Of Eczema Pigmentation
Inflammation stimulates the activity of melanocytes, the cells that give skin their color, boosting the production of skin pigment and causing darker patches of skin, or hyperpigmentation. Every time you scratch your skin, more melanin is released and the patch of skin gets darker. Since those with darker skin have more melanin, the reaction causes even more pigment production.
Darker patches of skin are a result of post-inflammatory pigmentation or lichenification.
Post-inflammatory pigmentation: After an eczema flare subsides, skin might be darker in the places where eczema lesions have healed. This is called post-inflammatory pigmentation and itâs also more common in darker skin .
While the dark patches caused by post-inflammatory pigmentation will eventually fade, they can remain on the skin for months and may last even longer. Research shows that post-inflammatory pigmentation lasted up to 5 years in more than 22% of diagnosed cases. Daylight can make post-inflammatory pigmentation worse, so sun protection is essential.
Lighter patches of skin are called pityriasis alba.
Eczema pigmentation is often mistaken for scarring. If eczema patches become infected, they can leave scars, but hypopigmentation and hyperpigmentation have a totally different cause than scarring the pigment changes affect only the upper layer of the skin and donât leave scars. Unlike scars, which are permanent, pigment changes are temporary and often resolve on their own.
How To Use Topical Corticosteroids
Do not be afraid to apply the treatment to affected areas to control your eczema.
Unless instructed otherwise by a doctor, follow the directions on the patient information leaflet that comes with your medicine.
This will give details of how much to apply.
Most people only have to apply it once a day as there’s no evidence there’s any benefit to applying it more often.
When using a topical corticosteroid:
- apply your emollient first and ideally wait around 30 minutes until the emollient has soaked into your skin, or apply the corticosteroid at a different time of day
- apply the recommended amount of the topical corticosteroid to the affected area
- continue to use it until 48 hours after the flare-up has cleared so the inflammation under the skin surface is treated
Occasionally, your doctor may suggest using a topical corticosteroid less frequently, but over a longer period of time. This is designed to help prevent flare-ups.
This is sometimes called weekend treatment, where a person who has already gained control of their eczema uses the topical corticosteroid every weekend on the trouble sites to prevent them becoming active again.
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How Can You Tell The Difference Between Paget’s Disease And Eczema
Pagets disease of the breast is a rare form of breast cancer that involves the skin of the nipple and can extend onto the areola. It has many of the same symptoms as breast eczema, which can sometimes lead to a misdiagnosis. These symptoms include:
- Itching, tingling or discoloration in the nipple area.
- Flaky, crusty or thickened skin.
- A flattened or turned in nipple.
- Yellow or bloody leakage from the skin of the nipple.
However, there are differences between Pagets disease and eczema. Pagets disease may affect your nipple, while eczema rarely affects your nipple. Pagets disease also typically only affects one breast, while eczema affects both breasts and other parts of your chest.
Pagets disease wont respond to the same treatments as eczema. The tests used to diagnose Pagets disease include:
Eczema In Young Children And Babies
Eczema can affect anyone at any age, but it is often quite common in young children. When young children have eczema, family history is almost always the cause. Even if eczema doesnt run in the family, genetics could still be at play children who have family members with hay fever, other allergies or asthma are at risk too.
Baby eczema, on the other hand, is often caused when a babys sensitive skin comes into contact with an environmental irritant. These irritants can include:
- certain cleansers, soaps and shampoos
- dry air or colder environments
- certain ointments and baby lotions
- home products with irritating fragrances
To learn more about what products can be used on sensitive baby skin or for children with eczema, check out these products that have the National Eczema Associations Seal of Acceptance.
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Eczema Can Vary By Ethnic Background
Alexis, director of Mt. Sinais Skin of Color Center, says that the 20-year-old center, the first of its kind, was created to address distinctions in skin type that can change how dermatological conditions are diagnosed and treated.
In dermatology, skin of color means the skin of anyone with non-white ancestry. Its important because, historically, white skin was the default used to teach medical students how to recognize and treat skin conditions, Alexis said.
That means the language and the images in textbooks have historically had a Eurocentric approach, he said.
