Stages of Eczema

Early stages of eczema can cause the skin to turn red, blister, and ooze. Later stages of eczema can cause the skin to turn a brownish color and be scaly. In almost every case, eczema itches. Eczema can be widespread or limited to a few areas.

The usual symptoms associated with the acute stage of eczema include pain, heat, tenderness, and possible itching. The affected areas are characterized by extreme redness and drainage at the lesion site. In acute eczema you would experience vesicles, blisters, and intense redness of the skin. The skin surface will sting, burn, or may itch intensely. The standard courses of treatment at this time would include cold wet compresses, antihistamines, antibiotics, and possibly a short-term course of steroids. The acute disease typically is characterized by inflammation, redness, swelling, and itching, as well as some blistering and oozing. Skin biopsies show inflammatory cells and swelling.

The sub acute phase of eczema includes symptoms associated with skin redness and crusting; however, there is no extreme swelling. You may observe redness, scaling of the skin, fissures, and a parched or scalded appearance to the skin. People in the sub acute phase tend to complain about the symptom of itching more than the pain. The itching in the sub acute phase is generally slight to moderate with possible stinging and burning. The basic course of treatment at this time would include a topical steroid, emollients, antihistamines, and antibiotics. The sub acute disease typically is characterized by inflammation, redness, swelling, and itching, as well as some blistering and oozing. Skin biopsies show inflammatory cells and swelling.

Individuals with lesions developed over three months are referred to as having chronic eczema. Itching is a predominant symptom in this phase as well and scratching causes the lesion to worsen. In the chronic stages of eczema the skin would show a thickened, lichenified, excoriation and or fissuring appearance. At this time you would experience a moderate to intense itch. Chronic dermatitis is identified by thickened, leathery skin with excess ridges, as well as dark and dull skin. Under the microscope, the outermost (epidermal) skin layer is seen to proliferate and become elongated.

Individuals with eczema often find that their symptoms tend to worsen in the winter months due to decreased humidity in the home or office.

Causes of Contact Eczema

A substance that has a direct toxic effect or exposure to an irritant produces irritant contact eczema and a skin reaction can occur immediately or gradually after repeat exposure. Examples of substances that cause irritant contact eczema include acids, certain toilet bowl cleaners or drain cleaners, oven cleaners, detergents, ammonia, lye, cement, turpentine, and paint thinners.

Allergic contact eczema will trigger an immunologic response that causes inflammation called a skin allergy. Examples of substances that cause allergic contact eczema include poison ivy, poison sumac, poison oak, dyes, fragrances, leather, rubber compounds (gloves and shoes) and nickel (jewelry accessories). Itching and burning are common symptoms in both types of contact eczema.

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The Stages of Eczema Symptoms

Early stages of eczema can cause the skin to turn red, blister, and ooze. Later stages of eczema can cause the skin to turn a brownish color and be scaly. In almost every case, eczema itches. Eczema can be widespread or limited to a few areas. Eczema runs its course through three distinct phases: acute, sub acute, and chronic.

The usual symptoms associated with acute eczema include pain, heat, tenderness, and possible itching. The affected areas are characterized by extreme redness and drainage at the lesion site. In acute eczema you would experience vesicles, blisters, and intense redness of the skin. The skin surface will sting, burn, or may itch intensely.

The sub acute phase of eczema includes symptoms associated with skin redness and crusting; however, there is no extreme swelling. You may observe redness, scaling of the skin, fissures, and a parched or scalded appearance to the skin. People in the sub acute phase tend to complain about the symptom of itching more than the pain. The itching in the sub acute phase is generally slight to moderate with possible stinging and burning.

Individuals with lesions developed over three months are referred to as having chronic eczema. Itching is a predominant symptom in this phase as well and scratching causes the lesion to worsen. In the chronic stages of eczema the skin would show a thickened, lichenified, excoriation and or fissuring appearance. At this time you would experience a moderate to intense itch.

Types of Eczema

General allergic over-sensitivity, called atopy also known as atopic eczema. Atopic eczema is linked with asthma and hay fever, which are conditions of the immune system. These conditions are often passed down through the generations of a family.

Contact with substances that irritate the skin chemically, called irritant contact eczema. This is caused by direct contact between the skin and the substance, which might be a detergent, soap, diesel or engine oil, strong chemicals in household cleaners, acids, alkaline mixtures, detergents, etc. and various other chemicals that acutely inflame the skin. The condition can become chronic with repeated exposure. This form of eczema is often encountered in the workplace. Direct irritant contact eczema can occur at the first exposure. For example, most people will develop this form of eczema on first exposure to strong chemicals that are acid or alkaline in nature.

Contact with substances that sensitize the skin, leading to acute inflammation when re-exposure occurs is called allergic contact eczema. This type commonly involves nickel, poison ivy, cosmetics, and rubber products. Prior exposure to the irritant allergen is necessary for allergic contact eczema to occur.

