Eczema: What Is It? Why It Occurs? What Are Its Types & Cures?

Diseases A-Z

According to some statistical surveys, around 230 million people worldwide suffered from eczema in 2010, around 3.5% of the world’s population. Eczema affects mainly young people: for example, in the United Kingdom, children suffering from dermatitis are about 20%; in the United States, around 10%. The most affected sex is female. Curiously and for reasons still unclear, from 1940 to 2000, the incidence rate of eczema has been increasing. In other words, over the years, eczema has become an increasingly common problem.eczema

An interesting 2010 US study investigated how widespread eczema was among those with a job in the United States that year. It emerged that dermatitis affected approximately 10% of workers (i.e. more than 15 million individuals) and was particularly prevalent among health care workers and social workers.

What is eczema?

An eczema, or dermatitis, is an inflammation of the skin that causes a characteristic rash. The typical manifestations of this rash are: itching, redness, presence of vesicles and / or crusting. Currently, the causes of eczema are still unclear. In this regard, the researchers hypothesized that a determining role is played by both environmental and genetic factors.

types of eczema:
Atopic eczema, contact dermatitis, seborrheic eczema and asteatosic eczema. Some of the less common eczema are: dyshidrosis, discoid eczema, varicose eczema, dermatitis herpetiformis and neurodermatitis.

Eczema is the term with which doctors indicate an inflammation of the skin (or skin), generally characterized by itching, erythema (i.e. redness), presence of vesicles and / or crusting. There are several types of eczema; each of these types has some peculiarities that an expert eye is able to recognize.

Eczema and dermatitis: are synonymous? In medicine, the terms eczema and dermatitis are synonymous, so they refer to the same inflammatory condition of the skin.

What causes eczema?

The causes of eczema are currently being studied, as doctors and researchers have not yet clarified what triggers and starts the processes of skin inflammation. According to the most accredited theories, the appearance of an eczema would contribute to a combination of environmental and genetic factors.

Environmental factors

An environmental factor is any circumstance, event or habit that can affect the life of an individual, to a certain extent. According to some scientific research, the environmental factors related to the appearance of eczema would be allergic reactions to certain substances (dust mites, drugs, etc.), exposure to certain irritants and some bacterial or fungal infections.

Genetic factors

Analyzing the genetic profile of numerous patients with eczema, the researchers noted that many subjects under examination expressed some specific genes differently than normal. Furthermore, paying attention to the family history of the patients themselves and others, they found that eczema was a recurring problem within different family groups.

These two curious findings, therefore, have led experts to think that, in some cases, eczema has a genetic-hereditary basis. Among the genes that would seem to influence the presence of some types of eczema, the gene for filaggrin, a protein found in the epidermis and which binds keratin filaments, deserves a special mention.

For reasons still unknown, people with celiac disease develop eczema with a frequency that is three times higher than individuals without this disorder.

Symptoms and complications of eczema

In general, the most characteristic sign of eczema is the rash, also known as rash or exanthema. A rash from eczema can occur with or without blisters; it may be the site of redness, irritation, swelling and / or dry skin; it can coincide with a highly itchy area (that is, itching); may develop suppurative and / or crusted lesions; etc.

What causes eczemaIt is important to clarify that the characteristics of the rash strongly depend on the type of eczema in progress. Although the triggering factors vary from subject to subject, dermatitis is characterized by common symptoms: redness of the skin, epidermis of the epidermis, transudate, crusts and desquamation.

Sometimes, vesicular lesions may appear in the acute phase. Pruritus is frequent and leads to scratching; precisely because of repeated voluntary chafing, the skin can become thickened and excoriated. Furthermore, it is possible that scratch wounds open the door to a secondary infection.

Dermatitis may occur occasionally (such as contact) or have a chronic course (as seen for eczema). The characteristic cutaneous manifestations can facilitate the diagnosis of the disease. Symptoms can be relieved by the use of topical or systemic drugs (cortisones, antihistamines, creams with a moisturizing and emollient action).

The body site, affected by the rash, depends on the type of eczema. In any case, the regions most often affected are: the neck, the trunk (chest, belly and back), the hands, the wrists, the forearms, the legs and the ankles. It is quite rare that eczema rash appears at the level of the genitals, so close to the vulva or scrotum. However, when it happens, the symptoms and signs are quite intense and with a tendency to ‘come and go’.