Weve now recognized that there are a number of educational, research and therapeutic gaps when it comes to skin conditions that affect patients of color. Our center has worked to close these gaps by raising awareness of the diagnostic and treatment nuances that can exist among people of different ethnicities.
How eczema appears on skin of color isnt the only clinically meaningful feature of the disease that can vary with ethnic background, said Mamta Jhaveri, MD, MS, a board-certified dermatologist and assistant professor of dermatology at the Johns Hopkins University School of Medicine in Baltimore, Maryland.
People with darker skin types also seem more likely to have papular eczema and to develop follicular prominence or bumps around hair follicles.
How To Get Rid Of Light Spots And Patches
To give you expert advice, we turned to Nada Elbuluk, MD, MSc, FAAD, who is a board-certified dermatologist and Director and Founder of the Skin of Color Center and Pigmentary Disorders Clinic at the University of Southern California in Los Angeles.
Dr. Elbuluk recommends these three self-care tips for anyone who notices light spots:
Pay close attention to your skin for a few weeks. Heres what to look for:
When to see a dermatologist:
Protect the light areas from the sun. Often, your body will start making pigment to heal a light area. If your body is making pigment, sunlight can cause your body to overdo it, says Dr. Elbuluk. When your body overdoes it on making pigment, those light spots become dark spots.To protect your skin from sunlight, dermatologists recommend following these tips when youre outdoors. Cover the light-colored skin with clothing like long sleeves and pants. You also want to stay in the shade.If you cannot cover up with clothing, apply sunscreen before going outdoors. To get the protection you need, use sunscreen that offers all of the following:
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Freckles Can Be Cute But If You Have Dark Spots On Your Skin That You Dont Want There Are Ways To Remove Them
If youre bothered by darks spots due to hyperpigmentation on your skin, one thing is clear: Today there are more options for erasing that harmless but irksome discoloration than ever before.
What exactly is hyperpigmentation? Its any patch of skin that looks darker than your natural skin tone due to overproduction of the brown pigment melanin. According to the American Academy of Dermatology , the most common causes of hyperpigmentation which can affect people of all skin tones in varying degrees are:
- Inflammation Skin trauma such as acne, eczema, bug bites, cuts, scrapes, even scratching or friction from, say, vigorous rubbing can set off inflammation. Inflammation, in turn, can send pigment-producing cells into high gear, leaving behind a dark spot after the injury has healed.
Can Eczema Cause Dark Skin Discoloration
Eczema is an inflammatory condition that often leaves dark patches of skin when it heals, especially on darker skin tones. The skin cells that affect pigmentation are sensitive to inflammation.
During the post-inflammatory stages, these cells produce extra pigment, leading to lichenification and dark spots. They can resemble acne scars and may last weeks to months. Eventually, they typically go away.
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Scratching Often Leads To Hyperpigmentation
Inflammation and scratching stimulate pigmentation. Simply scratching the skin, even without eczema, can cause brown patches, for example on the back. Eczema lichenificationthe thickening of the skin due to scratchingoften appears hyperpigmented on dark skin.
This hyperpigmentation is temporary and is gradually reduced with treatment.
We also observe on dark skin a particular form of lichenification comprised of, for example, isolated spots .
Home Cures For Eczema Scarring
As promised, here are some effective home remedies for soothing and minimising the appearance of eczema scars. Some may work for you whilst others may prove less effective. But since theyre all natural and many are made from ingredients you may already have in your kitchen cupboards all the fun will be in the experimenting.
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Pigment Changes Affect Quality Of Life
People of color often have more severe courses of AD, including more intense itching that can lead to chronic scratching and scarring, said Jhaveri.
Alexis noted that studies show African Americans with AD use more healthcare services for the skin condition, indicating a greater burden of disease.
The reason isnt completely understood, but Alexis thinks hypo and hyperpigmentation may be contributing factors. The pigment changes are often more noticeable and therefore more disfiguring in skin of color.
Pigment changes can affect quality of life, he said. If they involve arms or legs, patients may not feel comfortable exposing those areas, for example. This can mean they skip social events or arent comfortable with certain activities like swimming because of unevenness of skin tone.
Mercedes Matz, diagnosed with eczema at 6 months old, doesnt remember a life without severe AD. She has hyperpigmentation and scarring from the years she struggled to bring deep itching, that caused hours of scratching with no relief and other symptoms, under control.
