Eczema is a chronic and itchy inflammatory condition of the skin. It is not known what causes eczema but several possible links have been postulated with regards to genetic (family factor), environment (dust, temperature and change in season) as well as the “hygiene hypothesis” (where the lack of exposure to bacteria/virus causes the immune system to be oversensitive to own’s body).
Chronic eczema is characteristically recognised by the pattern of distribution of the skin rash, the symptoms and signs and the response towards the treatment given. The classic symptoms and signs of eczema are itchiness, dry scaly skin and red rashes. Due to the skin barrier becoming weak as a result of the constant inflammation process, the skin is more susceptible to foreign stress or exacerbators such as infection or irritants.
This makes bouts of eczematous exacerbations a common problem for eczema patients. It is sometimes difficult to differentiate between infection and irritants causing eczema exacerbation as the symptoms and signs are similar. However, from the history and examination, a doctor can make a correct diagnosis hence giving appropriate treatment.
What are the symptoms or signs of infected eczema?
A person who has chronic eczema will know immediately if their eczema behaves abnormally during the exacerbation period. The weakened skin barrier that supposes to protect the body from potential bacterial/viral infection such as Staphylococcus aureus and Herpes simplex 1 & 2 can easily get infected and worsen the eczematous condition of the skin.
The typical signs for bacterial infection of eczema skin are like swelling of the rashes, more itchiness, development of blisters (small or big) and crusted skin. Irritant-causing exacerbation of eczema is typically not presented with these features. Another type of infection is by fungus and this often harder to treat with characteristics of thick and scaly skin rashes.
Eczema infection by virus especially the Herpes simplex 1 or 2 virus can be presented as painful and multiple small blisters with golden-yellow crusts spreading all over the body. When the infection is caused by this virus, it is called eczema herpeticum. It is often mistaken with chickenpox, but with the former, the condition needs urgent review with anti-viral treatment to prevent complication especially to the eyes. Herpes simplex virus 1 & 2 are the same virus that is responsible for cold sore and genital herpes. This is why it is important for eczema patients to stay away from people with cold sores.
What are the treatment options?
Managing chronic eczema is challenging enough and adding skin infection to the already weakened skin, it surely a mountainous task for dermatologist and patient themselves to overcome. Chronic eczema is treated with advice to stay away from known exacerbating and triggering factors as well with topical (outside) use of emollients (creams or ointments), steroid creams/ointments, antihistamines (to prevent scratching due to itchiness), bandages, phototherapy and sometimes the use of systemic therapy.
Application of steroid-based treatments although relieves the itchiness and rash, paradoxically causing thinning of the skin and increase the susceptibility to infection. Antibiotics or antibacterial-based emollients are given during the exacerbation due to bacterial infection while antiviral such as aciclovir is given in case like eczema herpeticum.
Managing eczema needs cooperation from the patients and doctor as this condition can be lifelong. Nowadays people can have effective eczema treatment with ease from a certified doctor like the eczema treatments by DoctorOnCall. In summary, eczema is a long-term debilitating skin condition that needs a diagnosis and suitable treatments by the experts.
