Eczema, the most common skin disease

Eczema

Eczema, also called dermatitis, represents up to 30% of visits to the dermatologist, it is the most common skin disease. Why do we suffer from eczema? Are there several forms? How to treat these skin irritations?

Eczema: more and more cases

Eczema is one of the most common skin diseases. It is manifested by slightly swollen red patches, blisters that burst quickly, skin that peels and causes intense itching. Without treatment, these plaques develop into crusts and crusts. This non-contagious disease corresponds to a chronic inflammation of the skin. and it affects 2.5 million people, 20% of whom are children under 7, according to the French Eczema Association.

There are several types of eczema. Contact eczema most often affects adults. The problem is due to the sensitization of the skin to a substance present in the environment, called an allergen, in repeated contact with the skin. It can be, for example, metals like those present in a coin or a button of jeans. The contact ends up triggering an excessive and maladaptive reaction of the immune system.

The defense cells of our body will recognize the allergenic substance and release in reaction inflammatory molecules such as histamine. As a result, the skin becomes red and grainy. Small bubbles form. They can ooze if scratched, they end up drying out and giving crusts. When eczema becomes chronic, the skin thickens and takes on a greyish or brown lichen appearance.

Very common in children but also affecting adults, atopic eczema often begins very early in life, generally first on the face before affecting the "folds" such as the knees and elbows. In this case, the disease is favored by a genetic predisposition. In these children, the structure of the skin is abnormal and it becomes hyper-reactive to the environment.

In the case of normal skin, water evaporates little and allergens cannot penetrate. In the case of "eczema skin", the epidermis does not play its role as a protective barrier: it lets water escape, which makes the skin dry. At the same time, it allows allergens to penetrate much more easily. Here again, the immune system reacts disproportionately: the skin is red, dry and still very itchy which can cause children to scratch until they bleed.

Atopic eczema: an allergic reaction

Atopic eczema is the most common form of chronic eczema. It usually appears in babies before the age of 18 months - 10 to 15% of infants are affected by the disease according to the French Eczema Association.

It disappears, in 70% of cases, before the age of 4 years and, in 90% of cases, before adolescence. A treatment based on topical corticosteroids and emollients make the eczema regress.

To read also: Eczema, the right gestures

Identify the causes of eczema

Eczema flare-ups can be triggered by exposure to certain products. This is called contact eczema. In this case, it is necessary to test the reactions of the skin of the patients to find the guilty products and to be able to avoid them.

To find the causes of eczema, it is possible to do a test patch. The various possible allergens, determined beforehand by the doctor, are contained in adhesive cups which are put in contact with the skin for 48 hours.

Two test readings will be required: one after 48 hours and then another after three days. In five days, the doctor will be able to know if the eczema is of allergic origin.

A school of eczema

To treat eczema, there are on the one hand the treatment of inflammation, which are dermo-corticoids, corticosteroid creams or ointments, and on the other hand, basic treatments to reduce the severity of the sickness.

But there are also everyday gestures that are often overlooked: surgras products, rather than classic soaps, to be applied during a lukewarm shower, emollients to properly moisturize the skin, cotton clothes instead of synthetic clothes, etc.

To give a helping hand to sick children and their parents, there are atopy schools with therapeutic education courses. Objective: to explain the disease and the treatments.

This support is valuable for families and effective since since its creation in 2008, the results of the atopy school have been positive. Most children's eczema becomes less severe and their quality of life improves.

The fear of corticosteroids

Eczema affects 15% of infants. Regular treatment of inflammation can help prevent attacks, but it is sometimes difficult for parents to massage their baby with a corticosteroid cream, based on cortisone. Doctors call this apprehension corticophobia.

In Nantes, the atopy school works on this fear and teaches parents how to treat their child as well as possible.

Occupational eczema

Eczema can also be of occupational origin. Detergents, hairdressing products, solvents, plastics... Many jobs require contact with irritants or allergens that can cause eczema.

Occupational eczema can be either allergic in origin or irritative in origin or both. To find out if eczema is of allergic or irritative origin, dermatologists perform a series of tests.

While some patients find solutions to soothe their itching, for other patients, the discomfort is such that eczema can be recognized as an occupational disease and require professional retraining.

Eczema: children too

Eczema affects nearly 20% of children in France. This skin condition requires significant follow-up from the dermatologist but also from the parents.

Regular consultations with the dermatologist are necessary to monitor the evolution of children's eczema. In 50% of cases, children heal spontaneously from their eczema around the age of 5-6 and almost 90% are healed during adolescence.

Eczema: a new hopeful treatment

Nearly 2.5 million French people suffer from eczema. This skin disease generates significant redness and itching. To relieve adult patients, a new injection treatment seems promising.

Read also: Eczema, what treatment and what perspectives?

The injection treatment targets two immune system proteins responsible for causing the skin to dry out and cause red patches to appear. "This treatment has a much more targeted action on the molecules of inflammation, whereas immunosuppressants have a more general action and will reduce inflammatory cells in the blood and in the skin. This new treatment is therefore more effective and has less risk. 'side effects,' says Dr. Audrey Lasek, dermatologist.

At each consultation, the patient completes a questionnaire on his state of health, his sleep, his appetite. The doctor then establishes a score to measure the impact of his eczema on his quality of life. Patients remain under observation and must continue injections as long as their eczema persists.