What separates eczema from a rash?
It can be difficult to tell one rash from another, especially if, like me, you’re not a doctor. I can tell you that with eczema, your skin will be inflamed or irritated and it’s almost always intensely itchy. An eczema rash is usually localized into patches but can also cover large areas of the body. Eczema most commonly appears on:
- the face
- the backs of the knees
- the feet.
In infants, eczema is most often found on the face and scalp, but eczema can present anywhere. There’s more on different kinds of rash in the previous article.
What does the rash look like?
An eczema rash is typically dry, and the skin may appear thickened, or flaky. It is not a pimply rash. If you are fair-skinned, you will probably see reddish areas that may turn brown. If you are darker-skinned, however, eczema might make the affected area lighter or darker. In infants, the itchy rash can produce oozing and crusting.
Which type of eczema might you have?
‘Eczema’ is an umbrella term for lots of different kinds of rash. Knowing which of the many sub-types of eczema you have can help you relieve the symptoms more effectively.
Atopic dermatitis – this is the most common kind of eczema. It often begins in childhood and becomes less severe over time. It is often found alongside asthma and hay fever. Many people seem to have all three, so doctors call this the “atopic triad.”
Atopic dermatitis occurs when your skin, which acts as a natural barrier to the elements, is weakened. This might be due to dry skin, genes, an immune problem, or environmental triggers, which I will explore in more details in another blog. The skin becomes more sensitive to allergens and irritants, and this reaction is what causes the itchy rash.
Contact dermatitis – this kind of eczema is a reaction to something you have touched. This could be a chemical in your environment, a plant, or even the detergent used to wash your clothes.
Aside from the more common symptoms of eczema, you might also experience:
- burning or stinging
- hives (itchy bumps)
- blisters that may ooze and form a crust
The most common irritants that produce this reaction are:
- certain plants, including poison ivy
- chemicals in soaps and perfumes
- tobacco smoke
While it’s not always possible, avoiding the substances that provoke a reaction is the best way to manage this kind of eczema. There’s more on chemical irritants and eczema to come in a further blog. Some people find that keeping a diary of their symptoms and activities helps them to identify the trigger or triggers, and we'll discuss that in more depth too in this series of articles.
Dyshidrotic eczema – if you have small blisters forming on your hands and feet, you may have dyshidrotic eczema. It’s more likely to affect you if you are woman than if you are a man.
These small blisters will be filled with fluid, they might itch or hurt, and the skin might scale, crack, and flake. This type of eczema caused by allergies, stress, and exposure to certain substances, including chromium salt, nickel, or cobalt. It can also be caused by damp hands and feet.
Hand eczema –Hand eczema really does only affect the hands. If you work with your hands and regularly use chemicals that can irritate the skin – such as hairdressing, cleaning and fixing machinery, you might be more prone to hand eczema. Since symptoms are caused by contact, wearing gloves might help.
Neurodermatitis – this is very similar to atopic dermatitis. It’s characterized by thick, scaly patches appearing on the arms, backs of hands, legs and bottoms of feet, as well as the scalp, the back of the neck, and the genitals.
The patches can be extremely itchy, particularly when the afflicted person is relaxed or asleep.
Anyone with neurodermatitis, in particular, should avoid scratching, as the patches can bleed and become infected. Stress can be a trigger for this kind of eczema, and later, we will look at the influence of stress and other hormones in more depth.
Nummular eczema - nummular comes from the word ‘nummus’, which means coin in Latin. This kind of eczema appears in round patches. It’s also sometimes called discoid dermatitis or discoid eczema, and can be mistaken for ringworm.
These eczema flare-ups are typically triggered by an insect bite or an allergic reaction to chemicals, including metals, such as nickel buttons on jeans. Dry skin, however, can also be the culprit, and you’re more likely to develop nummular eczema if you already have another type of eczema.
Stasis dermatitis – this form of eczema occurs when fluid leaks from weakened veins and into your skin, where it causes redness, itching, swelling, and pain.
If you have this kind of eczema, you probably also have varicose veins and the skin there will be dry and itchy and slightly discoloured. Your legs may swell up, particularly during a day of walking, making your legs ache or feel heavy, and you may also develop sores on your lower legs and on the tops of your feet.
Whichever kind of eczema you have, there are things that you can do to reduce the symptoms – changing your diet, skincare products, detergent, and managing the irritants and allergens in your environment will each help to ease the symptoms a little and doing all the above will usually make a real difference. And of course, we will have an article about looking after your skin, coming soon 😊.
Right I’m off to check what all the zips and buttons in the house are made of!
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