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Eczema/Dermatitis Eczema is
a form of dermatitis, or inflammation of the upper layers
of the skin and is often linked with allergic or sensitive reactions to a
variety of substances including chemicals contained in household cleaning
products. The term eczema is broadly applied to a range of persistent or
recurring skin rashes characterized by redness, skin oedema (swelling),
itching and dryness, with possible crusting, flaking, blistering, cracking, oozing or bleeding. More Common Eczemas Atopic eczema (also known as infantile eczema, flexural eczema
and atopic dermatitis) is thought to be hereditary,
and often runs in families whose members also have hay fever and asthma.
Itchy rash is particularly noticeable on the face and scalp, neck, inside of
elbows, behind knees, and buttocks. Experts are urging doctors to be more
vigilant in weeding out cases that are actually irritant contact dermatitis,
which is very common in developed countries, and rising. Contact
dermatitis is of two types: allergic (resulting from a delayed reaction to
some allergen, such as poison ivy or nickel), and irritant (resulting from
direct reaction to, say, a solvent). Some substances act both as allergen and
irritant (e.g. dishwasher powder). Other substances cause a problem after
sunlight exposure, bringing on phototoxic dermatitis. About three quarters of
cases of contact eczema are of the irritant type, which is the most common
occupational skin disease. Contact eczema is curable provided the offending
substance can be avoided, and its traces removed from one’s environment. A patch
of eczema that has been scratched is known as Xerotic
eczema (also called asteatotic eczema, eczema craquele or craquelatum, winter
itch, pruritus or hiemalis).
It worsens in dry winter weather, and the limbs and trunk are most often
affected. The itchy, tender skin resembles a dry, cracked, river bed. This
disorder is very common among the older population. Ichthyosis
is a related disorder. Seborrheic dermatitis (also called cradle cap in infants, and
dandruff in adults) causes dry or greasy scaling of the scalp and eyebrows. Scaly
pimples and red patches sometimes appear in various adjacent places. In
newborns it causes a thick, yellow crusty scalp rash called cradle cap which
seems related to lack of biotin, and is often curable by removing contact
with irritants. Atopic Eczema Atopic eczema (also called atopic
dermatitis) is a group of diseases involving inflammation of the skin with
intense itching, reddening, dryness, blistering and scaling and the official
term is "the Atopic Eczema/Dermatitis
Syndrome" (AEDS), although most people simply
use the terms eczema and dermatitis. In many cases, the symptoms of AEDS are made severely worse by contact with chemical
irritants and in many cases, removing the source of these irritants, combined
with the application of a safe moisturiser, can bring about partial or total
relief. AEDS is not contagious – it cannot be transmitted by, or to,
another person. It is a condition that may continue to occur, with varying
degrees of severity, over a number of years. In the In
identical twins, if one twin has AEDS, the
likelihood of the other twin also developing AEDS is 75%-85%. In non-identical twins the likelihood is 30%.
In some people with AEDS, allergic reactions are
clearly responsible for the development of the disease. There are also many individuals in whom non-specific factors, such as skin irritants
or psychological influences, appear to be important. AEDS consists of at least two different disorders. Sufferers
belonging to the allergy-associated subgroup of AEDS
will get worsening of their eczema on contact with classical allergens, e.g.,
chemical residues from washing detergents. The other subgroups of AEDS are less well understood, but they are believed to
result from internal mechanisms although symptomatic relief is still aided by
the removal of chemical ittitants and the regular
application of safe moisturisers. AEDS often begins with "cradle cap" in babies, after
the first 3 months. As the baby becomes a toddler, the disease spreads to the
face, outer elbows and knees, and the skin becomes oozing and crusting. Later
on, eczema develops on the neck, hands, the inner elbows, and behind the
knees. The skin becomes dry and scaly as a result of scratching and rubbing.
In adults this may also result in weeping, itchy lumps and patches, the
"prurigo form" of AEDS.
New
flare-ups of AEDS often start without obvious symptoms, except for increased itching, which is followed
by raised red lumps. These features can also occur in other skin disorders,
and so to confirm a diagnosis the doctor will look for four of the following
symptoms: • Areas of skin showing the typical appearance of eczema; • Early onset of symptoms of eczema; • Typical location of the affected areas, bearing in mind
the patient’s age; • Itching; • Personal or family history of allergic diseases –
eczema, hay fever, asthma; • Evidence of reactions diagnosed by allergy skin prick
tests or allergy blood tests. Contact Dermatitis Contact
dermatitis is a skin reaction caused by an external agent – often a harsh
man-made chemical. This agent can affect the skin by direct contact, by
airborne contamination and inhalation, or by ingestion. In all types of
contact dermatitis, only the upper layers of the skin are affected. Upon
examination of the affected tissue, inflammation is observed to be present in
the epidermis (the outermost layer of skin) and the outer dermis (the layer
beneath the epidermis) Contact
dermatitis is unlike Contact Urticaria, in which a
rash that appears within minutes of exposure will fade away within minutes to
hours. Contact dermatitis takes days to fade away and only if the skin no
longer comes into contact with the agent that caused the damage in the first
place. Chronic contact dermatitis can develop where the removal of the
offending agent no longer provides expected relief. Irritant Contact Dermatitis (ICD) This is
the most common form of contact dermatitis, affecting around 1-2% of healthy
Europeans and can be caused by either a regular, prolonged, acute or chronic
exposure to a toxic chemical. It is also referred to as non-allergic contact
dermatitis (or housewives eczema). Chemical
Irritant Contact Dermatitis (CICD) can be
subdivided into acute and chronic ICD which are
usually associated with strong and weak irritants respectively. The way
damage is caused varies between toxins, and can even involve chemical burns.
