The term eczema is widely used not only by the medical fraternity but also the public at large to describe various different skin conditions but the name, when used correctly, refers only to a specific type of skin problem.
The word eczema has been in use since ancient times and is now considered to be modern Latin (like most medical terms) but it is derived from the Greek word ekzema which literally means something thrown out by heat. This in turn has its origins in earlier Greek words ek meaning out (similar to the prefix ex), zein meaning to boil, ekzein meaning to boil over or break out, zetós meaning boiled or zema which translates as that which is boiled.
Types of Eczema
There are various different types of eczema some of which can affect the face and others almost exclusively restricted to other specific parts of the body.
Hand eczema, for example, is a common condition in which the skin of the hands becomes inflamed with red itchy areas which are often dry, flaking or peeling. Blisters and cracks in the skin can develop and can be very painful. Contact dermatitis is a form of eczema which, as its name implies, arises from direct contact with either an irritant (which is a substance affecting most people) or an allergen (which only affects those with allergies or hypersensitivity). Various chemicals, detergents or skin products can cause this type of eczema as can allergy-triggers such as pets or fumes. Dyshidrotic eczema often occurs on the extremities such as the fingers and feet and takes the form of small itchy fluid-filled blisters. It may be triggered by stress but has also been associated with a reaction to certain metals such as those often used in costume jewellery. Stasis eczema (or stasis dermatitis) is almost exclusively limited to the lower legs. This is thought to be caused by an inadequacy of blood-flow in this region causing leakage of fluid from the blood vessels into the surrounding skin. This typically causes red, scaly and itchy skin and there may be swelling around the ankles. There may be some oozing and in severe cases ulceration and secondary infections may occur. Discoid eczema looks very different from other types and areas of dry scaly skin often exhibit wet open sores. Many of the lesions found in discoid eczema are coin-shaped and although its cause is largely unknown, there is a suggestion that in some cases it may be triggered by insect bites.
Neurodermatitis is a form of eczema where areas of thick itchy, scaly, skin develop with a characteristic purplish discolouration. Feet, ankles, wrists and the backs of the hands are most commonly affected but this type of eczema but it can also appear on the nape of the neck and on the scalp. The most common form of eczema is simply called atopic eczema and it is so-called due to the fact that it is not caused by any topical irritant, such as in the case of contact dermatitis, but from a remote, often unknown cause.
Types of facial eczema
The correct identification of eczema type is an important first step to dealing with the condition.
It can clearly be seen that many types can immediately be ruled out. Discoid eczema rarely affects the face but is easily identified. Neurodermatitis is also easily identified but again rarely affects the face although the neck and scalp can be sometimes be affected. Contact dermatitis should be considered in cases where there is some evidence of a correlation between the appearance of the condition and the use of, or contact with, a specific product or allergen which could trigger this reaction. Dyshidrotic eczema is also unlikely to affect the face but could possibly appear where jewellery has been in contact with the skin. By far the most common type of facial eczema is of the non-specific atopic variety.
How Long Does Eczema Last?
There is a great deal of uncertainty about the actual causes of eczema and the condition varies in intensity and longevity from person to person. Eczema is usually regarded as being connected with the body’s immune responses and it is therefore not surprising that the condition often affects young children usually in their first year of life, often in their first six months, when their immune system is still developing. In this juvenile form of eczema, various parts of the body can be affected but the face is almost always included. There is no specific cure for the condition and treatment usually concentrates on relieving the symptoms. In most cases, as the child grows, the eczema improves often disappearing completely. For adult sufferers, the likelihood of full recovery is rather less certain and it is generally regarded as being a chronic (long-lasting) condition.
What Causes Facial Eczema?
There is no one single cause of facial eczema. Perhaps the easiest things to consider are whether it is possible to identify any substance or event acting as a trigger. It is well known that persons who suffer from allergic reactions are more susceptible to eczema and the condition is regarded as being one of the atopic triad the other two conditions being asthma and allergic rhinitis (hay fever) so there is strong evidence that an overreaction of the immune system often plays a part. If a specific trigger can be identified, the taking of avoidance action may be enough to prevent future flare-ups. Unfortunately, it is often not possible to identify such triggers and it can be observed that eczema often runs in families so there is likely to be some genetic predisposition to the condition.
