The disease Eczema, affects the skin and can happen on any part of the body. Once this disease strike, the patient experiences burning and itching over the skin and sometimes water may ooze out of it.
The eczema affected skin starts chipping due to hardening and small lesions appear on them. What exactly is eczema, how it starts, what are its symptoms, how can we come out of the situation of eczema, and how can we prevent ourselves from getting eczema and other such skin allergies. Lets discuss these and other aspects with our Ayurveda expert Dr. Parmeshwar Arora.
Q. What kind of a skin disease is eczema?
Eczema is a type of dermatitis which refers to the condition of inflammation of skin. In Ayurveda, we term it as pama or chhajan . This is a condition in which your skin becomes darker, thicker and there is lot of itching in that region. In acute eczema, cuts, vesicle formations and oozing or secretion are also seen. The reasons for this type of skin inflammation can be allergy and various other factors which we shall discuss later. Thus basically, eczema is a type of skin inflammation or dermatitis.
Q. Are there different types of eczema also?
According to the stages, eczema can be classified into acute, sub-acute or chronic. In acute eczema, your skin will appear red, and edematous i.e. swollen and you will notice cuts which will have oozing or secretions. This type of eczema is also known as weeping eczema. This is very painful and difficult-to-bear condition. If the patient takes no treatment or minimal treatment at this stage, then the stage progresses to sub-acute stage in which the skin stabilizes to certain extent but internally the patches become permanent. The oozing reduces and there is Lichenification. Lichenification refers to a thickening of the epidermis seen with exaggeration of normal skin lines. The skin which was edematous, soft and having cuts gradually becomes hard. So the patients of eczema in sub-acute condition will have hard skin with too much itching, although, pain and inflammation will be less. If the patient does not take a proper treatment at this stage too, then he enters the stage of chronic eczema.
In Chronic eczema patients, the patches become permanent; there is itching, no secretion and generally no pain. So, basically we classify eczema into acute, sub-acute and chronic depending on the condition of the wound or dermatitis. This was a stage based classification. There is one more classification which is based on the origin of eczema. Here it is classified into exogenous and endogenous. In exogenous, the external factors are contributing to its origin while in endogenous, factors within our body are responsible. When we talk about exogenous eczema, it includes allergic dermatitis, contact dermatitis, photo allergic reactions, sensitive reactions, irritant contact dermatitis(when you somehow burn your skin or get an insect bite). These are acute type allergic reactions..e.g., when you are bitten by a wasp then the changes in the skin is also a kind of dermatitis wherein your skin swells and thickens. In contact allergic dermatitis, allergen (like soaps, cosmetics etc.) are involved. When we talk about photo allergic reactions, you will see that on exposure to sun, there is swelling in the skin and rashes appear.
Q. Doctor, as I understand, these are the contributing factors for eczema, but do we count them in normal skin allergies as well or do we name all of these situations as eczema?
Eczema and dermatitis are very closely related. Basic meaning of eczema, as I said earlier, is inflammatory condition of skin. Further, the contributing factors actually decide that whether this inflammatory condition will convert into classic eczema or not. And this also depends on how you manage the initial inflammation and what kind of treatment do you resort to.
Q. If we talk about internal factors, does our diet also contribute to this condition? Sometimes after eating a particular product we develop certain skin allergies. What kind of internal factors are responsible for eczema?
When internal factors are considered, again we observe few types of eczema. These are atopic dermatitis, seborrheic dermatitis and static dermatitis. In atopic dermatitis, we find a family history i.e. it is transferred from parents to the progenies. For example, bronchial asthama, which is also atopic type. Atopic, literally means “out of place” i.e. though we can’t find a reason still the person has eczema. In such case we check the patient’s igE (immunoglobin) and in 80% of these cases we notice that their igE is on higher side. This indicates the person is suffering from atopic eczema. In seborrheic eczema, we notice abnormal activity of sebaceous glands. Sometimes when we scratch our scalp with our fingernails we find some wet scaly things stuck under our nails. This kind of dermatitis can be seborrheic dermatitis.
Q. But sometimes we may confuse it with dandruff. How do we differentiate dandruff and a kind of eczema?
Absolutely, it might be confusing. Here, we can say that dandruff can be a mild seborrheic dermatitis, too. You have to very clearly differentiate three things in such a case. When you observe dust like thing falling down while combing, you have to be sure whether you have dandruff, seborrheic dermatitis or psoriasis. About psoriasis, we observe that generally it originates from the scalp. Dandruff basically refers to falling of dried upper layer of skin but if this loose layer has a bit of wetness in it, then it could be seborrheic dermatitis or eczema. Further if the dust coming off your scalp is flaky and the skin exposed seems red with a sort of shine in it, then it could be psoriasis. There are very minor differences, but when we treat a patient we have to determine the proper diagnosis for the patient.
Q. From the discussion so far, we have a fair idea of what kind of internal and external factors can be responsible for eczema. But, once we get into this condition, how do we come out of it?
In today’s scenario , if we are talking about pathology of Eczema, it is very clear but if we talk about etiology of eczema, it is not that much clear. Whenever a patient of eczema comes for consultation, he often wants to know that why it has happened to him but we have no clear answer for it. In Ayurveda, the answer for this question is ‘Tridosh prakop’. In case of eczema, we say that all the three doshas (vat, pitt, and kapha) have become abnormal. So as I always say, whenever you have the initial symptoms of a skin disease, you should visit a doctor immediately and get a proper diagnosis done. Often we ignore if we notice small lesions on our skin, because generally it does not influence or disturb our normal routine life but I would advise that whenever you observe any structural or functional abnormality in your body you should always seek a doctor’s advice. This is because any disease, if detected early, can be treated comparatively more easily as well as effectively. Thus please never ignore even mild symptoms. Secondly, in case of skin diseases we should control our ‘pitta’ which means we should avoid hot things like excess use of hot spices and pepper etc, avoid sour things and non vegetarian food.
Nowadays we observe increasing cases of skin disease as there is an increasing trend in number of people consuming non-vegetarian food which is often followed by milk products or ice-cream. This is a wrong combination and may give rise to skin disease and hence should be avoided. Additionally, if we consume very oily or stodgy food which is difficult to digest, this too causes disturbance of vayu in our body resulting in dryness of skin. Higher pitta level brings about cuts in the dry skin and the secretions which ooze out of the cuts is basically, increased kapha. So these three doshas together pollute our skin, our flesh, our blood, our lymphatics and eventually converts us into a patient of eczema.
To avoid it, you should be very sensitive about your diet. Along with the earlier mentioned precautions like avoiding things which have hot effect like pepper, spices, stodgy food, wrong combination of food items etc., you should increase your intake of water and milk. If we talk about medication then, you should use manikya yog, shodhi tablets, gandhak, khadirarisht, Kaishore Guggul which would help in purification of blood. Although simple, but Neem oil proves to be very beneficial to eczema patients. Sheetal oil relieves itching to a great extent. All theses medicines can be taken and the dosage can be decided based on your condition and symptoms which you can easily find out from an Ayurvedic doctor.