Excema is very common. It affects males and females and accounts for 10 to 20 percent of all visits to dermatologists (doctors who specialize in the care and treatment of skin diseases). Although Excema may occur at any age, it most often begins in infancy and childhood. Scientists estimate that 65 percent of patients develop symptoms in the first year of life, and 90 percent develop symptoms before the age of 5. Onset after age 30 is less common and is often due to exposure of the skin to harsh or wet conditions. Excema is a common cause of workplace disability. People who live in cities and in dry climates appear more likely to develop this condition.
Although it is difficult to identify exactly how many people are affected by Excema, an estimated 20 percent of infants and young children experience symptoms of the disease. Roughly 60 percent of these infants continue to have one or more symptoms of Excema in adulthood. This means that more than 15 million people in the United States have symptoms of the disease.
Types of Eczema (Dermatitis)
- Allergic contact eczema (dermatitis): a red, itchy, weepy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign, such as poison ivy or certain preservatives in creams and lotions
- Excema: a chronic skin disease characterized by itchy, inflamed skin
- Contact eczema: a localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an acid, a cleaning agent, or other chemical
- Dyshidrotic eczema: irritation of the skin on the palms of hands and soles of the feet characterized by clear, deep blisters that itch and burn
- Neurodermatitis: scaly patches of the skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) that become intensely irritated when scratched
- Nummular eczema: coin-shaped patches of irritated skin-most common on the arms, back, buttocks, and lower legs-that may be crusted, scaling, and extremely itchy
- Seborrheic eczema: yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body
- Stasis dermatitis: a skin irritation on the lower legs, generally related to circulatory problems
Causes of Excema
The cause of Excema is not known, but the disease seems to result from a combination of genetic (hereditary) and environmental factors.
Children are more likely to develop this disorder if one or both parents have had it or have had allergic conditions like asthma or hay fever. While some people outgrow skin symptoms, approximately three-fourths of children with Excema go on to develop hay fever or asthma. Environmental factors can bring on symptoms of Excema at any time in individuals who have inherited the atopic disease trait.
Excema is also associated with malfunction
of the body’s immune system.
Excema is also associated with malfunction of the body’s immune system: the system that recognizes and helps fight bacteria and viruses that invade the body. Scientists have found that people with Excema have a low level of a cytokine (a protein) that is essential to the healthy function of the body’s immune system and a high level of other cytokines that lead to allergic reactions. The immune system can become misguided and create inflammation in the skin even in the absence of a major infection. This can be viewed as a form of autoimmunity, where a body reacts against its own tissues.
In the past, doctors thought that Excema was caused by an emotional disorder. We now know that emotional factors, such as stress, can make the condition worse, but they do not cause the disease.
Skin Features of Excema
- Atopic pleat (Dennie-Morgan fold): an extra fold of skin that develops under the eye
- Cheilitis: inflammation of the skin on and around the lips
- Hyperlinear palms: increased number of skin creases on the palms
- Hyperpigmented eyelids: eyelids that have become darker in color from inflammation or hay fever
- Ichthyosis: dry, rectangular scales on the skin
- Keratosis pilaris: small, rough bumps, generally on the face, upper arms, and thighs
- Lichenification: thick, leathery skin resulting from constant scratching and rubbing
- Papules: small raised bumps that may open when scratched and become crusty and infected
- Urticaria: hives (red, raised bumps) that may occur after exposure to an allergen, at the beginning of flares, or after exercise or a hot bath
Studies also have shown that stress, anxiety, loneliness, and low self-esteem are part of daily life for people living
with excema. One study found that thoughts of suicide are three times higher for psoriatics than the general
population.
Embarrassment is another common feeling. Imagine getting your hair cut and noticing that the stylist or barber is
visibly uncomfortable. What if you extended your hand to someone and the person recoiled? How would you feel if you
spent most of your life trying to hide your skin?