When thinking about chronic eczema it is easiest to break it down into three levels and consider each one separately. The programme works by addressing each one of these factors with a different treatment, so it makes sense to think about them one at a time. The three levels are:

• Dry skin
• Eczema and itch
• Scratching

Dry Skin

Many people with dry skin don’t have eczema, but eczematous skin is always dry. The drying is caused by body fluids evaporating from the skin’s surface too quickly. This is because skin with eczema is much more porous than healthy skin. It is a less effective barrier against moisture loss, and the skin dries out faster. Dry skin is characterized by a taut, non elastic feeling and by the presence of white flakes of dead skin cells. But the main problem for people with eczema is that dry skin is itchy skin.

Eczematous Skin

There are several elements to eczematous skin. It becomes puffy and inflamed. The skin develop little fluid-filled vesicle, like bubbles, which weaken its structure. Blood vessels in the lower layers of the skin (the dermis) swell, and blood cells that fight infection migrate into the skin, causing redness and itch.

Normal cell growth in the epidermis (outer skin layer) speeds up, causing cells to pile up and thicken the skin. The cells are smaller and weaker than healthy skin cells, and the lubricating liquid between the cell, which helps make normal skin flexible and waterproof, is disrupted. Older cells build up on the skin’s surface, because the biological glue that holds them together stops breaking down and allowing the cells to be gradually shed. This results on a thick layer of dead skin at the top of the epidermis.

Itching and Scratching

The first point to make here is that there is deference between itching and scratching. Itching is a feeling while scratching is a behavior. This is an important distinction to get on board, because we will come back to it later in the program.

Scratching is a natural response to an itch or irritation. It is a reflex action, something that you don’t always need to think about before you do it. It can often be automatic. For example, if you get a mosquito bite, often the first time you notice it is when you find yourself scratching it. Doctors have recently discovered that are special nerves to sense itching, as well as those that sense temperature, pressure and pain.

Scratching is what makes the difference between acute and chronic eczema. Without scratching, chronic eczema cannot exist.

Skin with chronic eczema is unevenly thickened, with a rough, irregular appearance. This is called lichenification, because it can look similar to lichen growing on a tree or rock. It is due to the disruption of the epidermis that results from the continuous scratching of the sufferer. If healthy skin that has never had eczema is continually scratched it will develop the uneven appearance of skin with chronic eczema.

If the scratching is stopped the skin recovers, and returns to its healthy, regular structure. Doctor has experimentally demonstrated this using scratching machine to constantly scratch a small area of non-eczematous skin. The skin then reacts by becoming lichenified, and recovers when the machine is stopped. Scratching also tears the skin and makes it more vulnerable to infection and further inflammation. It probably drives allergens to which you are sensitive into the skin as well.

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Keywords: eczema, skin disorders, skin-disorders, dermatology, atopia, skin care, dermatitis, eczema,

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This entry was posted on Thursday, June 21st, 2007 at 9:07 am and is filed under Eczema. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.