Is eczema dangerous?

Eczema is a skin inflammatory condition characterised by the appearance of red, dry, and rough patches with irregular outlines. These lesions are often accompanied by intense itching. Subsequently, vesicles containing a clear liquid may form. When scratched, these vesicles rupture and cause oozing. In France, approximately 2.5 million people are affected by eczema, making it one of the main reasons for consultation with dermatologists, accounting for about 30% of cases. Different forms of eczema exist, among which atopic eczema and contact eczema are the most common.

• Atopiceczema, also known as atopic dermatitis, is a result of a genetic predisposition. Individuals suffering from this type of eczema have a fragile skin barrier, which easily allows allergens to penetrate. Moreover, their immune system reacts violently to external stimuli , causing disproportionate inflammatory responses when the skin is exposed to common environmental allergens (animal hair, pollen, dust...).

• Thecontact eczema, or contact dermatitis, occurs after the skin comes into contact with a specific allergenic substance. Four major sources of allergens, present in our everyday environment, are generally the cause of contact eczema. These are clothing items, cosmetics, topical medications and occupational allergens, that is, those present at work (cement, paint, pesticides, gloves...). Thus, although contact eczema causes symptoms similar to those of atopic eczema, its origin is different and is not linked to genetics.

Eczema is in most cases mild and harmless. Even though the itching and psychological impact of eczema cannot be overlooked, this condition does not pose a life-threatening risk to health. Moreover, appropriate management and adherence to dermatological advice can limit its impact on the quality of life of those affected. However, it is important to emphasise that eczema can in rare instances become complicated and progress to more severe forms.

An infection.

Following the scratching of lesions, it can occur that theeczema becomes infected. Certain viruses, such as herpes, certain bacteria, like the golden staphylococcus, or even certain fungi, like the candida albicans, can colonise the wound and lead to complications. Depending on the micro-organism causing the infection, this can result in pain and exacerbate itching/redness. It is imperative to consult a dermatologist in case of infection, so that they can identify the source and prescribe an appropriate treatment (antifungals if it's fungi, antivirals if they are viruses and antibiotics in case of bacterial colonisation).

A generalisation of eczema.

One of the most severe complications of eczema is its generalisation, also referred to as erythroderma. Eczema is said to be generalised when the patches spread. They can sometimes cover up to 90% of the body. In addition to the usual redness and itching, oedemas are added. This form of eczema constitutes a dermatological emergency and sometimes requires hospitalisation.

The complications of eczema can be avoided by adopting certain daily habits. The following advice may be useful in this regard:

• Avoid scratching eczematous lesions.

  When we scratch ourselves, there is a significant risk of opening skin lesions, thereby creating opportunities for bacteria and viruses to enter. To avoid scratching during sleep, some people, for example, opt for cotton gloves. It is also recommended to keep nails short to prevent accidental injuries. Finally, in addition to these precautions, the use of ingredients such as thermal water or certain essential oils, and the application of cold, can help to soothe itching.

• Regularly apply amoisturiser.

  In order to hydrate and protect the skin from the risk of infection, it is recommended to apply an emollient care product at least once a day. Possessing a very rich texture, this type of product forms a veil on the skin's surface, similar to the natural hydrolipidic film, in order to limit dehydration and the penetration of pathogens or allergens. We also advise you to consistently use an emollient after showering, as water can have a drying effect on the skin. Finally, avoid moisturisers containing perfumes, which can irritate sensitive atopic skin.

• At the slightest doubt, consult a dermatologist.

  If you notice a change in the appearance of your lesions or a generalisation of your eczema, do not hesitate to consult a healthcare professional. They will be able to determine if your eczema is indeed worsening and, if that is the case, prescribe a treatment. The earlier the intervention, the less significant the complications.

• GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).

• BORRADORI L. & al. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).