What is Eczema?

Eczema is also known as atopic dermatitis, or atopic eczema (the most common form of eczema). Atopic eczema mainly affects children, but it can continue into adulthood or start later in life. The word eczema comes from the Greek word ekzein meaning "to boil out"; the Greek word ek means "out", while the Greek word zema means boiling.

Eczema is a chronic skin condition in which the skin becomes itchy, reddened, cracked and dry. Approximately 30% of all skin-related GP visits in Western Europe result in a diagnosis of atopic eczema.
It affects both males and females equally, as well as people from different ethnic backgrounds. Most GPs (general practitioners, primary care physicians) in Western Europe, North America and Australia say the number of people diagnosed each year with eczema is has been rising in recent years.

Atopy is the hereditary predisposition toward developing some hypersensitivity reactions, such as hay fever, asthma, chronic urticaria, and some types of eczema. Atopic eczema, therefore, means a form of eczema characterized by atopy - in other words, inherited eczema.

Approximately 80% of atopic eczema cases start before the age of 5, and a sizeable number develops it during their first year of life.


Scottish researchers reported that children with severe eczema feel their quality of life is impaired to the same extent as those with chronic illnesses such as epilepsy, kidney disease and diabetes.

Many young children who get atopic eczema develop asthma months or years later, this is called The Atopic March. Scientists at Washington University School of Medicine in St. Louis found that a substance secreted by damaged skin circulates through the body and triggers asthmatic symptoms in laboratory mice when exposed to eczema-causing or dermatitis-causing agents, also known as allergens.

There are many types of eczema. This article focuses on atopic eczema.

What are the symptoms of eczema?

As atopic eczema is a chronic disease symptoms are generally present all the time. A chronic disease is a long-term one; one that persists for a long time. However, during a flare-up symptoms will worsen and the patient will probably require more intense treatment.

Below are some common symptoms of atopic eczema (without flare-up):

• The skin may be broken in places.
• Some areas of the skin are cracked.
• The skin usually feels dry.
• Many areas of skin are itchy, and sometimes raw if scratched
• Itching usually worse at night.
• Scratching may also result in areas of thickened skin.
• Some areas of skin become red and inflamed.
• Some inflamed areas develop blisters and weep (ooze liquid).
• The skin has red to brownish-gray colored patches.
• Areas of skin may have small, raised bumps.

Although the patches may occur in any part of the body's skin, they tend to appear on the hands, feet, arms, behind the knees, ankles, wrists, face, neck, and upper chest. Some patients have symptoms around the eyes, including the eyelids. Scratching around the eyes may eventually lead to noticeable loss of eyebrow and eyelash hairs. Babies tend to show symptoms on the face.

When there is a flare-up the previous symptoms still exist, plus some of the ones below:

• The skin will be much more itchy.
• Itchiness and scratching will make the skin redder, raw and very sensitive.
• Many of the affected areas will feel hot.
• The skin will be much more scaly and drier.
• The raised bumps will be more pronounced and may leak fluid.
• Blisters will appear.
• The affected areas may be infected with bacteria.

Flare ups can last from a day or two to several weeks.

Patients with mild atopic eczema will generally have only small areas of dry skin which may itch sometimes. When symptoms are severe large areas of skin become very dry and the itching is constant. Many areas will ooze fluid.

A vicious circle can set in. It starts with unpleasant itching, then scratching which makes the itching worse, which makes the patient scratch more - eventually the skin can bleed. Children who get into this cycle can suffer serious sleep disruption and may find concentrating at school extremely challenging.

The following may worsen the symptoms of atopic eczema:

• Prolonged hot showers or baths.
• Allowing the skin to stay dry.
• Mental stress.
• Sweating.
• Rapid temperature changes.
• Dry air.
• Certain fabrics for clothing, such as wool.
• Cigarette smoke.
• Dust.
• Sand.
• Some soaps, solvents, or detergents - a Swedish study found that linalool, the most common fragrance ingredient used in shampoos, conditioners and soap is a powerful allergen for a significant number of people