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Eczema is a condition wherein patches of skin

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Eczema is a condition wherein patches of skin become inflamed, itchy, cracked, and rough. Some types can also cause blisters.

Different types and stages of eczema affect 31.6 million people in the United States, which is over 10% of the population.

Many people use the word eczema when referring to atopic dermatitis, which is the most common type. The term atopic refers to a collection of conditions that involve the immune system, including atopic dermatitis, asthma, and hay fever. The word dermatitis refers to inflammation of the skin.

Certain foods, such as nuts and dairy, can trigger symptoms. Environmental triggers include smoke, pollen, soaps, and fragrances. Eczema is not contagious.

Some people outgrow the condition, whereas others will continue to have it throughout adulthood.

This article will explain what eczema is and discuss its symptoms, treatments, causes, and types.

Symptoms

a woman applying cream to eczema on her arm
Applying moisturizer may prevent eczema flares and ease symptoms.

The symptoms of atopic dermatitis can vary depending on the age of the person who has it.

Atopic dermatitis is common in infants, with dry and scaly patches appearing on the skin. These patches are often intensely itchy.

Continuous rubbing and scratching can lead to skin infectionsLearn how to identify infected eczema here.

In most cases, however, eczema is mild. The most common symptoms of atopic dermatitis include:

  • dry, scaly skin
  • skin flushing
  • itching
  • open, crusted, or weeping sores

Some of the symptoms of eczema are different in people with darker skin. Learn more here.

People with severe eczema will need more intensive treatment to relieve their symptoms.

Most people with the condition develop it before the age of 5 years. However, an estimated 60% of children will no longer show symptoms by adolescence.

People with the condition will often experience periods of time when their symptoms worsen, followed by periods of time when their symptoms will improve or clear up.

The symptoms in children and adults may be different. The following sections will outline some of these differences in more detail.

Symptoms in infants

The following atopic dermatitis symptoms are common in infants under the age of 2:

  • rashes on the scalp and cheeks
  • rashes that bubble up before leaking fluid
  • rashes that can cause extreme itchiness, which may interfere with sleeping

Symptoms in children

The following atopic dermatitis symptoms are common in children age 2 and above:

  • rashes that appear behind the creases of elbows or knees
  • rashes that appear on the neck, wrists, ankles, and the crease between the buttocks and legs
  • bumpy rashes
  • rashes that can become lighter or darker
  • skin thickening, also known as lichenification, which can then develop into a permanent itch

Symptoms in adults

The following atopic dermatitis symptoms are common in adults:

  • rashes that are more scaly than those occurring in children
  • rashes that commonly appear in the creases of the elbows or knees or the nape of the neck
  • rashes that cover much of the body
  • very dry skin on the affected areas
  • rashes that are permanently itchy
  • skin infections

Adults who developed atopic dermatitis as a child but no longer experience the condition may still have dry or easily irritated skin, hand eczema, and eye problems.

The appearance of skin affected by atopic dermatitis will depend on how much a person scratches and whether or not the skin is infected. Scratching and rubbing can further irritate the skin, increase inflammation, and make the itching worse.

Treatments

There is currently no cure for eczema. Treatment for the condition aims to heal the affected skin and prevent flares of symptoms.

Doctors will suggest a treatment plan based on an individual’s age, symptoms, and current state of health.

For some people, eczema goes away over time. For others, however, it is a lifelong condition.

The sections below will list some treatment options.

Home care

There are several things that people with eczema can do to support skin health and alleviate symptoms.

For example, they can try:

  • taking lukewarm baths
  • applying moisturizer within 3 minutes of bathing to “lock in” moisture
  • moisturizing every day
  • wearing cotton and soft fabrics
  • avoiding rough, scratchy fibers and tight fitting clothing
  • using a humidifier in dry or cold weather
  • using a mild soap or a non-soap cleanser when washing
  • taking extra precautions to prevent eczema flares in winter
  • air drying or gently patting the skin dry with a towel, rather than rubbing the skin dry after bathing or taking a shower
  • where possible, avoiding rapid changes of temperature and activities that cause sweating
  • learning and avoiding individual eczema triggers
  • keeping fingernails short to prevent scratching from breaking the skin

People can also try various natural remedies for eczema, including aloe vera, coconut oil, and apple cider vinegar.

Medications

Doctors can prescribe several medications to treat the symptoms of eczema, including:

  • Topical corticosteroid creams and ointments: These are anti-inflammatory medications and should relieve the main symptoms of eczema, such as inflammation and itchiness. People can apply them directly to the skin. A range of topical corticosteroid creams and ointments are available online. Some people may benefit from prescription-strength medications, however.
  • Systemic corticosteroids: If topical treatments are not effective, a doctor may prescribe systemic corticosteroids. These are available as injections or oral tablets. People should only use them for short periods of time. Also, it is important to note that the symptoms may worsen upon stopping these drugs if the person is not already taking another medication for the condition.
  • Antibiotics: Doctors prescribe antibiotics if eczema occurs alongside a bacterial skin infection.
  • Antiviral and antifungal medications: These can treat fungal and viral infections.
  • Antihistamines: These can reduce the risk of nighttime scratching, as they tend to cause drowsiness.
  • Topical calcineurin inhibitors: This drug suppresses the activities of the immune system. It decreases inflammation and helps prevent flares.
  • Barrier repair moisturizers: These reduce water loss and work to repair the skin.
  • Phototherapy: This involves exposure to UVA or UVB waves. This method can treat moderate dermatitis. A doctor will monitor the skin closely throughout the treatment.