Eczema complications

The complications of eczema are often linked to a very intense itching. In fact, a particularly marked pruritic sensation induces the individual with eczema to repeatedly rub the skin, thus obtaining skin lesions from scratching. Such skin lesions represent, for bacteria, a possible access to the organism. The entry of bacteria into the body can trigger an infection, whose typical symptoms are: high fever, pus appearance and acute pain.

In general, for a correct diagnosis of eczema, objective examination and evaluation of the patient’s clinical history are essential and sometimes sufficient. Doctors resort to more in-depth analysis - such as allergic tests and skin biopsy - when doubts remain about the type of eczema.

Eczema treatment

Each patient with eczema is a case in itself. Thus, a valid treatment for an individual could be completely useless for another subject and so on.

Eczema therapy includes the use of emollients and various drugs, including:

  • Corticosteroids for topical or oral use (N.B: ‘topical use’ means that the preparation in question should be applied directly to the affected area).
  • Immunosuppressants with topical administration.
  • Topical or oral antibiotics.
  • Antihistamines.

Eczema treatmentFor some types of eczema, doctors could also prescribe some form of phototherapy (photochemotherapy, photodynamic therapy, etc.).

Eczema types

Doctors distinguish the various types of eczema in two broad categories: the category of common eczema – to which the most popular types of eczema belong – and the category of non-common eczema, which includes the lesser known eczema. Common eczema are: atopic eczema, contact eczema, seborrheic eczema and asteatosic eczema.

The non-common eczemas, however, are: dyshidrosis, discoid eczema, varicose eczema, dermatitis herpetiformis, neurodermatitis, auto-eczematization, stasis dermatitis, perioral dermatitis and eczema due to particular morbid conditions (infections, lymphomas, etc.).

Atopic eczema

Atopic eczema, or atopic dermatitis, is the most widespread type of eczema among men. According to doctors and experts in skin diseases, it would be an allergic disorder, with a genetic-hereditary component.

Particularly widespread among children (but potentially able to arise at any age), atopic dermatitis mainly affects:

  • Individuals suffering from asthma or hay fever.
  • Individuals with a family history of eczema, asthma or hay fever (i.e. subjects with relatives suffering from one of these conditions).
  • Individuals with some skin barrier defect.

Generally, the rash of atopic eczema involves pruritus, erythema, skin flushing and blisters. Favored by contact with soaps, rough clothing, some household chemicals and / or dust mites, the manifestations of atopic eczema affect, for the most part, the face, hands, feet, the inside of the elbows and the back of the knees.

Among the most suitable treatments, include: the use of emollients, the application of corticosteroids on the affected areas, the administration of immunosuppressants and antibiotics (if there are bacterial infections) and finally some sessions of photochemotherapy.

Contact eczema

Contact eczemaContact eczema, or contact dermatitis, is an inflammatory condition of the skin that appears after contact with innocuous substances for most people. Contact dermatitis can be of two types: irritative contact dermatitis and allergic contact dermatitis. Irritative contact dermatitis results from the interaction (sometimes occasional, sometimes repetitive) with particularly potent irritants, such as sodium lauryl sulfate. Allergic contact dermatitis, on the other hand, arises as a result of the interaction with allergens (i.e. substances that in some individuals trigger an allergic reaction).

Some typical allergens that characterize contact dermatitis are: nickel, poison ivy and cosmetics containing the so-called balsam from Peru. Based primarily on the level of the hands, contact eczema causes a rash characterized by itching, swelling, dry skin and redness of the skin. Among the most suitable treatments, include: the application of emollients, the use of corticosteroids, the use of antihistamines and, only in the presence of bacterial infections, the intake of antibiotics. In the presence of allergic contact dermatitis, physicians advise to avoid contact with any product or substance that contains the allergen.

Seborrheic eczema

Seborrheic eczema is a typical condition of the scalp, which in some cases may also affect the eyebrows, the sides of the nose, the anatomical area behind the ears, the groin and the center of the chest. Seborrheic eczema causes a rash, characterized by the formation and loss of oily scales. At the level of the scalp, these oily scales take the generic name of dandruff.

