Eczema: Symptoms, treatment and prevention

1. Eczema: Endogenous and exogenous disorders

According to the National Eczema Association (NEA), eczema is a chronic inflammatory skin condition characterized by acute flare-ups superimposed on a chronic course. It develops in episodes or recurs, with clinical manifestations varying according to the disease stage. These may include red patches, blisters, oozing, or dry, thickened, scaly, and itchy skin.

2. Common signs and symptoms of eczema

The causes of eczema are complex and involve both endogenous and exogenous factors. Histologically, eczema is characterized by spongiosis, which manifests as tiny blisters on an erythematous background and causes itching and discomfort. Although eczema does not generally pose a serious threat to overall health, it can interfere with daily activities and social interactions. It is not contagious and cannot be transmitted from person to person.

The term eczema originates from the Greek word eczeo, meaning a lesion associated with blistering. According to medical literature, the term dates back to the second century BC, when the condition was understood to result from disturbances in certain internal bodily factors. Eczema lesions can vary considerably depending on the stage of development and the type of eczema.

A characteristic feature of eczema is that it can affect the skin at any age. Although its exact cause remains unknown, studies suggest that its development may be associated with increased levels of immunoglobulin E (IgE) antibodies in the blood and lymphocytes.

Eczema is divided into four important stages: the erythematous stage (skin redness), the vesicular stage (fluid-filled blisters and oozing), the dry and scaly stage, and the lichenification stage (thickened skin with prominent skin markings). Each stage has distinguishing signs, but the condition is generally characterized by persistent itching and frequent recurrence, with periods of remission alternating with flare-ups.

3. Stress can trigger eczema flare-ups

Eczema has a wide range of causes, including both endogenous and exogenous factors.

Endogenous factors include nervous system disturbances, such as prolonged stress, fatigue, and psychological pressure, which may disrupt immune function, lead to hypersensitivity reactions, and trigger eczema. Hormonal imbalances may also contribute, particularly in women with disruptions in female sex hormones, which can directly affect the menstrual cycle and reproductive function. In addition, hormonal disturbances may influence the immune system and stimulate lymphocyte activity, triggering flare-ups. Dysfunction of internal organs may also play a role.

Exogenous factors include other skin conditions, such as dermatitis, fungal infections, and scabies; exposure to disease-causing substances; air pollution and dust; highly detergent-based soaps; hazardous chemicals; venomous insects; sunlight; and food.

Although eczema does not generally have a major impact on overall health, its prolonged course and frequent recurrence, accompanied by itching, skin thickening, and hyperpigmentation, can interfere with daily activities and affect psychological well-being, appearance, and quality of life.

If not adequately controlled, eczema may lead to significant complications, including secondary infection of eczema lesions, which makes treatment more difficult, and generalized erythroderma. Eczema may also be associated with other conditions, including diarrhea and otitis media in infants; cataracts and conjunctivitis in children; and asthma and hay fever in adults. In young children, eczema may affect growth, cause fatigue, and contribute to physical weakness.

4. Treatment and prevention

Because the exact cause of eczema remains unclear, there is currently no definitive cure. Treatment primarily focuses on managing symptoms. However, patients need not be overly concerned. With appropriate treatment, adherence to medical advice, a balanced diet and lifestyle, and proper skin care, the condition can be controlled and recurrence reduced.

Anti-inflammatory medications are used to control symptoms promptly and limit secondary infections. Ointments and moisturizers help prevent dry skin, reduce peeling, and provide essential hydration.

For severe cases, doctors may prescribe oral or injectable corticosteroids. Other available treatment options include the biologic medication dupilumab, administered by injection, and phototherapy, which uses ultraviolet (UV) light directed at the skin to help heal lesions and promote skin recovery.

For prevention, maintain good skin hygiene and use moisturizer and sunscreen daily to protect the skin from harmful external factors. People with eczema should choose appropriate skin care products with a pH suitable for their skin and avoid highly alkaline products and harsh cleansers. Maintaining a healthy lifestyle, limiting prolonged stress, managing hormonal imbalances, and preventing physical exhaustion are also important.

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.