Last Sunday, the Presbyterian Church organised a “Christian Girls In Training (CGIT)”. During questions and answers I interacted with the young girls. 5 out of 15 questions were about eczema and acne. It was then I realised that puberty, adolescence and their related complications were the least of teenage worries.

   They wanted flawless skins, so as to look good, and because they made a huge fuss, about the afflictions of their skins. These girls knew more “dermotones” than a qualified doctor, so I decided to discuss eczema.

What is eczema?

Eczema also known as atopic dermatitis is a common chronic skin disease that causes dry, itchy and flaky red skin. It appears as small red bumps. With continuous scratching the skin may become thickened and leathery.

  Eczematous patches have a poorly defined edge and at various stages may show erythema, oedema, scaling, papules, vesicles, weeping and pustules.

   Eczema is also a general term for any skin condition usually resulting from exposure to a particular substance. Some substances normally have an irritating effect on people’s skins; others only affect people who are hypersensitive to some substances(allergy).

   An irritant reaction usually develops immediately. In an allergic reaction, there is normally a delay of 7 to 21 days between the first exposure to the offending substance, and the re-exposure which produces dermatitis.

What are the causes of eczema?

   1) Idiopathic – which is a medical term that means unknown.

  2) Allergy – frequent culprits include cosmetics, dyes, clothes, industrial chemicals, insecticides, detergents, paints, rubber, metal, plastic, and sometimes certain plants and food. Many are encountered by the young girls at school or work.

After contact with the offending substance, the blood vessels dilate and become porous. This allows fluid from the cells to collect in the skin and form blisters, which eventually rupture and expose the skin beneath. Later, the fluid dries out, and the area becomes encrusted. The skin thickens around the sores, and flakes off in scales.

3) Genetics – the current research has shown that eczema is also genetically linked

4) Abnormal function of the immune system is also linked to eczema.

  5) Environment has also been implicated as a causative agent of eczema.

What are the types of eczema?

   Eczema may be divided into two main groups a) Constitutional and b) Endogenous.

A) Constitutional Eczema – this is a genetically determined disorder, there is often a previous or family history of eczema or asthma. In a few patients the skin may be permanently rough and dry(xeroderma). Several patterns of distribution of eczema can be distinguished.

   1)) Eczema predominantly affecting the front of elbows, back of the knees and around the neck.

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   2)) Eczema of the palms and soles. If vesicles and bullae(minor swelling)  are prominent the condition is known as pompholox(what a name).

3) Seborrhoeic eczema – involves the back of the ears, under the breasts, the axillae, groins and perineum(around the genitals).

   4) Discoid eczema – which is common in Africa, takes the form of a well demarcated-coin-shaped plaques on any part of the body. Affects mostly children.

   5) Infantile eczema – this starts in the first 6 months of life usually on the face and scalp.

6) Pityriasis Alba – These are superficial, pale, scaly plaques of eczema occur on the face in children, but can spread to the trunk and limbs.

What are the symptoms of eczema?

   a) Skin will itch before a rash.

   b) Patches of chronically itchy, dry, thickened skin, usually on the hands, neck, face, and legs.

   c) If scratched, dry patches of skin and open sores with crusts may develop and may get infected.

How do we treat eczema?

   1) Good skin care is the key. If the eczema is mild, that may be all that you need, along with some changes in your daily habits.

   2) Soap and moisturizer – use a mild soap, a good moisturizer in cream, lotion or ointment form.

   3) Stress management – get regular exercise, and set aside time to relax.

   4) Drugs – Hydrocortisone, antihistamines, corticosteroids and ultraviolet light therapy could be used for treatment of eczema at the prescription and direction of your doctor.

5) Protective measures such as the wearing of cotton gloves under rubber gloves may be required to protect you from contracting eczema. Be medically guided.

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