The Basic Facts About Eczema

Medical textbooks refer to eczema as "the itch that rashes."

That's because one of the basic facts about eczema vs. infection is that eczema rash only appears after you scratch your itch. In the highly unlikely event you never scratched, soaked, heated, rubbed, or even touched your itchy skin, eczema would not cause a rash.

Technically, the medical term "eczema" refers to a crusty, dull (seldom shiny except in infants) red rash. Eczema is caused by an underlying condition, a common skin irritation called atopic dermatitis. You can have atopic dermatitis without having eczema, but you can't have eczema without having atopic dermatitis.

What does "atopic" mean? Atopic conditions (also known as "atopy") are a group of diseases that tend to occur together. These include "allergies," not just skin allergies, itching, and hives but also respiratory allergies, especially hay fever, along with asthma and eczema.

One way to distinguish eczema vs. infection is the order in which symptoms appear in atopic dermatitis. Eczema symptoms include at least itch, followed by:

Red, irritated rash, followed by White scaly buildup on the skin (hyperkeratosis), followed by Thickening, darkening, and roughing of the skin when it heals (lichenification), followed by Altered skin color, followed by Scratch marks.

What does eczema look like on specific parts of the body? There may also be:

Eczema symptoms on hands including especially irritated skin and thickened, pitted, or ridged fingernails, Eczema on soles of feet featuring flaking, thickening, and cracked skin, Red patches on the tongue starting in the center and spreading outwards (geographic tongue), Eye irritation (conjunctivitis), Creases in the lower eyelid (Denny-Morgan folds), Enlarged lymph glands, and, in the very worst cases, Malnutrition, unhealthy low blood pressure, and shock.

People who have eczema tend to have skin that is dry, sensitive to irritants, pigmented with age spots or freckles, and tight, that is, with limited sagging and wrinkling. People who have eczema usually don't get acne.

An important part of eczema treatment is simply dealing with the weather. Age spots and freckles darken with exposure to sun. Dry winter cold aggravates eczema, although moist cool relieves it. Desert climates aggravate eczema any time of year. Moisturizers with peptides and ceramides are the first line of defense against low humidity.

People with eczema have to be careful around any household product designed for scrubbing surfaces clean. Dolomite in detergents and household cleaning powders can especially aggravate eczema. Be sure to wear gloves when using any cleansing powder around the house.

Skin color and skin type make a difference in how cosmetics interact with eczema-affected skin. Asians, Hispanics, and Blacks tend to have more rashes and more spotting of the skin, while Caucasians have more wrinkles and skin cancer. Asians, Hispanics, and Blacks with eczema respond better to oil-based cleansers, and should avoid any products containing hydroquinone.

In everyone's eczema skin care, moisturizer, creams, and facial waters are fine, but alpha-hydroxy acids and skin toners are a major no-no.

No one who has eczema should use skin toners, as these products contain drying ingredients. Instead of toners, people with eczema should spray the skin with a facial water and then apply a moisturizer. Vichy water (which contains sulfur) and La Roche-Posay water (which contains selenium) are a little more expensive but contain anti-inflammatory minerals.

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