Eczema is an inflammatory skin disorder characterized by patches of red, dry, flaking skin and areas that are inflamed, moist, and oozing. If the condition becomes chronic, the affected skin cells may become thick and scaly and the skin may change color. Itching can be so severe that scratching is virtually inevitable. A person with eczema may scratch until the skin cracks and bleeds, preferring the hurt caused by rubbing the skin raw to the intolerable itching.

The condition can affect any part of the body, but is most common on the face and scalp, behind the ears, and in the creases of the elbows, knees, and groin. It can be short lived (acute) or last for several years with periods of remission and exacerbation (chronic). It is not contagious. People who have eczema usually have very dry, itchy skin that doesn't hold moisture well.

Eczema can be a result of either atopic dermatitis or contact dermatitis. Atopic dermatitis is an inherited form of hypersensitivity that usually first appears in infancy or early childhood. People with atopic dermatitis often have other family members with allergies and a history of eczema. It can become worse after you eat certain foods or are exposed to an allergen like dust or pollen. Atopic eczema can be a long-term condition.

Contact dermatitis is the more common form of the condition. This type of eczema is often an allergic response to something a person has touched, including topical medicines. Eczema can also be caused by many irritants that come in contact with the skin, such as soaps, bubble bath, fabric dyes, feathers, cosmetics, wool, plants, and environmental pollutants.

Both types of eczema are considered allergic responses. If you have eczema, you may have other allergies as well, such as food sensitivities, asthma, or hay fever.

Emotional stress can exacerbate a case of eczema.

Also, even though eczema is not caused by a virus or bacteria, the open lesions can become infected. When dealing with eczema, watch for signs of infection, and if infection develops, call your doctor.

CONVENTIONAL TREATMENT

• Topical anti-inflammatory ointments containing corticosteroids such as hydrocortisone (in Hytone, LactiCare HC, Vytone, and others), triamcinolone (Aristocort, Triacet, and others), or betamethasone (Beta-Val, Dipro1ene) are the medications most commonly prescribed for eczema. Your doctor will direct you to rub a small amount into the affected area, taking care not to apply it to open lesions. In more severe cases, you may be instructed to wrap the area with an occlusive dressing, such as Saran Wrap, to increase the medication's effectiveness. Because long-term use of steroids often creates side effects, such as thin, fragile dry skin and even suppression of the adrenal glands over time, these medications should be used only for short periods.

• To counter the allergic response and help decrease the awful itching, an antihistamine such as diphenhydramine (found in Benadry1 and other over-the-counter medications), hydroxyzine (Atarax, Vistaril), or chlorpheniramine (Chlor- Trimeton) may be recommended. Antihistamines can cause sleepiness, but this can be very helpful at bedtime, when itching is often at its worst, making it difficult to fall asleep.

• If the lesions are weeping, Burow's solution may be recommended. This soothing powder is available over the counter at many drugstores. Be aware that it contains aluminum.

• Coal-tar cream (Fototar) may contain the flaking and itching, but it can stain clothing, irritate skin, and cause sensitivity to sunlight.

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