The precise causes of seborrheic eczema still remain unknown. However, researchers believe that infections produced by the Malassezia furfur fungus are a possible factor favoring this type of dermatitis. The most suitable treatments include: the use of detergents and shampoos based on salicylic acid, selenium, zinc or coal tar; the application of corticosteroids; and finally the intake of antifungal preparations.

Asteatosic eczema

Asteatosic eczema, or xerotic eczema or xerosis, is a skin inflammation that causes, above all, hardening and dryness of the skin and, with less frequency, itching. It is typical of old age and is usually based on the limbs and trunk.

Dyshidrosis

Dyshidrosis, or dyshidrotic eczema or pompholix, is a dermatitis that mainly affects the hands and feet. Generally, it is responsible for a rash, characterized, initially, by blisters and itching and, later, by redness. Dyshidrosis has, in many cases, the characters of a chronic disorder. The most effective treatments and remedies include: the administration of corticosteroid drugs, phototherapy (in particular phototherapy) and the application of wet / cold compresses on symptomatic areas.

Discoid eczema

Discoid eczema, or nummular eczema, is a dermatitis that causes oval or circular patches, reddish-brown in various parts of the body. The most important anatomical sites are: the forearms, the hands, the feet, the trunk and the legs. The precise factors triggering discoid eczema are unknown, although some clinical studies report the possible influence of dry skin condition. Among the most effective treatments, include: the application of emollients, the administration of corticosteroids and the use of antibiotics (if there is an infection).

Eczema from stasis varicose

Stasis eczema, or venous dermatitis or varicose dermatitis, is an inflammation of the skin that develops people with venous circulation problems in the legs (varicose veins, reduced venous return to the heart, etc.). From totally unknown causes, stasis eczema causes a rash, characterized by redness, itching, formation of scales and dark skin. It is more common in people over the age of 50.

Eczema herpetiformis

Eczema herpetiformis is a dermatitis that produces a rash, characterized by blisters and itching and with a symmetrical appearance. The most affected anatomical areas are: the arms, legs, knees and back. For reasons still unknown, eczema herpetiformis is particularly common among people with celiac disease.

Neurodermatitis

NeurodermatitisNeurodermatitis is a particular eczema that appears in those who have a nervous habit of scratching in a certain area of ​​the skin. Generally, it causes itching and thickened skin. To heal, the remedies consist in finding a way to not scratch and taking some anti-inflammatory drugs.

Self-eczematization

Self-eczematization is a type of eczema that appears as a result of parasitic infestations or fungal, bacterial or viral infections. In general, the site of the rash is far from the site of infection. By adequately treating the infection that favors it, self-eczemaing is treatable with excellent results.

Perioral dermatitis

Perioral dermatitis is an eczema that causes a rash around the mouth. Typical features of this rash are: the presence of blisters, itching and burning. Possible risk factors include: the use of fluoride-based toothpaste, the use of oral contraceptives, the application of some cosmetics, the use of certain detergents, exposure to cold, etc. Typically, doctors treat this type of eczema with immunosuppressants and antibiotics, and discouraging exposure to the sun.

Eczema drugs

Since we are treating a cutaneous type of disorder, eczema treatment is often carried out with drugs to be applied locally; in the most troublesome forms, when the itching and redness of the skin are considerable, it is possible to associate with the topical therapy also the systemic administration of specific drugs, such as antihistamines and cortisones. As an example, in atopic dermatitis, creams or ointments based on corticosteroids are usually recommended, while in the contact eczema it may also be necessary to administer antihistamines to remove all allergic symptoms.

In the case of established bacterial co-infection in the context of eczema, specific antibiotic treatment is recommended against the responsible pathogen. In the event of particularly severe eczema, associated with severe allergic reactions, it is possible to opt for immunosuppressants or corticosteroids to be taken systemically. Furthermore, in some patients affected by eczema UV therapy is recommended: the patient undergoes direct lighting with UVA and UVB rays. The contact between skin and UV rays can lighten the symptoms that accompany eczema, such as itching and irritation. Seborrheic eczema (seborrheic dermatitis) should be treated with specific anti-dandruff drugs or anti-fungal creams.

