Eczema in Adults

Growing older (and wiser) often brings unexpected changes to our bodies, including skin conditions like eczema. Eczema affects male and female children similarly, but is more prevalent in adult women.

As we age, it’s important to be aware of the different types of eczema and how they can affect us. Many adults don't realize that they may at risk for developing Adult Eczema as we get older because its primary demographic is infants and toddlers.

More than 30 million adults across the country suffer from this common skin condition that is characterized by redness, dryness, itching, and possible flaking of skin on various parts of the body.

Dermatitis (eczema) has been found to affect nearly 1 in 5 people ranging from different varieties, presenting pattern, and its most likely causes.

Dermatitis can be acute or chronic or both and can be lifelong.

Dermatitis may fluctuate in its severity. As a general rule, dermatitis is found and described as an erythematous (red), itchy and scaly rash. Through epidermal changes, dermatitis presents a common histopathological characteristic of having spongiosis (an abnormal accumulation of fluid in the epidermis) or intercellular oedema.

Dermatitis can appear (known as acute eczema) with a rapidly evolving rash that may swell, weep then crust, blister from vesicles, present with scale, and is usually erythematous-like with poor defining borders. Its chronic version can also appear with all the acute characteristics, but most of the time is seen as more of a present and persistent rash. The rash may be darkened or more pigmented, thickened, fissured, increased in scales, and may display lichenification due to extensive scratching.

For many sufferers, this annoying but generally non-life threatening issue can be uncomfortable at times and could even lead to complications if left untreated. In addition Eczema will often display unsightly scales, may cause embarrassment, withdrawal from society, or even depression. And worse, Eczema in adults can potentially be a serious health issue if not addressed in a timely manner.

Dermatitis is a complex disease.

It has many variants and is difficult to pinpoint its origin. For example, atopic dermatitis occurs through complex interactions between genetics, inflammation and the environment the person is living in, such as the weather, exposure to irritant, temperature and non-specific triggers. Family history plays a huge role and is found to be 70% of the case in atopic dermatitis.

Up to 50% of people have an abnormal epidermal barrier where there is a deficiency in the filaggrin protein, resulting in a skin surface that struggles to hold water and is susceptible to irritants, allergens and infections. The defensins proteins are also found to be faulty increasing infection susceptibility. The result causes the keratinocytes cells to die, spongiosis and further infiltration of inflammatory cells.

Individual trigger factors vary from person to person and often you will find you have more than one trigger factor that can cause a ‘flare’ of your eczema. Some trigger factors may be easy to identify whilst others may not be so easy to work out. If you suspect something in the environment may be a trigger factor keeping a symptom diary can be helpful to work out patterns of exposure and signs and symptoms. This can be useful when speaking to your health care professional to identify potential triggers.

Aggravating factors of Eczema

Family History
Age and Health condition
Cold and dry weather
Sand (beach or sand pits)
Bathing too often may exacerbate eczema
Lukewarm water and showers are shown to be better.
Certain clothes may exacerbate dermatitis.
Avoid coarse fibres and wear soft and smooth garments.
Avoid any irritants such as chemicals, dust, solvents, detergents, and physical injury.
Staphylococcus aureus or Streptococcus pyogenes infections.
Occupation exposure.

Clinical features

As mentioned above dermatitis may appear as a patchy, red (erythematous), poorly defined rash that is mostly found in the cubital fossae (the flexure between the forearm and the biceps), the popliteal fossae (behind the knees), and the face, but can be found anywhere on the body if it is severe enough. Dryness of the skin is common.

Patients with dermatitis experience itching of the skin, and in some cases, the itching may be so severe that patients may scratch the top layer off which is called excoriation of the skin. Itching may accelerate the epidermal changes and thickens the top layer of the skin; this is called lichenification.

Dermatitis may occur due to a bacterial infection and may present the skin as crusty or weepy. Do bear in mind that dermatitis can come in many forms and each type can present with their unique general presentation; hence a correct diagnosis is essential.

Being certain of the diagnosis is crucial in treating dermatitis.

Derm Texas will look at its clinical features or perform a skin biopsy for certainty. It is essential to understand that dermatitis is a lifelong/chronic disease and takes time and patience to treat. Having said that, dermatitis has a good prognosis.

Fortunately for those affected by Adult Eczema, there are treatments and therapies to reduce its symptoms and manage flare ups through lifestyle changes; as well as medical options provided today.

Our medical practice at Derm Texas specialize in providing excellent care tailored to meet the unique needs of of both men and women. We at Derm Texas invite you to click or call! Our friendly and welcoming staff will greet you and give you an outstanding patient experience. And we accept most all types of insurance!

This above is general information and discussion about medical, cosmetic and surgical dermatology. The words and other content provided above, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately-licensed dermatologist or other health care worker. Derm Texas images, brochures, descriptions of procedures, websites and other advertising material are intended solely for illustration examples of our services and products and do not represent our patient or any individual or results.