Dermatitis (or eczema) is an inflammation of the skin. It is typically characterized by redness, itching, swelling and blistering. Crusts and scales may form during the healing process. Chronically, the outermost skin layer may appear thickened and the skin may take on a leathery appearance. There are multiple forms of dermatitis, the most common being atopic dermatitis, contact dermatitis and seborrheic dermatitis.
The word eczema describes certain kinds of dermatitis (inflamed skin). Early eczema can be red, blistering, or oozing. Later on, eczema can be scaly, brownish, or thickened. Almost always, eczema itches. Examples of eczema include allergic contact dermatitis, seborrheic dermatitis, and nummular dermatitis.
Atopic Dermatitis or Atopic Eczema
The word "atopic" refers to a tendency for excess inflammation in the skin, linings of the nose, and lungs. It often runs in families. These families may have allergies such as hay fever and asthma, but can also have sensitive skin and a history of eruptions called atopic dermatitis. While most people with atopic dermatitis have family members with similar problems, 20 percent of patients may be the only one in their family bothered by this condition.
Atopic dermatitis is very common in all parts of the world. The disease can occur at any age but is most common in infants to young adults. The skin rash is very itchy and can be widespread or limited to a few areas.
The condition frequently improves in childhood or at least before the age of 25. About 50 percent of patients are affected throughout life, although not as severely as during early childhood. Atopic dermatitis cases can cause frustration to both the patient and the physician.
When the disease starts in infancy, it's often called infantile eczema. The itchy rash is an oozing, crusting condition that occurs mainly on the face and scalp, but patches can appear anywhere. Because of the itch, children may rub their head, cheeks, and other patches with a hand, a pillow, or anything within reach. Many babies improve before two years of age. Proper treatment can help until time solves the problem.
Infantile Eczema/Atopic Dermatitis
After infancy, the skin tends to be less red, blistering, oozing, or crusting. Instead, the patches are dry, red to brownish-grey, and may be scaly or thickened. The intense, almost unbearable itching can continue, and may be most noticeable at night. Some patients scratch the skin until it bleeds and crusts. When this occurs, the skin can get infected.
In teens and young adults, the patches typically occur on the hands and feet. Although these are the most common sites, any area such as the bends of the elbows, backs of the knees, ankles, wrists, face, neck, and upper chest may also be affected.
Recognizing Atopic Dermatitis
An itchy rash, along with a family history of atopic problems, may indicate atopic dermatitis. Proper, early, and regular treatment can bring relief and may also reduce the severity and duration of the disease.
The disease does not always follow the usual pattern. It can appear on the palms, backs of the hands and fingers, or on the feet, where crusting, oozing, thickened areas may last for years.
Your dermatologist can prescribe external medications such as cortisone creams, ointments on lotions and sometimes tars. Internal medications such as antihistamines can help deal with the itch. Oral antibiotics may be prescribed if there is also a secondary infection. For severe cases, your dermatologist may recommend ultraviolet light treatments. There are several newer types of medications that may be helpful for patients when standard treatment doesn't work.
Internal cortisone should be avoided if possible. However, when other measures have failed, your physician may prescribe cortisone in the form of pills or an injection.
It has been 40 years since a new class of topical medications specifically for this disease has been introduced. However, a new class of drugs called topical immunomodulators (TIMs) will soon be available that show promise in the treatment of moderately severe eczema. Two TIMs in development, tacrolimus and ascomycin, are steroid-free. Studies have shown that this new class of drugs will improve or completely clear eczema in more than 80 percent of treated patients, with an improved side-effect profile compared with topical steroids.
Atopic dermatitis is a very common condition. With proper treatment, the disease can be controlled in the majority of people.
The National Eczema Association for Science and Education works to improve the health of people living with eczema. www.eczema-assn.org
The National Eczema Society is a worldwide organization dedicated to the needs of people with eczema, dermatitis, and sensitive skin. Based in the United Kingdom, they can provide information and encouragement for children in the 11-16 age group. www.eczema.org
A single patient with atopic dermatitis treated with TENS has been reported. A 15-year-old girl had suffered since infancy from atopic dermatitis, asthma and rhinitis. This patient was treated with low-frequency (2 Hz) TENS with a square wave pulse, each stimulation consisting of bursts of five pulses with an internal frequency of 100 Hz. Electrodes were placed on the hand only, and the treatment of 30 min duration was conducted three times daily for the first month and twice daily for the following four months.
The intensity of itch was recorded daily using a modified VAS scale. A reduction in the itch appeared after 30 min of treatment and lasted until the next treatment session. During a 16 months’ follow-up only slight eczema occurred and the patient was relieved of her itch. It was suggested that increases in beta-endorphins, ACTH and plasma cortisol may have been the reasons for the improvements.
Dermatitis and Acupuncture
The opinions held by acupuncturists of how skin diseases should be dealt with vary greatly, and it is difficult to perceive a common denominator. However, in all studies very long periods were used involving 5 to 30 sessions, and in reports disclosing the treatment technique, stimulation of the needles took place either by manipulation or with electricity. The various studies generally testify to many cases of total recovery, and for the remaining patients a considerable degree of improvement.
To treat by Acupuncture and Moxibustion
Therapeutic principle: Acupuncture or moxibustion can eliminate damp-heat by using points mainly from Large Intestine meridian of Hand Yangming and Stomach meridian of Foot Yangming.
Hegu (LI 4), Quchi (LI 11), Neiting (ST 44), Weizhong (BL 40), Xiaxi (GB 43)
Always seek health advice from your doctor, or local Health Outlet. AcuMedic will be very pleased to offer advice regarding difficulties with this condition. Please see our Clinic
Please note that although we are confident that our treatments will help the majority of our patients, we cannot absolutely guarantee a cure as the needs and difficulties of each patient can differ greatly