Atopic Facial Eczema Symptoms
Not all of the possible symptoms may be present but it is useful to know whether each of the symptoms may be attributed to atopic eczema or whether some other condition may be involved. Firstly it is fairly typical for atopic eczema to be a variable condition which may improve considerably but then be subject to a flare-up. Erythema (redness of the skin) is one of the most obvious symptoms and the skin is usually dry, scaly and itchy. A rash is usually present most commonly on the cheeks but can be more widespread and often affects other parts of the body. Open, crusted, or weeping sores may appear and there is sometimes cracking of the skin behind the ears.
Dermatitis vs Eczema
The names dermatitis and eczema are often regarded as being interchangeable and used as synonyms but this is not absolutely correct.
Eczema specifically refers to a skin condition which breaks out, or erupts and typically involves the exudation of serous matter. Dermatitis on the other hand is a very general term. The word is derived from the Greek word derma or dermat meaning skin and the suffix itis which indicates inflammation. The four main requisites of inflammation are: heat, pain, swelling and redness so it can clearly be seen that eczema fully justifies its inclusion in the term dermatitis but there are many other forms of skin inflammation which do not correlate with the definition of eczema. To put it briefly, eczema is a form of dermatitis but dermatitis may not necessarily be eczema.
Facial Eczema Treatment
When dealing with any illness, the normal procedure is to first address any known underlying causes and then deal with the symptoms.
Atopic eczema however usually has no known cause meaning that dealing with it from the inside out is rarely an option. Treatment for eczema therefore normally concentrates on the relief of the symptoms. It is important to obtain medical help as there are many highly effective products available. One of the most effective long-term treatments is the use of emollients. These are medical moisturisers but should not be confused with cosmetic moisturisers. These are available as gels, creams, ointments and lotions. Each type has advantages and disadvantages. Most people find that lightweight creams are best for all-day use. Gels and ointments are sometimes more effective but can be rather greasy so are considered best for night-time use. Lotions are generally less concentrated but are the best choice for hair-covered areas. Emollients can help to keep the skin soft thereby reducing itchiness and the tendency to flake or crack. In addition to emollients, topical steroids are frequently employed to deal with periods of flare-up and assist rapid healing. Eczema skin is also very vulnerable to infection especially bacterial with staphylococcus aureus posing a particular threat. Fungal and viral infections can also occur and medical treatments to fight infections may occasionally be required. Effective washing and bathing are essential and soaps and bubble-baths should be avoided due to their skin drying properties. Special emollient bath and shower products are available. Severe cases of eczema may require further more advanced treatment and a dermatologist may provide a course of ultraviolet light therapy. A recent development for use in cases involving the immune system is the application of topical immunomodulators to reduce the appearance of skin lesions. Many eczema sufferers also prefer to try complimentary therapies sometimes with great success but this is very much a matter of trial and error and of course great care must be taken to ensure that only top quality products from reputable sources are used.
Treatments for Eczema around the Eyes
The skin around the eyes is thinner and more sensitive than on the rest of the face and any eczema outbreaks near the eyes are likely be very painful. In some cases the eye itself can be affected causing vision problems. The treatment for skin in this area is along the same lines as the rest of the face but specific emollients may be needed and in some cases, steroid eye-drops may prove necessary.
Further Facial Eczema Relief – Creams etc
It is all too easy to feel that nothing can be done to effectively deal with facial eczema but making a few lifestyle changes, trying to identify causative triggers and using effective treatment products really can make a difference. Just as there is no single cause of eczema, there is also no single remedy but there is a huge variety of different products offering to help and although none can be guaranteed to be 100% effective, many are worth trying including some of the natural remedies and there are many anecdotal accounts of success.