Eczema drugsThe following are the classes of drugs most used in therapy against eczema, and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and dosage most suitable for the patient, based on the severity of the disease, the health status of the patient and his response to treatment:

Cortical drugs with topical application
  • Hydrocortisone (e.g., Locoidon, Colifoam): this is a topical steroid drug. It is recommended to apply the solution in the area affected by eczema once a day; the therapy should be continued for a few weeks, as the first improvements are observable at least after 7 days.
  • Clocortolone (e.g. Cloderm): apply the drug in the form of cream or ointment three times a day, directly on the site involved in eczema. It is recommended to massage until complete absorption of the product.
  • Desonide (e.g. Sterades, cream or cutaneous solution): for the treatment of eczema, the drug is available as cream, lotion, foam or gel to be applied directly on the lesion. The indicative dosage involves applying a thin layer of cream 2-3 times a day. Do not give to children under three months of age. For the treatment of infantile eczema, do not exceed two applications per day with this medication.
  • Mometasone (e.g. Nasonex, Rinelon): for the treatment of eczema, apply a thin layer of cream on the infected area, once a day, in full compliance with the instructions dictated by the doctor.
  • Corticosteroids with a systemic action: indicated to treat severe forms of eczema, which do not resolve with the mere topical application of creams or lotions.
  • Prednisone (e.g. Deltacortene, Lodotra): approximately, take the drug at a dose of 60 mg per day for one or two weeks. Respect the doctor’s instructions: the dosage can be modulated according to the severity of the symptoms and the patient’s response to the treatment.
  • Dexamethasone (e.g. Decadron, Soldesam): indicated for the treatment of severe forms of eczema, especially if associated with immune disorders. For the dosage: consult the doctor.
Antifungal drugs for the treatment of fungal eczema
  • Ciclopirox (e.g. Fungizione): antifungal topically applied. In the form of gel, it is recommended to apply the product twice a day for 4 weeks; the drug is also available in the form of 1% shampoo: apply the product (5mg, corresponding to about a teaspoon, or to two if it is long hair) on wet hair. Rub vigorously to form a persistent foam; after which leave to rest for 3 minutes. Avoid contact with eyes.
  • Systemic antiviral drugs: indicated for the treatment of eczema in case of proven Herpes simplex coinfection.
  • Famciclovir (e.g. Famvir, Famciclovir): available as tablets, orally, 1500 mg (1 tablet) in a single dose. The drug is particularly effective when taken at the onset of symptoms (burning, pain, tingling, pruritus).
  • Valaciclovir (e.g. Talavir, Zelitrex): take one tablet (2 g) every 12 hours; once again, it is good to start the therapy right from the first prodromes.
  • Immunosuppressants for the treatment of eczema: the use of these drugs for the treatment of eczema is not the first choice; it is in fact essential to carefully evaluate the possible long-term side effects before starting a therapy.
  • Pimecrolimus (e.g. Elidel cream): formulated in topically applied products, pimecrolimus is indicated for the treatment of atopic eczema of the face and neck, especially for children aged between 2 and 16 years. Start the therapy by applying the drug directly on the skin lesion, twice a day, until symptoms are remedied. If the symptoms do not reverse within 6 weeks of starting treatment, it is recommended to replace the drug. Do not administer the drug for long periods.
  • Tacrolimus (e.g. Protopic ointment, Advagraf, Modigraf): this drug is indicated both for the treatment of childhood eczema and for that of adulthood. Begin the therapy by applying the product (0.1%) twice a day, until the disappearance of the characteristic symptoms. It is necessary to modulate the therapy in case of non-response within 2 weeks of starting treatment with this drug.
Recommendations:

It is recommended to regularly apply moisturizers and emollients, especially in case of chronic eczema: these products, while not directly acting on the triggering cause, improve the general symptoms such as skin irritation and skin xerosis.

Here are some active ingredients used in emollient preparations to treat eczema:

  • sweet almond oil
  • glycerine
  • tar
  • ichthyol

Nummular eczema

Nummular eczema is a dermatitis, that is an inflammatory disease of the skin, which causes very characteristic skin patches. The precise causes have not yet been clarified, although they have been the subject of lengthy research. For a precise diagnosis, a physical examination, an allergic test and various cultural examinations are required. The therapeutic choice is wide, but identifying the most appropriate treatment is not always easy.