My skin is 1,000% better than it used to be. With the help of my dermatologist and an interleukin blocker , I dont get flares as frequently as before, and if I do, theyre fairly mild, said Matz, 25, who is African American.
I think, just like anybody, I have days when I wish I had perfect skin. Then I reflect on where I used to be and how my skin was, and Im grateful for where it is now.
When To See A Healthcare Provider
Eczema can usually be managed at home. However, there are times when it is best to contact a healthcare provider. Contact a healthcare provider if:
- You have a new case of eczema.
- The eczema on your face does not get better with treatment.
- Your skin appears to be infected.
- You experience changes in your vision.
Eczema on the face can appear for a few days or can last for a long time. If the eczema is new or is not improving, it’s time to contact a healthcare provider. A healthcare provider will determine the cause of the rash.
When someone has eczema, they are at a greater risk for an infection. The healthcare provider may want to see the infection and test it to determine if it is a bacterial, viral, or fungal. Determining the cause of the infection will guide the healthcare provider’s treatment.
Anytime you experience a change in eyesight, contact a healthcare provider. There could be changes in the cornea from keratoconus.
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How Do I Manage My Eczema Symptoms
Treating and managing eczema can be difficult if the cause is something you cant control, like genetics. Fortunately, you may have some influence over your environment and stress levels. Do your best to figure out what triggers or worsens your eczema, and then avoid it. The goal is to reduce itching and discomfort and prevent infection and additional flare-ups.
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Laser Therapy And Chemical Peels
Ablative laser procedures remove layers of skin, while non-ablative laser procedures can help tighten skin and promote the growth of collagen.
Your dermatologist can help you determine the best type of laser therapy for your skin type.
Chemical peels, like glycolic acid peels, remove the top layer of the skin, which can help get rid of patches of hyperpigmentation. You can get this procedure done at a dermatologists office or by a licensed aesthetician at a spa.
Research on using chemical peels for hyperpigmentation has found mixed results.
Chemical peels seem most effective when used with topical prescription medications like tretinoin and hydroquinone. According to Fowler, gentler lactic and mandelic acid peels may be a better option if you have sensitive, irritation-prone skin.
All of these treatments can increase your sensitivity to the sun, so its crucial to wear sunscreen daily while using them.
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How Did I Get Eczema On My Breast
Eczema can develop anywhere on your skin, including your breasts. A combination of immune system activation, genetics, environmental triggers and stress can cause it.
- Immune system: If you have breast eczema, your immune system overreacts to minor irritants or allergens. This overreaction can inflame your skin.
- Genetics: Youre more likely to have breast eczema if you have a history of eczema in your family. Youre also at a higher risk if you have a family history of hay fever, asthma and allergens. Allergens are substances like pollen, pet hair or foods that trigger an allergic reaction. There might also be a change in your genes that control a protein that helps your body maintain healthy skin. Without normal levels of that protein, your skin wont be completely healthy.
- Environment: A lot of irritants in your environment can irritate your skin. Some examples include tobacco smoke, air pollutants, harsh soaps, fabrics such as wool and some skin care products. Low humidity can cause your skin to become dry and itchy. Heat and humidity can cause sweating, and sweating can make itchiness worse. If you have a breast eczema flare-up after coming into contact with an allergen or irritant, you may have contact dermatitis.
- Stress: Your stress levels can cause or worsen your breast eczema. There are mental and emotional signs of stress and physical signs of stress.
What are the mental/emotional signs of stress and physical signs of stress that can cause breast eczema?
Is Lemon Bad For Eczema
Oranges, lemons, grapefruit, and other fruits that fall under the category of citrus fruits are known to be common sources that cause allergic reactions. The chemicals found in citrus fruits may increase the symptoms of eczema, so it is best to avoid them if suffering from eczema.
Does eczema leave discoloration?
A major concern for people of color is the skin discoloration associated with eczema. Eczema or scratching secondary to the itch of eczema can lead to darkening or lightening of the skin.
Can eczema cause permanent scarring?
Permanent scars can be a complication of eczema. The dry skin associated with eczema can cause itching and scratching that can damage, break, and scar already sensitive skin. To prevent scarring, avoid rubbing and scratching.
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