Understanding Eczema: Symptoms, Triggers, and Management

Eczema is a common chronic skin condition characterized by recurrent skin inflammation and itching. Symptoms can vary from person to person and may change with age, environmental triggers, and individual health status. Understanding the symptoms of eczema can help with early identification and appropriate care measures.

The most typical symptoms of this condition include skin redness, dryness, flaking, and unbearable itching. These symptoms not only affect the quality of daily life but can also lead to secondary infections or psychological stress in severe cases. Through careful observation of symptoms, patients and healthcare providers can more accurately adjust treatment strategies.

Early Symptoms and Signs

The early symptoms of eczema are often subtle and may be mistaken for general skin dryness or allergic reactions. Common initial signs include:

• Localized skin slight redness, especially in the creases such as the elbow and behind the knees
• Mild itching, which may worsen after contact with specific irritants
• Abnormal skin texture, such as roughness or slight flaking

If these early signs are not properly addressed, they may gradually develop into more pronounced inflammatory reactions.

Trigger factors play a key role in the appearance of early symptoms. Environmental factors such as low humidity, contact with chemical detergents, or increased personal stress can act as "kindling," triggering potential eczema flare-ups. Early use of moisturizers or avoidance of irritants may help slow the worsening of symptoms.

Common Symptoms

Structural Changes in the Skin

Patients with eczema often exhibit various structural changes in the skin:

• Dryness and dehydration: The stratum corneum's moisture-retaining function is impaired, leading to visibly cracked skin with a rough texture like sandpaper
• Erythema and swelling: Blood vessels in the affected area dilate, forming well-defined red patches that may temporarily blanch when pressed
• Scaling accumulation: In chronic cases, patients may develop silvery scales on the skin surface, particularly noticeable in the bends of joints such as elbows and knees

These changes can vary depending on the degree of inflammation.

Functional Symptoms

In addition to visible changes, patients also experience various functional disturbances:

• Severe itching: This may worsen at night, leading to sleep disturbances
• Burning sensation: Damaged skin often feels uncomfortable, as if scalded by hot water
• Pain: In cases of severe cracking or secondary infections, the skin may produce a sharp, needle-like pain

These symptoms may create a vicious cycle of "itch-scratch-inflammation exacerbation," requiring medical intervention to break this process.

Disease Progression and Symptom Changes

The course of eczema often presents periodic changes, generally divided into three stages: acute phase characterized by intense redness and blister formation; subacute phase transitioning to dryness and scaling; and chronic phase showing long-term changes such as skin thickening and lichenification. For example, pediatric patients may start with facial erythema, gradually shifting to areas such as hands or the elbow creases as they grow.

Environmental factors can exacerbate symptom fluctuations: low temperatures and humidity in winter may worsen dryness symptoms, while summer sweat irritation may trigger recurrent flare-ups in specific areas. Some patients may observe sudden symptom exacerbation during periods of stress, indicating a close relationship with the neuroimmune system.

When to Seek Medical Attention

Seek medical attention promptly if the following signs occur:

• Symptoms persist for more than two weeks without improvement after home care
• Skin shows yellow crusting or oozing tissue fluid, which may indicate bacterial infection
• Itching severely affects sleep or daily activities

These signs suggest the potential need for professional treatment, such as antibiotics or immunomodulatory medications.

Special populations should proactively monitor symptoms: if infants show erythema on the face or diaper area, or if adult patients have symptoms spreading to over 30% of the body surface, immediate medical evaluation is necessary. Chronic patients should also seek professional diagnosis if they notice skin color deepening or the appearance of cracks to rule out complications.

 

Frequently Asked Questions

How should daily care be adjusted for atopic dermatitis symptoms that worsen in winter?

Winter dryness can easily trigger inflammation; it is recommended to moisturize 2-3 times daily using fragrance-free, low-irritant lotions or ointments, keeping bath water temperature below 38°C, and avoiding scratching to prevent subsequent infections. For clothing, cotton garments are preferable to reduce irritation, and bedding should be cleaned regularly.

Does the use of steroid ointments lead to skin thinning or addiction?

Short-term use of low to medium potency topical steroids as directed typically does not cause skin thinning. Physicians will adjust the strength and duration of medication based on the degree of inflammation, and patients should have regular follow-ups to avoid self-extending the usage period. Non-steroidal anti-inflammatory medications (such as JAK inhibitors) can be alternatives, with specific treatments following professional advice.

Can emotional stress directly trigger or exacerbate symptoms?

Stress can indeed trigger atopic dermatitis flare-ups, as stress hormones suppress immune regulation, leading to decreased skin barrier function. It is advised to alleviate stress through mindfulness meditation, regular exercise, or professional counseling, and to enhance skincare in the early stages of symptoms to reduce the risk of acute flare-ups.

What precautions should patients take during hydrotherapy or hot spring treatments?

Minerals in hot spring water may irritate sensitive skin; it is advisable to conduct a patch test on the skin beforehand. Water temperature should be kept below 40°C, with soaking time limited to 15 minutes, and moisturizers should be applied immediately afterward to lock in moisture. Avoid using sulfur-containing or high-mineral springs; opting for gentle treatments without additives is preferable.

What should patients do if symptoms worsen after contact with pet hair?

Pet dander and secretions may act as allergens; it is recommended to use HEPA-filtered air purifiers and to prevent pets from entering the bedroom. Regular cleaning of pet fur and using anti-IgE monoclonal antibody medications can block allergic reactions, but these should be used only after evaluation by a physician, and patients should not adjust medications on their own.