Nummular eczema or discoid eczema is an inflammatory disease of the skin, which causes the appearance of red-brownish oval or circular spots in various parts of the body. In particular, the areas most often affected are: the forearms, the hands, the feet, the trunk (chest, stomach and back) and the legs.

Nummular eczema is also known as nummular dermatitis. Nummular eczema can affect anyone and at any age, but it is much more common in males between the ages of 50 and 70. According to an Anglo-Saxon statistical study, nummular eczema would have an annual incidence of about 2 cases per 1,000 people. Its appearance is almost always associated with dry skin (so much so that we believe there may be a link between the two conditions) and sometimes atopic dermatitis, with which, however, there does not seem to be any particular connection.

The causes of nummular eczema are currently being studied, as it has not yet been clarified what trigger skin inflammation accurately. The most accredited hypothesis (but still to be demonstrated) would concern the association with dry skin; this condition, in fact, would make the skin less protected and allow the penetration of some substances, such as soaps and detergents, from harmful, inflammatory and irritating effects.

The hypothesis that sees dry skin at the origin of discoid eczema is not the only one. According to some studies, in fact, it would seem that nummular dermatitis was caused by the bite or sting of an insect. According to others, however, it seems triggered by the intake of certain medicines, such as interferon and ribavirin for the treatment of hepatitis C or TNF-alpha blockers (anti-TNF-alpha) for the treatment of arthritis.

Nummular eczema causes the appearance of skin patches with very variable characteristics.

In fact, these stains can be:

  • Oval or circular
  • Large few millimeters or a few centimeters
  • Pink or brownish-red in color
  • Dry, scaly and chapped or moist, swollen and vesicose (i.e. sprinkled with blisters).
  • Bouts of itching, irritation, burning and pain

Nummular eczemaThe areas concerned can be more than one: there are, in fact, patients with only one affected area and patients with multiple regions involved. In this second case, the skin between the various affected regions is not normal, but tends to be very dry.

The spots can appear anywhere on the body. However, it is very rare that they arise on the face or on the scalp, while it is very common that they form in the lower parts of the legs, in the forearms, in the trunk (understood as chest, belly and back), in the hands and feet.

Although not treated with appropriate treatments, nummular eczema can heal itself; however, the spontaneous healing process may take several weeks, if not even several months. Symptoms of nummular eczema tend to worsen in dry and / or very cold weather conditions; vice versa, they tend to improve in the presence of a sunny and humid climate.

Although not aware of the precise triggers, nummular eczema is certainly not caused by a contagious infectious agent; therefore, it is impossible for it to spread through simple physical contact between people.

At some times of the day (for example at night), the itching becomes very intense, so much so that the patient is brought to rub his skin to feel relief. The rubbing, however, involves the injury of the skin, especially if the affected area is covered by some bladder. A skin infection can follow a bacterial infection, which causes the onset of further disorders such as high fever, pus and acute pain.

Discoid eczema manifests with obvious signs, which, however, can be confused because of their similarity to the signs of other dermatological diseases, supported for example by fungi (ringworm or fungal mycosis) or other substances present in the environment. Therefore, in order to correctly diagnose a nummular eczema, not only a thorough physical examination, but also different cultivation tests and various allergic tests are needed.

Objective examination. In addition to carefully observing the suspicious area, the dermatologist asks the patient certain questions regarding his clinical history. This, in fact, can contain fundamental information about the causes and how dermatitis appeared. For example, knowing that the patches appeared after contact with certain substances could exclude a nummular eczema and make one think of a contact dermatitis. It is good, however, that every hypothesis made is then confirmed by more specific laboratory analyzes, such as culture tests and allergic tests.

Laboratory culture examinations. Crop examinations are performed on a sample of scales and a skin swab (skin swab), both taken from the suspect area. From the analysis of the scales we understand if the patches are due to a fungal infection (ringworm) or not. The absence of fungus could mean that a nummular eczema is actually underway.

With the cutaneous pad, on the other hand, it is understood if there has been a bacterial contamination. If the outcome of this second test is positive (i.e. the bacteria are present in the wounds of the skin or in the bladders), the patient must be given antibiotics.

