Comment se développe l'eczéma (la dermatite) ? -

How does eczema (dermatitis) develop?

Eczema is an atopy of the skin, an inflammatory disease which is characterized by redness which often itches and by the appearance of very small vesicles which can develop into scales. It is a chronic inflammatory disease of the skin due to an abnormal immune response and a deficiency in the skin barrier .

It is the most common skin disease : it is estimated that a third of consultations in city dermatology relate to a problem of eczema, both in adults and in young children!

Its treatment is based on measures aimed at avoiding allergenic substances and strengthening the resistance of the surface layer of the skin. Drug treatments are also used to relieve symptoms and prevent recurrences.

How often ?

It very often happens that dermatitis comes quite early. It is estimated that one in 10 children is affected!

Later, dermatitis is generally found in the folds (neck, behind the knees, elbow folds), hands and around the mouth. Most atopic dermatitis disappears during childhood (50% before 5 years), but 10 to 15% of cases persist until adulthood.

This disease affects on average up to 20% of infants, young children and almost 10% of adults against 3% of the elderly.

The factors of dermatitis?

The factors can be linked to genetic predispositions or an immune reaction caused by environmental factors or food substances for example.

Studies have shown that atopic dermatitis is associated with genetic predisposition factors: between 50 and 70% of affected individuals have a first-degree relative who is also atopic. If both parents are affected, the risk for the child of developing allergic eczema reaches 80%.

What do the symptoms look like?

The first phase of symptoms is defined by reddish and generally hot spots that itch. In the second phase, you can see small yellow/red crusts which form and disappear in a few days, but which will leave often very dry red lesions.

These lesions can disappear temporarily, recur or persist in a chronic form: scratching relieves temporarily but causes lesions which aggravate the disease because there is an increase in the passage of foreign substances. When they pass through the skin, the immune cells are activated and then maintain the inflammation which manifests itself by redness and the typical lesions. It's a real vicious circle!

The increase in the prevalence of atopic dermatitis observed over the past forty years indicates that environmental modifications play a role in the phenomenon, genetic causes cannot explain such a rapid evolution. Many factors can contribute to this sudden increase: excessive hygiene and loss of stimulation of the immune system at an early stage of development, excessive washing of the skin, very isolated and poorly ventilated habitat favorable to dust mites, increased presence of domestic animals , evolution and early diversification of eating habits, exposure to tobacco and industrial urban pollution, later pregnancies and children more often cared for in the community... It is however difficult to estimate the relative weight of these factors, which are complex in nature and affect often in combination.


How to treat eczema? 

Eczema shoots develop more if you use irritating products such as soap, shower gel, or if your skin is exposed to harsh fabrics and certain foods. Outdoor environments can also be involved: heat, perspiration or even air that is too dry.

The different treatments, basic or related to flare-ups (during crises):

  • Basic: to fight against skin dryness and restore the function of the skin barrier thanks to an emollient cream/balm (DEF)
  • Thrust: to fight against inflammation and itching with local corticosteroids or antiseptics. In some cases, the patient may be prescribed antihistamines to supplement the local effect of the creams and thus reduce relapses.