Managing Chronic Eczema: Causes, Symptoms, and Treatment Options

Q: Managing Chronic Eczema: Causes, Symptoms, and Treatment Options

Hello： Eczema should not be scratched, as scratching can cause the skin to become rough and thick, resembling the bark of an old tree, leading to chronic eczema. <br>Any further scratching will definitely lead to a relapse. <br>It is advisable to avoid wearing necklaces temporari

Chronic eczema

Hello, doctor.
I used to not have any allergies, but now I often experience itchy nose and hives.
Recently, I developed eczema that took a long time to heal, but it has now relapsed into chronic eczema.
It's really frustrating because I have patches on my neck and feel embarrassed to wear sleeveless clothing.
What can I do to improve my chronic eczema? Will it keep recurring? I appreciate your help, thank you!

Angela, 10~19 year old female. Ask Date: 2010/09/29

Dr. Huang Ruiyun reply Dermatology

Hello: Eczema should not be scratched, as scratching can cause the skin to become rough and thick, resembling the bark of an old tree, leading to chronic eczema.
Any further scratching will definitely lead to a relapse.
It is advisable to avoid wearing necklaces temporarily to prevent friction and irritation.
For collared clothing, choose cotton fabrics, as materials that are itchy or irritating should be avoided.
Eczema on the neck is often related to stress, so if there is mental stress, it is important to find ways to adjust and alleviate it.
Wishing you peace.

Reply Date: 2010/09/29

More Info

Chronic eczema, also known as atopic dermatitis, is a common skin condition characterized by dry, itchy, and inflamed skin. It can be particularly frustrating for those who experience recurrent flare-ups, as you described. Understanding the causes, symptoms, and treatment options is crucial for managing this condition effectively.

Causes of Chronic Eczema
The exact cause of chronic eczema is not fully understood, but it is believed to be a combination of genetic and environmental factors. Individuals with a family history of eczema, allergies, or asthma are at a higher risk. The skin barrier in people with eczema is often compromised, leading to increased moisture loss and susceptibility to irritants and allergens. Common triggers include:
1. Irritants: Soaps, detergents, shampoos, and certain fabrics can irritate the skin.

2. Allergens: Pollen, pet dander, dust mites, and certain foods can provoke allergic reactions.

3. Weather: Extreme temperatures, humidity, and sweating can exacerbate symptoms.

4. Stress: Emotional stress can trigger or worsen flare-ups.

5. Hormonal Changes: Fluctuations in hormones, particularly in women, can influence eczema severity.

Symptoms of Chronic Eczema
Chronic eczema can present with various symptoms, including:
- Dry, sensitive skin
- Intense itching, which may worsen at night
- Red, inflamed patches of skin
- Thickened, leathery skin (lichenification) due to prolonged scratching
- Oozing or crusting in severe cases
In your case, the appearance of hives and nasal itching suggests that you may also be experiencing allergic reactions, which can often accompany eczema.

Treatment Options
Managing chronic eczema typically involves a multi-faceted approach:
1. Moisturizers: Regularly applying emollients or moisturizers is essential to maintain skin hydration and restore the skin barrier. Look for products that are fragrance-free and designed for sensitive skin.

2. Topical Corticosteroids: These are commonly prescribed to reduce inflammation and itching during flare-ups. It's important to use them as directed by your healthcare provider to avoid potential side effects.

3. Topical Calcineurin Inhibitors: Medications like tacrolimus or pimecrolimus can be used as alternatives to corticosteroids for sensitive areas, such as the face and neck.

4. Antihistamines: If itching is severe, oral antihistamines may help alleviate symptoms, especially at night.

5. Phototherapy: In some cases, controlled exposure to ultraviolet light can help reduce symptoms.

6. Systemic Medications: For severe cases that do not respond to topical treatments, systemic medications such as corticosteroids or immunosuppressants may be considered.

7. Avoiding Triggers: Identifying and avoiding personal triggers is crucial. Keeping a diary of flare-ups can help pinpoint what exacerbates your condition.

8. Lifestyle Modifications: Stress management techniques, such as mindfulness or yoga, can also be beneficial in reducing flare-ups.

Prognosis and Recurrence
Chronic eczema is often a lifelong condition, and while it can improve with treatment, flare-ups may still occur. Many individuals find that their symptoms lessen with age, but some may continue to experience eczema into adulthood. Consistent management and preventive measures can significantly reduce the frequency and severity of flare-ups.

Conclusion
In summary, managing chronic eczema requires a comprehensive approach that includes moisturizing, medication, and lifestyle adjustments. It's essential to work closely with a healthcare provider to develop a personalized treatment plan that addresses your specific needs. If you find that your symptoms persist or worsen, consider seeking a referral to a dermatologist or an allergist for further evaluation and management. Remember, you are not alone in this journey, and with the right strategies, you can achieve better control over your eczema.

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