Detergents, surfactants, extremes of pH (acidity or alkalinity) and organic
solvents all have the common effect of directly affecting the barrier
properties of the epidermis (the outer layer of skin). Cellular damage can be
caused and the outer skin layers can become thinner thus reducing the
resistance to further skin damage and infections. Strong concentrations of
chemical irritants cause an acute effect, but this is not as common as the
accumulative, chronic effect of weaker irritants whose effects build up with
subsequent doses – the longer your skin is exposed to harsh chemicals, the
more serious the condition tends to become. Eczema/Dermatitis and Detergents The first
and primary recommendation is that people suffering from eczema/dermatitis
shouldn't use detergents of any kind unless absolutely necessary. The current
medical school of thought is that people wash too much and that eczema
sufferers should use cleansers only when water is not sufficient to remove
dirt from skin. Another
point of view is that detergents are so ubiquitous in modern environments and
so persistent in tissues and surfaces that safe soaps are necessary to remove
them in order to eliminate the eczema. Although most recommendations use the
terms "detergents" and "soaps" interchangeably, and tell
eczema sufferers to avoid both, detergents and soaps are not the same and are
not equally problematic to eczema sufferers. Detergents increase the
permeability of skin membranes in a way that soaps and water alone do not.
Sodium lauryl sulfate,
the most common household detergent, has been shown to increase sensitivity
to the allergic response caused by other chemicals. The use
of detergents in recent decades has increased dramatically, while the use of
soaps began to decline when detergents were invented, and levelled off to a
constant around the 1960s. Unfortunately
there is no one agreed upon best kind of cleanser for eczema sufferers.
Different clinical tests, sponsored by different personal product companies,
unsurprisingly tout various brands as the most skin friendly based on
specific properties of various products and different underlying assumptions
as to what really determines skin friendliness. The terms
"hypoallergenic" and "doctor tested" are not regulated (according
to Consumer Reports), and no research has been done showing that products
labelled "hypoallergenic" are in fact less problematic than any
others. Perhaps the best way to find which products are actually best is to
see what other users have to say – and then try them yourself. Dermatological
recommendations in choosing a soap generally include:
How to
use soap:
Moisturizing Eczema/Dermatitis
severely dries out the skin, and keeping the affected area moistened can
promote healing and retain natural moisture. In addition to removing harsh
chemicals from your home, this is the most important self-care treatment that
you can use in atopic and contact
eczema/dermatitis. The use
of anything that may dry out the skin should be discontinued and this
includes both normal soaps and bubble baths that remove the natural oils from
the skin. The
moistening agents are called 'emollients'. The rule to use is: match the
thicker ointments to the driest, flakiest skin. Light emollients like Aqueous
Cream may dry the skin if it is very flaky and whilst it is the moisturiser
traditionally prescribed by doctors in the Emollient
bath oils should be added to bath water and then suitable agents applied
after patting the skin dry. Generally twice daily applications of emollients
work best and whilst most creams are easy to apply, they are quickly absorbed
into the skin, therefore needing frequent re-application. Ointments, with
their lesser water content, stay on the skin for longer and so need fewer
applications but some must be applied sparingly if you are to avoid a sticky mess. Many
people report that taking a combined approach of removing the harsh chemicals
contained in household cleaners or personal care products from their homes
and also using suitable moisturisers has had a dramatic beneficial effect….. Eczema, Psoriasis and chemical residue “Since replacing all the chemicals in my house and using
the Intensive Skin Therapy lotion, my eczema and psoriasis have disappeared.
My doctor admitted that we were treating the result of the problem – not the
cause! What was the cause? Irritating and drying chemical residue.
He explained that our skin is our largest organ. Consequently, everything
that comes in contact with it can have an effect. That made me think… just
about all of the clothes detergents on the store shelves today leave some
sort of residue on your clothes. Then my attention turned to our personal care stuff,… everything from deodorant to shampoo and lotions. What
did I find? Many of our personal care products that come in contact with our
skin contain Formaldehyde!!!! Which by the way, goes by many different names
AND is NOT required to be listed on the label! For those who do not know,
this is used to preserve dead bodies! Can we say "EEEYYYEEEWWWW"? The Company has truly given me peace of mind, knowing that
their scientists do extensive research to provide only the safest ingredients
in their products.” Jean Smith |