Allergy tests. They are used to exclude that it may be a contact dermatitis. On the patient’s skin under observation, in fact, various substances are applied that could trigger an allergic reaction; if there is no abnormal response to simple contact, the diagnosis favors the nummular eczema.

There are several therapeutic treatments for the treatment of nummular eczema; however, finding the right therapy and healing from this skin inflammation is not always that simple, as each patient is a case in itself. Some individuals, in fact, respond very well to a certain remedy that, instead, for other subjects is ineffective and sometimes even counterproductive (for example an allergic reaction may take place).

possible treatments:
  • Emollients
  • Corticosteroids for topical use
  • Oral corticosteroids
  • Antibiotics
  • Antihistamines

Emollients

What are emollients? All the preparations able to soften, moisten and make the superficial layers of the skin more elastic are considered emollient. Generally, they are based on oily substances. Their application stops irritation and allows the skin to restore its normal appearance. On the market, different types of emollients are available; in fact, there are creams, lotions and ointments, which possess different quantities of oily substances. Generally, the higher the content of oily substances, the more emollient is effective; however, the choice of the most suitable product also depends on the area affected by stains and the type of skin.

How do the emollients apply? They must be applied several times during the day and in good quantities. It is advisable not to rub them, but to rub them gently and always in the same direction as the skin. In case of very dry skin, the application should be done every 3-4 hours.

Immediately after a shower, it is very important to spread the used preparation, because bath detergents tend to dry out the skin.

Side effects. Emollients are one of the most used products in the case of nummular eczema and dry skin, because they rarely cause side effects. The only contraindications could be allergic reactions to one of the substances contained in the emollient preparation. Therefore, at each initial application, it is recommended to apply small amounts of product to see how the skin reacts.

Corticosteroids for topical or local use

What are corticosteroids? Corticosteroids are powerful anti-inflammatory drugs belonging to the steroid family. Steroids are hormones also naturally present in the human body. For topical or local use it is meant that the preparation is applied directly on the affected area. Types of corticosteroids for topical use. There are more or less powerful corticosteroids. It is possible to apply them in the form of creams or ointments, depending on the area concerned and the severity of the dermatitis. For example, ointments are particularly suitable in case of very severe nummular eczema; creams, on the other hand, are very good for moderate nummular eczema.Corticosteroids for topical or local use

Eczema discoid corticosteroids

How are corticosteroids applied? Before using any corticosteroid medication, you should contact your doctor to be informed about the methods of administration.

In general, these medicines should not be applied more than twice a day and for more than 3-4 weeks. Before applying to the affected area, it is recommended to soften the skin with an emollient, so as to favor the pharmacological effects of the corticosteroid in use.

Side effects. At the first administration, the patient may experience a slight discomfort, to which, however, he gets used to it in a short time. Possible side effects are: acne, increased hair growth, telangiectasia and thinning of the skin. Their appearance is usually due to prolonged use of the corticosteroid.

Oral corticosteroids

Oral corticosteroids differ from topical corticosteroids only by the route of administration, by mouth, and by the type of side effects.

Antibiotics

Antibiotics, available both in topical (or local) and oral (to be taken by mouth), are administered only if the area affected by nummular eczema has developed a bacterial infection. Before using them, it is recommended to contact your doctor.

Antihistamines

Antihistamines are medicines that block the release of histamine, a compound produced by some cells of the body and released in case of inflammation. They are prescribed if the patient with nummular eczema complains of severe itching and intense irritation, especially during the night. Before using them, it is recommended to contact your doctor.

In addition to the aforementioned remedies, patients with nummular eczema are advised to avoid excessive use of the most common bath soaps and detergents, which tend to dry and irritate the skin. Ask your doctor and pharmacist for the most suitable cleansers for dry skin. Cut the nails and keep them very short, so as not to scratch the skin when, at the onset of itching and irritation, you scratch. The scratches, in fact, could give rise to a bacterial infection. Continue to apply emollients even after healing.

If no complications arise (for example a bacterial infection) and if the most appropriate treatment is identified (the type of emollient, the kind of corticosteroids, etc.), the nummular eczema can be cured in a few weeks.

