Nkiruka Odinkemelu
It is the desire of everyone to have a healthy and glowing skin. But in a situation where the skin gets infected, especially on parts of the body that cannot be hidden, it becomes an embarrassment. One of such skin conditions is Eczema.
Eczema also known as Atopic Dermatitis (AD) according to National Eczema Association (NEA), is an umbrella term used to describe a group of medical conditions that causes dry, discoloured, itchy and inflamed skin.
In Nigeria, eczema is usually seen as a minor condition that requires little medication to clear. But experts say it is a long lasting condition that tends to flare periodically, can be accompanied by hay fever and even asthma; and may only be managed because it has no cure.
A report on “Prevalence of Childhood and Adult Atopic Dermatitis,” published by NEA says that one in three children with AD will additionally develop asthma or allergic rhinitis. The risk of developing asthma increases with AD severity as more than 50 per cent of children with severe AD will develop asthma.
More than 20 per cent of adults with AD also have asthma, and they have a two to four times increased risk for having allergic rhinitis and food allergy. It added that people with eczema are at increased risk of developing serious bacterial, viral and fungal skin infections.
AD in adults is associated with other serious chronic conditions that contribute to poor health including diabetes, obesity, autoimmune disease, high blood pressure and heart disease. Also adults with AD have an increased risk of eye-related conditions including conjunctivitis, keratitis, and keratoconus.
Children with Eczema are more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD). They are 2 to 6 times more likely to have depression, anxiety or conduct disorder than children without AD. Risk for these conditions increases with AD severity.
Recent studies have also suggested that people with AD are up to 44 per cent more likely to exhibit suicidal ideation, and 36 per cent are more likely to attempt suicide.
It is not known how many people in Nigeria suffer from the condition, but reports have it that 31.6 million people (10.1 per cent) in the United States have some form of eczema.
The NEA report said: “One in 10 individuals will develop eczema during their lifetime, with prevalence peaking in early childhood, adding that people of all skin colors and ethnicities can be affected by eczema. Eleven per cent of white skinned populations are likely to have the condition, African American/black – 10 per cent, Asian or Pacific Islander – 13 per cent, while in Native American, 13 per cent live with the condition.”
Although it was estimated that more people may develop the condition from childhood, maybe because statistics show that it is prevalent in children, for example, approximately 9.6 million U.S. children under the age of 18 have AD, and one-third have moderate to severe disease, just as the prevalence of childhood AD has steadily increased from 8 per cent to 12 per cent since 1997, AD is not solely a disease of childhood onset as 1 in 4 adults report adult-onset of initial symptoms.
It affects a similar number of male and female children. However, studies have shown it is more common in adult females than males. Even as children with more severe, persistent condition have a higher risk for prolonged disease, although AD may persist regardless of severity.
Types
Experts identified about seven types of eczema and they range from: Atopic dermatitis, a type caused by a malfunction in the immune system and problems with the skin barrier; Contact dermatitis- this occur as a result of skin touching known irritant and /or allergen; dyshidrotic eczema- occurring as on the feet and hands as itchy blisters, usually caused by exposure to allergen; to neurodermatitis- this results in thick, scaly patches on the skin, often caused by too much scratching and rubbing.
Others are: nummular eczema- usually caused by allergens or dry skin and appears as round lesions that can weep fluid, especially in older people; seborrheic dermatitis- white or yellow flaky, greasy patches in places with more oil-producing glands, caused by a combination of genetics, hormones and microorganisms on the skin and Stasis dermatitis – this occurs when poor circulation to the legs causes the veins to swell and leak fluid, causing swelling and skin redness and itch, mostly in older populations.
Symptoms
Mrs Sola Ogungbe, a skin care specialist and owner, Sholly Beauty World, said symptoms vary from person to person. But generally, the symptoms include: dry skin, itching, which may be severe, especially at night, red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees.
And in infants, it may be on the face and scalp, small, raised bumps, which may leak fluid and crust over when scratched, thickened, cracked, scaly skin and raw, sensitive and swollen skin from scratching.
Causes
There was no known cause for eczema; however, Ogungbe said it is believed to develop due to a combination of genetic and environmental factors:
Her words: “There are no known causes for eczema but there are predisposing factors and one of them is genetic. Some families have history of eczema, for instance, children whose parents have had eczema can develop it; this is even as the risk tends to be greater if both parents have the condition.
“This can start showing as early as infant when a child is born, you see some kind of patches on the face, chest or back. Although sometimes, the child in about a year or two can out grow it even without medication while some persist.
“It is not really contagious but, you have to upgrade your hygiene. As much as it has not been known to be contagious, but if a person is sweaty and rubs her skin on another person’s skin, the person can start picking some irritations.
“Another predisposing factor is allergy; some people are allergic to some certain things, this happens following contact with a substance or allergen that the immune system recognizes as foreign.”
Environmental factors known to trigger eczema symptoms include: Allergens – dust mites, pets, pollens and dandruff; hot and cold temperature; foods such as eggs, nuts and seeds, soy products and wheat; irritants like soap, detergents, shampoos, meats, juice from fresh fruits and disinfectants; Stress, microbes such as viruses, staphylococcus aureus and certain fungi as well as hormonal changes like in pregnancy:
“Another thing is the product that you use, there is what we call hydroquinone eruption. This happens when people have used hydroquinone for a long time and they can start having eczema signs. Another thing is long use f corticosteroids, this also cause itching, which develops into an infection.
“It is not something one is proud of especially if it shows on the face of which it does most times and no matter the makeup to cover it up, it still shows that the person has eczema.”
Care and treatment
To manage the symptoms, Ogungbe advised:“Try to identify and avoid triggers that worsen the condition, take your bath at least twice a day, avoid places with high temperature because of sweat. It may make you a little bit smelly especially those who have this problem as a result of bleaching, the sweat contains uric acid.
“When they sweat there could be odour; moisturize your skin at least twice a day, use only gentle soaps and dry yourself carefully, wear clothes that will allow cross ventilation on your skin and visit your skin care specialist when you notice anything.”
On treatment, she said it depends on the cause: “For example, if it genetic, some people get depressed. I always advise my clients that there is no reason for that. A good specialist will not only treat the condition, but will work on their client psychologically assuring them that it is not a death sentence. Thanks to modern technology, there are treatments that are available.
“Other aspect of treatment boils down to what the individual feeds on. I will advise that you drink a lot of water because, water cleanses the system. The beauty of the skin lies in the purification of the internal organs, which is why you have to make sure you drink a lot of water, this boosts your immune system because internally when you are clean, it helps.
“Also because of the itchy nature of eczema, a patient should try to stay away from a dry environment, if a child has it, I always advise the parents to use humidifier and also use of corticosteroids creams, mostly prescribed by doctors.
“However, I use both medical and herbal to treat such conditions because I work with a team of oriental doctors in America and we have come up with certain herbal formula to treat this kind of conditions. Another way we do here is complexion overhauling.”