Exposure to sunlight as well as certain medications that cause photosensitivity can result in light sensitive eczema.

Infants exposed to moisture from drool or those that have inflammation of the scalp (cradle cap) can develop infantile eczema.

Varicose veins can lead to a form of eczema affecting the lower legs, called stasis eczema. This is also known as varicose or gravitational eczema.

Cause of Eczema

Eczema can cause a wide range of symptoms. All types of eczema cause a desire to scratch. The primary symptoms of eczema include: redness, weeping skin, pain, heat, tenderness, scaling, crusting, dryness, broken skin which may be a result of intense scratching and small blisters may also occur. Over time, damage to the upper layer of the skin can cause the skin to thicken and become scaly.

Each subset of eczema has it’s own distinct causes:

The cause of atopic eczema is related to the presence of hay fever and asthma, which are conditions of the immune system. These conditions are often passed down through the generations of a family.

Irritant contact eczema is caused by a direct contact with the skin and an irritant substance such as soap, detergents, gasoline, diesel or engine oil, various chemicals such as household and industrial cleaners, acids, alkaline mixtures which can acutely inflame the skin. The condition can worsen with repeated exposure.

Allergic contact eczema is a result of contact with substances, which sensitize the skin such as poison oak, ivy or sumac, cosmetics, rubber, nickel, wool, dye, polyester. Initial exposure to the irritant occurs and it is the re-exposure that causes acute inflammation.

Trigger Factors That May Influence Atopic Eczema

Trigger factors for atopic eczema may include soap, harsh chemicals, heat and humidity, stress, certain foods (most common offenders include eggs, milk, wheat, soy protein, and peanut). Many of these ingredients can turn up in unusual places, such as all-natural soaps, makeup, cream, or lotions. Inhalant allergens such as house dust mites, pets, pollen, and cut grass are also triggers that can cause eczema.

Other common trigger factors include:

Dry skin.
The skin’s main function is to provide a barrier against dirt, germs and chemicals from the outside. We don’t notice this barrier unless it gets dry, and then it’s scaly, rough and tight. Dry skin is brittle — moist skin is soft and flexible. People with Atopic dermatitis have a defect in their skin and it won’t stay moist. It is especially bad in winter when the heat is on in the house and the humidity drops. Other things that dry the skin are too much bathing without proper moisturizing.

Irritants.
Irritants are any of the substances outside the body that can cause burning, redness, itching or dryness of the skin.

Stress.
Emotional stress comes from many situations. People with Atopic dermatitis often react to stress by having red flushing and itching.

Heat and sweating.
Most people with atopic dermatitis notice that when they get hot, they itch. They have a type of prickly heat that doesn’t occur just in humid summertime but any time they sweat. It can happen from exercise, from too many warm bedclothes or rapid changes in temperature from cold to warm.

Infections.
Bacterial "staph" infections are the most common, especially on arms and legs. Such infections might be suspected if areas are weeping or crusted or if small "pus-bumps" are seen. Herpes infections (such as fever blisters or cold sores) and fungus (ringworm or athlete’s foot) can also trigger Atopic dermatitis. If some lesions look different, ask your doctor. If they turn out to be infected, they can be treated with antibiotics.

Allergens.
Allergens are materials such as pollen, pet dander, foods, or dust that cause allergic responses. Allergic diseases such as asthma and hay fever, which flare quickly, are easy to tie to allergens. Itching and hives appear soon after exposure to these airborne allergens and last only briefly.

The Term 'Eczema' Encompasses Many Skin Responses

The term 'eczema' covers a wide range of skin problems, which trouble people at different stages in their lives. It occurs in many different ways, such as in an elderly person with dry red skin around the ankles, a child with weeping red areas on the wrists, or someone whose eyelids have become itchy, red, dry, and puffy in reaction to make-up.

Itching occurs with nearly all forms of eczema, varying from mild irritation to a hopelessly distracting and distressing symptom that makes life miserable for the sufferer and others involved.

Redness is usually present in eczema and this redness can fluctuate, appearing bright red at some times of the day while at others it is barely noticeable. The redness is usually most obvious when you are hot, have just exercised, or after a hot bath.

Eczema is usually dry, making your skin feel rough, scaly, and sometimes thickened. Dryness reduces the protective quality of the skin, making it less effective at protecting against heat, cold, fluid loss, and bacterial infection.

In severe eczema, or after a prolonged period of scratching, the skin's protective character can be reduced further and the skin becomes wet with colorless fluid that has oozed from the tissues, sometimes mixed with blood leaking from damaged capillaries (small blood vessels). Wetness usually occurs when eczema is at its most itchy and is very likely to become infected.

Some wetness may come from small vesicles (pin-head blisters), which burst when scratched. These are most commonly found on the hands and feet, along the edges of the digits or on the palms or soles.