Atopic Dermatitis: Often hereditary, this is the most common form of eczema. It typically presents as itchy, inflamed skin and is frequently associated with asthma or hay fever. Presents often in Infancy and can have a tumultuous progression throughout life. This tends to have an effect on the physical growth of child and their educational performance. Treatments can include immunosuppressant medications like Steroids, Cyclosporine, Azathioprine and latest biological drugs.
Contact Dermatitis: Caused by skin's reaction to irritants or allergens, this type leads to localized redness and inflammation where the substance came into contact.
Dyshidrotic Eczema(aka Pompholyx): This form affects the hands and feet, causing small, itchy blisters. It’s often triggered by stress, allergens, or exposure to certain metals.
Nummular Eczema: This variety manifests as coin-shaped patches of irritated skin, commonly caused by dry skin or environmental changes.
Seborrheic Dermatitis: Often linked to oil-producing areas like the scalp and face, this form leads to flaky patches and redness. It starts due to overgrowth of a fungus, Malassezia species on scalp which is the result of poor immune response secondary to stressful lifestyle.
Stasis Dermatitis: (aka Gravitational eczema) Related to poor circulation in the lower legs, it can cause swollen, itchy skin and discoloration around ankles progressing upwards when not treated. Often this can lead to cellulitis needing hospital admission for IV antibiotics.
Managing eczema requires a tailored approach based on the type and severity. Common treatments include:
Moisturizers: They are the most important part of treatment of eczema. Regular use of emollients can help lock in moisture, reducing dryness and irritation. The choice of moisturizer as per skin type and season is very important for achieving optimal benefit.
Topical Corticosteroids: These are prescribed to reduce inflammation and itching during flare-ups. Dr Nilesh Goyal prescribes them in 5 day cyclical pattern reducing their side effects and at the same time getting maximum benefit.
Antihistamines: Often used to manage itching, particularly at night.
Topical Calcineurin Inhibitors: Non-steroidal creams like tacrolimus or pimecrolimus help control inflammation in sensitive areas. They help in reducing dependency on steroid creams.
Light Therapy: Phototherapy using UV light may be recommended for persistent or severe eczema.
Systemic Medications: In severe cases, oral medications like steroid, cyclosporine or azathioprine and latest entrant, tofacitinib are employed. When these are found ineffective then Dr Goyal resorts to injectable drugs like biologics (e.g., dupilumab) to manage the disease.
Trigger Avoidance: Identifying and avoiding triggers like allergens, irritants, or stress is crucial for long-term management. Adopting healthy lifestyle choices helps a lot in halting disease progression and frequent flareups. These include wearing soft cotton fabrics, regular skin care routine, eating and sleeping at natural times.
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