Eczema Treatment in Delhi

Eczema is a form of dermatitis, which is known as inflammation of the upper layers of the skin. Eczema is characterized by redness, itching, and dryness of the skin. These skin rashes are often persistent or recurring and scaling of the skin is also experienced in advanced stages of eczema.

However, It is not a contagious skin condition and cannot spread from one person to another. Itching is sometimes very severe and as a result of constant scratching leads to opening up of the skin and lead to infection and bleeding.

Eczema is a relatively common condition, where the symptoms vary greatly between patients. The cause of eczema is genetic and it is more common during childhood, which most people grow out of, but it can also be caused by an allergic reaction to environmental factors.

Eczema is hard to cure disease, but the symptoms can be reduced and even eliminated, with the right eczema treatment in Delhi. 

Different Types of Eczema

There are different types of eczema including atopic eczema, contact allergic eczema, discoid eczema, irritant eczema, and varicose eczema. These can be acute (presenting within 6 weeks) or chronic ( more than 6 weeks).

1. Atopic Eczema is common in children and is also related to conditions, such as allergic asthma. Studies show that 6.75% of children in India suffer from atopic eczema. What is more alarming is that the number of affected children has increased tremendously in the last decade. Eczema is troublesome in the way that it causes, lack of sleep, slowing growth, and causing tiredness, and irritability. Atopic eczema presents as a red, itchy, and sometimes weepy rash. In most babies, these rashes start on the face while in older children it appears in the skin folds first including the elbows and knees. It is a chronic condition and sometimes can flare up badly, and may also become infected. Most children find relief from this ski condition with age. However, many of them have to deal with chronic (long-term) atopic eczema.

2. Seborrhoeic Eczema is mainly caused by Malassezia, a naturally occurring yeast on the skin. Malassezia is also the main cause of dandruff. The symptoms of seborrhoeic eczema include redness, scaling, or dandruff on the scalp. However, it is not limited to the scalp, and red, dry, scaly patches may be observed in the skin folds like the sides of the nose, back, chest. Those who have a tendency to develop psoriasis or rosacea are usually at more risk of getting seborrhoeic eczema. Seborrhoeic eczema generally responds very well to treatment with antifungal shampoos and anti-inflammatory skin creams prescribed by dermatologists.

3. Contact Allergic Eczema is caused by an allergic reaction to a chemical that comes in contact with the skin. The most common cause of these allergies is skin’s contact with metals like nickel, fragrant perfumes, and other skin/ hair products, chemical preservatives in cosmetic products, and sometimes medications or topical antibiotics. Sometimes, these allergies can also happen because of the products one has been safely using for long but suddenly develops an allergic reaction and it might remain the same for life. Diagnosis of contact allergic eczema is made by identifying the allergen, history of its use, and physical examination of the affected sites. A patch test (allergic test) may also be suggested by the eczema specialist doctor in Delhi if required.

4. Discoid Eczema is caused by chronic stress and a reaction to staphylococci bacterial antigens commonly seen in adults and typically causes a few well-defined, very itchy, and weepy coin-shaped patches of inflamed skin and generally affect the entire body. It is usually chronic and recurrences can also be experienced. 

5. Pompholyx is one of the endogenous eczemas. The root cause of this type of eczema is unknown. However, it has been found that heat or emotional upsets or small amounts of nickel in food can also trigger this condition.

It is an unpleasant form of eczema presenting as recurrent bouts of vesicles or larger blisters that appear on the palms, fingers, and/or the soles of adults lasting a few weeks only to recur at irregular intervals.

6. Asteotic Eczema
This occurs in old age patients who always have had dry skin and a tendency to chap.

Over-washing, low humidity, central heating, use of diuretics, and hypothyroidism can aggravate this type of eczema. It is characterized by red superficial fissures and dry skin. Most commonly it affects the legs of elderly patients.

Sometimes association with malabsorption syndromes, zinc deficiency, or internal malignancy is also observed.