Even though the condition itself is not currently curable, each person should have a tailored treatment plan.

Also, even after an area of skin has healed, it is important to keep looking after it, as it may easily become irritated again.

Causes

The specific cause of eczema remains unknown, but many health professionals believe that it develops due to a combination of genetic and environmental factors.

Children are more likely to develop eczema if a parent has it or another atopic condition. If both parents have an atopic condition, the risk is even higher.

Some environmental factors can bring out the symptoms of eczema. These factors include:

  • Irritants: These include soaps, detergents, shampoos, disinfectants, juices from fresh fruits, meats, and vegetables.
  • Allergens: Dust mites, pets, pollens, and mold can all lead to eczema. This is known as allergic eczema.
  • Microbes: These include bacteria such as Staphylococcus aureus, viruses, and certain fungi.
  • Hot and cold temperatures: Very hot and very cold weather, high and low humidity, and perspiration from exercise can bring out eczema.
  • Foods: Dairy products, eggs, nuts and seeds, soy products, and wheat can cause eczema flares.
  • Stress: This is not a direct cause of eczema, but it can make the symptoms worse.
  • Hormones: Females may experience increased eczema symptoms when their hormone levels are changing, such as during pregnancy and at certain points in the menstrual cycle.

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Eczema symptoms often get worse at night and interrupt or delay sleep. Medications, wet wraps, medicated baths, and other methods can help people with eczema to get a good night’s rest.

Eczema, or dermatitis, is a skin condition that causes patches of itchiness, inflammation, swelling, and cracked skin. When eczema flares up at night, the discomfort can make it difficult to get to sleep.

This sleep disruption is common, affecting 33.0 to 87.1 percentTrusted Source of adults with eczema. The condition causes difficulty sleeping in 83 percent of children with eczema, and this can significantly affect the quality of life.

In this article, we look at why eczema symptoms flare up at night and how to prevent them.

Why does eczema flare up at night?

eczema itching at night
Eczema symptoms may worsen at night.

Researchers are not sure what causes eczema, but various genetic and environmental factors may be involved.

Eczema symptoms may feel worse at night for a few reasons:

  • Due to the body’s sleep and wake cycles, a person’s temperature decreases at night, which can make the skin feel itchy.
  • If a person has moisturized during the day, the effects may have worn off by night.
  • People are more likely to scratch in their sleep, which can make itchiness worse.

People tend to wake up a few times during the night without realizing it. They may be scratching because they are too sleepy to remember to hold back. This can make the itchiness worse, which can interrupt sleep further.

How to prevent eczema itching at night

One of the best ways to prevent nighttime eczema flare-ups is to avoid triggers before bed. Some triggers can include activities and materials.

The following tips may help prevent eczema itching at night:

  • Moisturize well before bed. Use an oil-based moisturizer or a medicated cream, such as a steroid cream, before bed. A doctor can provide stronger versions.
  • Bathe at night. Bathing regularly is important for keeping the skin hydrated and preventing infections. Always moisturize within 3 minutes of bathing to lock in hydration. Try medicated baths, which may include colloidal oatmeal, bleach, or vinegar.
  • Use wet wrap therapy. If the skin tends to dry out during the night, try wrapping a damp cloth around the affected area after moisturizing. Leaving the wrap on overnight can help keep the skin hydrated.
  • Avoid harsh fabrics. Do not use sheets or pajamas made from fabrics that can irritate the skin, such as wool or polyester. Clothing and linens made from 100 percent cotton are gentler on the skin.
  • Avoid allergens before bed. Many people with eczema also have allergies, and reactions can make eczema symptoms worse. It can help to stay away from common allergens, such as pet dander and pollen, at night.
  • Take an antihistamine. While antihistamines may not reduce itchingTrusted Source, they may make a person drowsy, helping them to sleep in spite of the itching.
  • Try melatonin. ResearchTrusted Source from 2016 suggests that the supplement melatonin can help children with eczema get to sleep more quickly.
  • Wear gloves to bed. Making it more difficult to scratch can help control eczema itching at night. Some people find relief by keeping their fingernails short or wearing gloves to bed.
  • Keep the bedroom cool. Sweating or just feeling hot can make the skin itchier.
  • Get into a good sleep pattern. Go to sleep at the same time each night and make time for a relaxing activity, such as reading or meditation, before bed.

People with eczema and others who have sensitive skin should avoid the following, especially before bed:

  • soaps, lotions, and cosmetics that contain fragrances or dyes
  • household cleaners
  • mold
  • dust mites
  • gasoline
  • nickel and other metals
  • cigarette smoke
  • sweat
  • high-stress situations

If eczema is stopping a person from sleeping, or if the condition is severe, a doctor may recommend immunosuppressant medications. These prevent the immune system from overreacting and triggering flare-ups.

