Eczema is a chronic inflammation of the skin which occurs as a reaction to various substances. It manifests as flat dry patches, or red colored rashes or multiple small vesicular eruptions with oozing of serous fluid which is known as, "weeping eczema”. There may be associated crusting over these lesions. These different kinds of skin problems may occur separately or may be combination of all. 

Atopic dermatitis is a kind of eczema associated with bronchial asthma. Underlying cause for both the conditions remains the same, i.e. allergy to some exogenous substance. This type of dermatitis is usually generalized.

There may be dry scaly patches with flaking or vesicular eruptions with oozing and intense itching. Similar to asthma, this type of eczema is also intermittent. It occurs with rains or change of climate or exposure to potential allergens, i.e. allergy producing substances.

Allergic contact dermatitis is a type of delayed allergic reaction to the body after the skin is exposed to some substance to which it is sensitive. This type of reaction commonly occurs due to artificial jewellery, cosmetics with chemical base and contact with allergy producing plants like poison ivy.

This type of eczema is localized to the site affected in the body. Intense itching occurs with formation of rashes, scaling or small eruptions.

Any potentially toxic or irritant substance can cause direct injury to the skin and subsequent eczema, when exposed chronically. There is cracking, redness and scaling along with itching on the affected part. A common example is cracking of hands and fingers of people who wash daily due to direct irritation by the washing soap.

Seborrhoiec dermatitis is characterized by grayish yellow scales and red patches. It commonly occurs over the scalp, eyebrows, behind the ears, near crease of the nose, under the arms, etc.

What exactly causes eczema, why some people suffer, while some have no problem on exposure to the same kind of substances is not known. Some breach of the defence of the skin and/ or some derangement in immune response are the hypothesis postulated.

Anybody suffering from eczema knows how the severe itching becomes troublesome and embarrassing. Apart from the discomfort, the visible skin problem gives a wrong impression to others that this person has some "dirty” skin disease. Scratching caused by the chronic itching leads to secondary bacterial infections and multiple boils.

Though out of ignorance people fear it, eczema is never contagious. It can occur in any age or gender, including babies. Rather babies are more susceptible to it due to hypersensitivity to the baby soaps, creams and powders applied by mothers to keep the infant clean and fragrant.

Eczema is diagnosed by the recurrent nature of the problem, typical skin changes and the site. Atopic eczema is mostly generalized whereas other types of eczema are localized to site of exposure.

Treatment includes drugs or local ointments which help reduce the itching and ungainly skin eruptions or rashes. But relapses invariably occur. Those suffering from eczema should take precautions avoid it.

Persons suffering from eczema should avoid the potential allergens like exposure to dust, allergy producing foods, etc., substances which provoke it. In other types of eczematous dermatitis, a person can know with experience what is causing the problem and avoid it. Mostly it is the chemical based toiletries and cosmetics which lead to eczema. Instead of using cosmetics with chemicals, one should try using natural herbal products.

There is minimal chance of reaction with natural products. Synthetic clothes and socks made of nylon or polyester should be avoided. A patient of eczema should use only pure cotton or natural silk material for clothes.

Dr Rachna Pande is a specialist in Internal Medicine at Ruhengeri Hospital

rachna212002@yahoo.co.uk