What is the difference between eczema and dermatitis? How do the two conditions differ?

Eczema and dermatitis are common names used for the group of symptoms that accompany inflamed skin for various reasons, and are basically the two names for the same condition. In some instances, dermatitis can mean more acute inflammation, whereby eczema will be used as a term for a more chronic or recurring condition.

What are the causes and symptoms of eczema?

In most cases the exact cause of eczema is unknown. It is believed that it is an immune disorder whereby our immune system over reacts and causes inflammation of the skin. Most of the time, the condition will start off with itchiness of the skin and develop into redness, heat and swelling, that can form fissures, secondary infections, scabs and pigmentation changes etc. Today it is believed that most eczemas are due to allergic reactions, or generalised allergic conditions.

Are there different types of eczema?

There are different types, and these are classified mainly due to location and what is believed to be the original cause of the condition. For instance, the most common term atopic eczema is used to describe skin inflammation that accompanies a severe allergic reaction. Most of the eczemas are believed to be allergic reactions. So any detailed classification of eczema is impossible without us knowing more about the condition itself.

What topical treatments would you recommend for eczema?

Most common eczemas are treated with cortisone creams. They give quick relief of the symptoms, but do not cure the cause (which is unknown most of the time). Applying cortisone or hydrating cream often provides very effective relief. In some instances, anti-histamines are fairly effective too.

Is eczema sometimes mistaken for psoriasis?

Yes it is, especially on the first onsets of psoriasis manifestation. Even though they are completely different conditions, they have similar symptoms and complications in common.

What are the causes and symptoms of psoriasis?

Psoriasis is a genetically predisposed condition which is mediated by the immune system. Therefore there is no external cause of the psoriasis, though external triggers like stress, trauma to the skin and phasing out of corticosteroid therapy can bring on the onset of symptoms. Psoriasis often affects the joints as well as skin, so it is seen as auto-immune disorder.  There are numerous symptoms and manifestations, but the most common symptoms include redness of the skin with the formation of plaques, covered with white scales, which peel off and produce typical “dandruff” like scales on the affected skin. The skin is itchy and inflamed and often cracks and is prone to secondary infection by opportunistic bacteria.

What treatments would you advise for psoriasis?

Treatment for psoriasis is very complex and not always effective. Usually, psoriasis will be medically treated with corticosteroids. Dietary changes, exposure to UV light and moisturising creams may also improve recovery and reduce recurrence.

What treatments would you recommend for rosacea?

Rosacea is a condition of the skin that is not easy to treat. The variety of treatments available are effective to some degree for different types of rosacea. As exposure to sunlight is often a very big cause of rosacea, wearing a good sun screen is an essential part of treatment and prevention. In instances where there is infection, antibiotics will be beneficial. Avoiding foods and beverages rich in histamine will significantly help in controlling skin redness. Some laser therapies can also help with treating rosacea, especially if capillary blood vessels are permanently affected.

Could one describe keloids as bad scarring?

In essence yes. Keloids are a form of scarring caused when regulatory mechanisms do not adequately control the type of collagen (skin matrix) produced as well as the amount.

What non-surgical treatments are recommended for keloids?

The most effective medical treatment for keloids is with superficial radiotherapy. This form of radiation can be effective in removing excessive amounts of the extracellular matrix. The best treatment for those predisposed to keloids is prevention, i.e. avoiding unnecessary surgeries, piercings and skin trauma. Some new cosmeceutical formulations will also assist in preventing and reducing the formation of keloids.

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