7. Varicose Eczema or gravitational eczema affects the lower legs. It is caused by poor blood circulation and leakiness of some of the valves in the lower leg veins. Ultrasound investigations are required to diagnose the condition and treatments focusing to improve blood circulation are advised.

Most of these eczemas can also present with episodes of remissions and exacerbations and can be associated with aggravating factors.

A proper and thorough workup needs to be done to identify the triggers as they vary from patient to patient. Some eczemas can really impact the quality of life of patients.

Diagnoses

Eczema is a chronic debilitating itchy condition of the skin, so when you first visit a dermatologist, he will ask all about the age of onset of disease because Eczema looks different in childhood than in adulthood. In childhood, it starts in the folds of the skin, but as you grow, it can affect any part of the body. It is an immune condition meaning that the immune system reacts too strongly and inappropriately to a variety of triggers, ranging from food to clothing to products or ingredients.

Identifying the type of eczema is the prerequisite to form an effective eczema treatment plan. Hence, a detailed history regarding aggravating, relieving factors for your condition, number and duration of episodes, the difference with weather and climatic conditions, family, and history of previous and current medical treatment will be asked.

It is always useful to keep all your medical records handy. The doctor may also order some blood workup, Doppler USG for varicose veins, Patch tests to know allergens in case of contact eczema, examination of skin under dermatoscope, KOH test sampling and fungal culture of scales from the skin, physiological examination of skin biophysical parameters using tewameter, pHmeter, can be done. In some resorts, a skin biopsy may be required to make a diagnosis.

Best Eczema Treatments in Delhi

There is a wide range of treatment options available depending on the severity, extent, and duration of the condition.

Upon consultation, a dermatologist will recommend a personalized treatment protocol for you, tailored to your particular case of eczema which may include some moisturizers or maintenance medications to help restore the protective skin barrier and reduce the penetration of irritants into the skin.

1. Emollients
Regular and generous use of emollients is advisable in eczema to keep the skin barrier working. An emollient is a type of moisturizer containing Ceramides, Shea Butter, Hyaluronic Acid, free fatty acids, cholesterol, glycerin, etc. that helps to soften the skin. Eczema disrupts the outer skin layer and leads to a loss of water. Hence, causing excessive skin dryness, itching and rough skin texture. In the case of mild or moderate eczema only emollients may be enough to soothe the skin.

The emollient acts as a barrier and also provides much-needed moisture to the skin. Thus, calming the red, itchy skin.

Emollients are available as creams, ointments, and lotions. Patients with eczema should also use emollient-based cleansers for washing, which do not foam like regular soaps but are just as effective at cleaning the skin. 

2. Topical Steroids
During periods of active eczema or flare-up sessions - the skin can become very red, itchy, sore, blistered, and weepy. So, topical steroids are suggested along with the emollients to help reduce inflammation in the outer/topmost skin layers.

Topical steroids are available in the form of creams, ointments, lotions, scalp applications, plasters and tapes. There are four different strengths of topical steroids available: mild, moderate, potent, and very potent. The ideal strength of a topical steroid varies from person to person depending on the severity of the flare-up, affected body part and other treatments being used.

Your dermatologist may prescribe you Topical steroids for short periods of time such as 2 days a week to the areas where eczema usually flares up. This is a preventive strategy applied for those suffering from severe eczema. It is also referred to as ‘weekend therapy’.

3. Steroid-alternative Treatments
Topical calcineurin inhibitors (TCIs) are a form of topical treatment for eczema. These are safe steroid alternatives to control eczema flare-ups. There are two types: pimecrolimus) and tacrolimus). These do not have side effects like steroids. One may experience warmth or burning sensation after the application of TCI but it is normal and one should not discontinue the treatment because of this reason. These treatments are licensed in India for the treatment of eczema in adults and children over the age of two.

Other alternative treatments that are used less frequently for the management of eczema are phototherapy, bandages, and antibiotics or antiviral medication to control secondary infection.

Those with severe eczema may require oral treatments to control the immune cells that trigger eczemas such as oral immunosuppressants- steroids and steroid-sparing immunosuppressants, omega 3 fatty acids, probiotics, and prebiotics.

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