Sensitive skin and eczema

Eczema is a common scene in persons with sensitive skin. Sensitive skin is an extremely common condition among the population and often unfortunately underestimated. In the absence of skin diseases or obvious inflammations, a fragile skin is more sensitive and more prone to react (negatively) to irritating physical or chemical agents than ‘normal’ skin. Sensitive SkinIn addition, sensitive skin is more susceptible to allergies, redness, irritation, itching and burning of the skin. But that’s not all: people who complain about skin hypersensitivity are statistically more subject to the early formation of wrinkles and other imperfections typical of photoaging.

A sensitive skin is more susceptible to skin conditions or disorders, such as in particular atopic dermatitis, erythema, couperose and rosacea. These pseudo-pathological conditions are often found in patients who experience sensitive, sensitive and reddening skin. In any case, we remember once again that a sensitive skin does not necessarily hide an underlying pathology.

However, sensitive skin is a very subjective phenomenon and, as such, it is difficult and laborious to draw precise and universal parameters to objectively ascertain the condition of skin hypersensitivity.

Given that sensitive skin is a common discomfort and constantly growing among the population, it is understandable how this skin feature has attracted the attention of cosmetologists and dermatologists, increasingly stimulated by the search for safer, more effective and more delicate skin products. Not surprisingly, in these last decades, a good part of the cosmetic market is moving towards the creation of creams, deodorants, lotions, tricks and anything else dedicated exclusively to sensitive skin.

In this section we will try to explain why a skin becomes sensitive and how it can react to the application of some pseudo-irritating agents. After analyzing briefly what symptoms can generate a highly sensitive skin, we will focus on possible dermocosmetic treatments to counteract their hypersensitivity.

On the podium: sun, wind, temperature changes and aggressive cosmetic products, the main (and undisputed) causal factors of cutaneous hypersensitivity. While the climatic agents heavily weaken the natural skin barrier, on the other hand the regular application of potentially irritating cosmetic substances on the skin promotes the appearance of inflammatory-irritating phenomena, dehydration and reddening of the skin.

An abuse of particularly aggressive cosmetics ends up weakening the skin, making it more sensitive and more exposed to the risk of irritation, desquamation and reddening of the skin. Poor quality cosmetic products, especially if formulated with irritating ingredients, are probably one of the main causes that predispose to the onset of cutaneous hyper-reactivity. In the list of cosmetic products most at risk for sensitive skin, we cannot omit: depilatory creams, deodorants, make-up products, shampoos, hair dyes, bath-shower / foam and make-up removers.

However, it seems that sensitive skin is a genetically established feature: in other words, skin hypersensitivity can be considered a hereditary trait, transmitted directly from parents to children. However, it is right to reiterate that a ‘normal’ skin can become ‘sensitive’ over the years, regardless of the genetic note. In fact, in addition to constitutional and hereditary factors, many and varied elements can predispose to a sensitive skin. Among these we can not forget stress, hectic life, unbalanced diet, alcohol abuse, smoking, frequent exposure to solar or artificial UV radiation (especially in the absence of adequate photo-protection), smog and pollution in general. Even the color of the skin can lay the foundations for sensitive skin: statistics show that Caucasians (white skin) are more exposed to the risk of skin hyper-reactivity to climatic agents and cosmetic products.

As analyzed, sensitive skin is a complex condition, characterized by purely subjective and not yet standardized symptoms. However, it is possible to describe and analyze some common sensations and symptoms reported by many patients who experience a certain cutaneous sensitivity

The hypersensitivity status of the skin towards external agents is more pronounced and evident at the level of the face compared to other body sites. In particular, most patients complain of a sensitive skin especially in the chin, lips, nasolabial region, eyes and foreheads: what is said is probably explained by the greater cutaneous permeability and the peculiar thinness and fragility of the stratum corneum in these regions of the face.

A sensitive skin can be recognized through the observation of several aspects:

  • Unpleasant burning sensation and skin tingling, which is accentuated by the application of some cosmetic products
  • Unfriendly skin
  • Strong tendency to skin desquamation
  • Skin itching
  • Dry, dehydrated and chapped skin
  • ‘Pulling’ skin

In addition to the symptoms just reported, in patients who complain of sensitive skin it is not rare to observe some signs of premature skin aging, such as above all superficial wrinkles and spots on the skin of the face.

