MEDIA/
How to Differentiate Between Eczema and Skin Sensitivity?
Dr. Chan Sheung Hey Thomas, a dermatologist, emphasizes that eczema and urticaria (hives) may present similar symptoms such as itching and rashes in the early stages, but they are fundamentally different in terms of causes, pathology, and treatment.
When the skin suddenly itches, becomes swollen, and develops rashes, how can one tell if it’s a sign of skin sensitivity or the early symptoms of eczema? Applying anti-itch creams may not alleviate the symptoms. Should one resort to steroid ointments? Dr. Chan emphasizes that self-diagnosing and self-treating can worsen eczema or common skin conditions like urticaria. Here, we clarify five common misconceptions about eczema and urticaria.
Misconception 1: Is Eczema Just Skin Sensitivity?
Dr. Chan explains that skin sensitivity is a broad term, while eczema (medically known as “atopic dermatitis”) and urticaria (also known as “hives”) may share initial symptoms like itching and rashes, but they differ significantly in their causes and pathology.
The causes of eczema include both genetic and environmental factors, with genetics playing a major role. This can lead to a deficiency in the body’s ability to produce protective oils, weakening skin repair functions. As a result, the skin barrier is easily compromised, triggering eczema. Additionally, genetic factors can affect immune responses, causing the skin to react excessively to certain allergens or irritants.
Environmental factors include contact allergens, food allergens, and irritants. In summary, individuals with eczema often have a combination of genetic predispositions and various external triggers.
In contrast, urticaria occurs when contact with an allergen stimulates mast cells in the skin to release histamine, leading to blood vessel dilation, swelling, and plasma leakage. “Initially, it may feel like a mosquito bite, but it can quickly develop into large welts, potentially spreading to various parts of the body within one to two hours.”
Misconception 2: Urticaria Symptoms Are Quick to Resolve, While Eczema Can Last a Lifetime?
Dr. Chan notes that urticaria can be acute or chronic. Acute urticaria lasts less than six weeks, with common triggers being food allergies (such as shellfish), and mild cases can indeed resolve within one or two hours. However, chronic urticaria persists for more than six weeks and is often more challenging to identify triggers. “About 50% of patients may require treatment over months or even years and may need oral steroids.”
Misconception 3: Does Treating Eczema Always Require Steroid Medication?
| Eczema (atopic dermatitis) | Urticaria (Hives) | |
|---|---|---|
|
Type |
Allergic or irritant contact dermatitis, discoid eczema, hand eczema, and more. |
Can be acute or chronic |
|
Cause |
Genetic Factors: related to skin structure and immune function.
Environmental triggers: like dust mites or food allergies.
|
Many cases appearing spontaneously without a clear cause—some may relate to immune system issues or reactions to non-steroidal anti-inflammatory drugs (NSAIDs).
|
Dr. Chan emphasizes that there are many treatment options for eczema. First-line treatments primarily involve topical moisturizers, topical steroids of varying strengths, and topical immunomodulators. “However, if scratching causes skin damage, leading to fluid leakage that attracts bacteria (like Staphylococcus aureus), antibiotics may be necessary to prevent infection. Doctors may also prescribe antihistamines to help alleviate itching.”
If the condition remains uncontrolled, second-line treatments such as oral steroids or immunomodulators may be considered. Recent advances in understanding eczema have revealed that inflammatory mediators called interleukins, secreted by type 2 T cells, play a significant role in its pathology. Subcutaneous biologics that specifically inhibit interleukins can help control immune system imbalances, targeting only a small part of the immune response.
Misconception 4: Eczema Recurrences Always Get Worse, and Steroid Treatments Become Ineffective?
Many eczema patients worry that excessive use of steroids leads to dependence or worsening conditions upon cessation. However, Dr. Chan emphasizes that most patients experience improvement when steroids are used appropriately. “The key is to have the right dosage prescribed by a dermatologist. If patients purchase steroids inappropriately, either too strong or too weak, it can exacerbate the condition or delay healing.”
As for the concern that recurrences become increasingly severe, he believes that many cases are inherently severe. “Such patients often have a strong genetic predisposition to eczema or have suffered from it since infancy, leading to recurring episodes in adulthood.”
Misconception 5: Are Home Remedies Effective for Eczema or Skin Sensitivity?
What should one do when experiencing rashes or unbearable itching? Dr. Chan admits that there are many home remedies for eczema, but he has seen patients using ginger water or coriander water to wash affected areas, thinking it provides relief. However, these practices can strip the skin of its natural oils and irritate it further, worsening the condition and ultimately requiring medical treatment.
Dr. Chan advises that even before seeking medical attention, the following first-aid measures should be taken:
– Apply a non-medicated moisturizer to soothe itching.
– Use ice packs or cold compresses to reduce inflammation and swelling.
– Avoid washing or applying alcohol, vinegar, hot water, ginger water, coriander water, or other irritants to the affected areas, as these can worsen the condition!
https://eczema.mingpao.com/濕疹-皮膚敏感如何分辦拆解5個謬誤-正確對付濕疹/