Light therapy, or phototherapy, can also help with severe eczema.MEDICAL NEWS TODAY NEWSLETTERKnowledge is power. Get our free daily newsletter.

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Bedtime itching in infants and babies

eczema itching at night baby wipes
Using baby wipes on an infant may trigger a skin reaction.

Eczema can first appear during infancy, usually as a rash on the face and scalp. This can cause nighttime itchiness and discomfort.

Often, treatments for children and babies are the same as those for adults, but caregivers can take certain extra precautions to keep babies more comfortable, particularly at night.

To reduce the symptoms of eczema in babies:

  • know and avoid the triggers
  • follow a daily bathing and moisturizing routine
  • avoid or exercise caution when using antibacterial ointments, such as those that contain neomycin or bacitracin, as they can irritate the skin
  • avoid using baby wipes that contain isothiazolinones, which can trigger skin reactions
  • avoiding shampoos and other products that contain cocomidopropyl betaine

Eczema elimination diet and foods to eat

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Eczema or atopic dermatitis is a condition that causes a person to develop patches of dry, itchy skin on their body. It often develops as a result of inflammation in the body, so eating foods that do not cause inflammation may help reduce symptoms.

While no cure exists, over-the-counter creams and medications that can help to reduce inflammation are available. Sometimes, a doctor may recommend avoiding foods known to make eczema worse.

Some foods may trigger the release of T cells that cause inflammation, as well as immunoglobulin-E or IgE, which is an antibody that the body produces in response to a threat. Foods that contribute to inflammation include nuts, milk, and wheat.

Foods to eat

close-up-of-cherries-that-may-help-with-an-eczema-diet
Cherries are high in inflammation-fighting flavonoids.

For people with eczema, eating certain foods can trigger the body to release immune system compounds that cause inflammation, which, in turn, contributes to an eczema flare-up. An anti-eczema diet is similar to an anti-inflammatory diet.

Examples of anti-inflammatory foods include:

  • Fish, a natural source of omega-3 fatty acids that can fight inflammation in the body. Examples of fish high in omega-3s include salmon, albacore tuna, mackerel, sardines, and herring.
  • Foods high in probiotics, which are bacteria that promote good gut health. Examples include yogurt with live and active cultures, miso soup, and tempeh. Other fermented foods and drinks, such as kefir, kombucha, and sauerkraut, also contain probiotics.
  • Foods high in inflammation-fighting flavonoids. Examples of these include colorful fruits and vegetables, such as apples, broccoli, cherries, spinach, and kale.

Eating more of these foods and cutting down on any trigger foods could help to reduce eczema flare-ups.

Elimination diet and foods to avoid

Food-sensitive eczema reactions will typically occur about 6 to 24 hoursTrusted Source after a person eats a particular food. Sometimes, these reactions may be delayed even longer.

To determine what foods may be causing the reaction, a doctor will often recommend an elimination diet. This diet involves avoiding some of the most common foods known to cause eczema.

Before eliminating any foods, a person will need to slowly add each food type into their diet and monitor their eczema for 4 to 6 weeks to determine if they are sensitive to any particular food.

If a person’s symptoms get worse after adding a particular food to the diet, they may wish to consider avoiding it in the future. If a person’s symptoms do not improve when eliminating a food, they probably do not need to remove it from their diet.

Some common foods that may trigger an eczema flare-up and could be removed from a diet include:

A doctor may also recommend allergy testing. Even if a person is not allergic to a particular food, they may have sensitivity to it and could experience skin symptoms after repeat exposure. Doctors call this reaction food responsive eczema.

People with dyshidrotic eczema, which typically affects the hands and feet, may experience benefits from eating foods that do not contain nickel. Nickel is found in trace amounts in the soil and can, therefore, be present in foods.

Foods that are high in nickel include:

  • beans
  • black tea
  • canned meats
  • chocolate
  • lentils
  • nuts
  • peas
  • seeds
  • shellfish
  • soybeans

Some people with eczema also have oral allergy syndrome or sensitivity to birch pollen. This means they may have reactions to other foods, including:

  • green apples
  • carrot
  • celery
  • hazelnuts
  • pears

People with eczema are more prone to oral allergy syndrome and should speak to their doctor if they have a pollen allergy or experience mild allergic reactions to the above foods.

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Dietary supplements and eczema

sauerkraut-may-be-recommended-for-an-eczema-diet
Probiotics are naturally present in sauerkraut, which may reduce the symptoms of eczema.

Research has shownTrusted Source that taking probiotic supplements may reduce the symptoms of eczema. More studies are needed, however, to confirm the effectiveness and dosage required.

Probiotics are available in a variety of supplements, such as the selection available here. If a person is not sure which probiotics to buy, they may find the online reviews helpful and can also talk to their doctor.

Probiotics are also naturally present in many foods. Probiotic foods include:

  • yogurt
  • sauerkraut
  • kimchi
  • miso
  • tempeh
  • kombucha

Other supplements that have been studiedTrusted Source include fish oil and Chinese herbal preparations; neither of which made a significant difference in eczema symptoms.


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