Note:
Sensitive skin is not the same as allergy. Contrary to what one might believe, sensitive skin is not always synonymous with allergy: in fact, it is not uncommon for these two conditions to be confused and misinterpreted. Many times, the general symptoms of sensitive skin are wrongly considered to be warning signs of intolerance or allergies towards some cosmetic ingredients. In reality, the common sensitive skin does not recognize any kind of immunological causes.

The solution to the disturbance of sensitive skin is rather complex and not as immediate as it might seem. In fact, first of all, the main causative agent should be recognized as well as the triggering cause (eventuality is not always possible). Leaving aside the most severe cutaneous manifestations – which require medical / pharmacological intervention – the cardinal objective of the dermocosmetic intervention for an extremely sensitive skin is, without a doubt, reducing the main symptoms (pain, tingling, burning, etc.), restoring at the same time the altered hydration of the tissue.

What to do, therefore, to pamper a sensitive skin? Here are some useful tips to mitigate, as much as possible, the symptoms of sensitive skin:

Use cosmetic products specifically designed for sensitive skin: for this purpose, formulations prepared with emollient and soothing active ingredients are particularly indicated. Many cosmetic products for sensitive skin are formulated with plant extracts able to exert a beneficial and therapeutic-like action on the skin. To this end, some of the (innumerable) plants indicated for sensitive skin are:

1. Aloe vera gel

Aloe vera gelAloe vera gel, a mine of polysaccharides, polyunsaturated fatty acids, vitamins and mineral salts with emollient, soothing, moisturizing and anti-inflammatory properties.

2. Wheat germ oil

A concentrate of beneficial properties that gives the sensitive skin the right balance between hydration and nutrition. The vitamin E contained in it, acting in synergy with vitamin A, visibly improves the status of the skin, especially in the presence of itching, abrasions and sunburn.

3. Licorice

From the rhizome of this plant is obtained 18-beta-glycyrrhetinic acid, a substance that excels for its anti-inflammatory virtues.

4. Orange flowers

Very well tolerated by sensitive skin, the essential oil extracted from bitter orange flowers has tonic, regenerating, antiseptic (disinfectant) properties and stimulates cellular turn-over. The distilled water of orange blossoms is another effective remedy for sensitive skin, given that – after skin application – has a refreshing and anti-reddening effect.

5. Oats

Oat extracts are a source of starch, steroidal saponins, vitamins and minerals. The oat extract is known to be highly dermocompatible: this characteristic makes it suitable for preparing creams or other cosmetics for delicate and sensitive skin, especially for children and newborns. It should be remembered, in fact, that the presence of oat extracts in a cosmetic gives the skin hydration and protection against external irritants. Furthermore, oats are also exploited for their antioxidant, moisturizing, soothing, anti-reddening and film-forming properties.

Recommendations:
  • Pay particular attention and care to the cleansing of the face: a sensitive skin requires a mild detergent to avoid unpleasant sensations of stretching of the skin, desquamation, dryness and redness
  • Use the exfoliating products in moderation and only when necessary: the scrubs and the chemical peels can in fact irritate a skin already fragile and delicate in itself
  • Avoid so-called non-rinse cleansers: by remaining in contact with the skin, these substances can sensitize the skin or, worse still, irritate it
  • After daily cleansing of the body, it is recommended to apply a generous layer of emollient, moisturizing and nourishing cream to the sensitive skin: regular application of these products on a sensitive skin is extremely important both to avoid cutaneous delipidation and to raise the skin. cutaneous tolerance threshold against external irritating agents
  • When necessary, we recommend that you supplement your diet with a supplement of specific supplements formulated with antioxidant vitamins and essential fatty acids
  • Avoid, or limit to the maximum, contact with external aggressive stimuli responsible for a possible damage to the natural skin defensive barrier. Among the major defendants, a major role is due to excessive solar exposure (worse still in the absence of adequate sun protection) and thermal changes.
  • Choose cosmetics free of allergens, perfumes, preservatives, nickel, cobalt and chrome, enemies of sensitive skin.
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