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Symptoms of an eczema flare-up

Regardless of the type of eczema, its location or even the person's age, an eczema flare-up generally presents in the same way. Let's find out more about the main symptoms of an eczema flare-up.

Red plaques (erythema, eczema that stings, eczema that burns)

Eczema is an inflammatory disease, characterized by red plaques that are sometimes swollen and not clearly defined, meaning that the edges are not distinct, as if a child has colored in a shape without keeping within the lines. These plaques are associated with sensation of heat and pain such as tingling and itching. Skin affected by eczema is particularly uncomfortable: it burns, it tingles and it itches.

In cases of acute eczema, the skin often becomes very inflamed and may even ooze due to the bursting of the small blisters that constitute eczema plaques. In the case of chronic eczema, the opposite is true: the skin becomes thicker and very rough to the touch.

Itching

Itching associated with eczema is unavoidable. When a patient gives in to itching and is unable to control it, this inevitably means that they scratch their plaques. Furthermore, we often picture people with eczema scratching. All eczema patients experience itching, including the youngest patients: a baby with eczema scratches as best it can, by rubbing the skin against the sheets and wriggling around in their cradle. The sleep of both the child and the parents is often disturbed.

Dry skin (xerosis)

Dry skin in eczema sufferers is also known as xerosis. This dryness is often referred to as the "poor relation" of eczema. It is a symptom that is often underestimated and overlooked. However, xerosis caused by eczema causes considerable discomfort. It causes itching, although this is not quite as intense as the itching caused by eczema plaques, it is enough to trigger the scratching reflex and thus an eczema flare-up for such dry and fragile skin. It is therefore essential to hydrate the skin daily, using a suitable hydrating cream, known as an emollient.

Points to remember

There are three main symptoms of an eczema flare-up: red plaques + itching + dry skin. However, symptoms vary in intensity depending on the person. For example, a baby with eczema that is a few months old will often have less dry skin than a child of 3-4 years old. Similarly, babies often present with highly inflamed plaques that sometimes ooze, whereas older children and adults experience more chronic eczema with thicker plaques.

Other symptoms may be associated with eczema but not systematically: for example, some atopic children have a specific fold under the eyes that is often affected by eczema; in the case of a secondary infection due to the lesions, these children may also present with a light fever. From a psychological perspective, regardless of its severity, an eczema flare-up can make people irritable and affect their mood.

These symptoms help physicians to diagnose eczema. However, if an appointment takes place when the patient is in a remission period, there may be few or no visible signs of eczema at all! In order to get the full picture and make a diagnosis, it is necessary to question the patient, particularly regarding personal and family medical history, and to carefully examine their skin.

If left untreated, plaques disappear spontaneously with no scarring due to the action of immune-regulation mechanisms. However, scratching the lesions and other aggravating factors such as cold, wind, perspiration, etc., can lead to inflammation and prevent the skin from healing on its own. Scratching also increases the risk of secondary infection and scarring, and significantly affects quality of life. It is therefore essential to treat the skin with topical corticosteroids and emollients. In general terms, an eczema flare-up treated correctly will only last a few days, however it can take over a week for some plaques to heal, namely in chronic cases of eczema where the skin has thickened, which are more difficult to treat. The earlier treatment begins, i.e. as soon as the red plaques and itching occur, the faster and more effective it will be and therefore the less time the flare-up will last.

A solution for each symptom:
  • For red plaques: I apply a topical corticosteroid to target the inflammation. This can be combined with a medical device to accelerate the healing process;
  • For dry skin: I apply an emollient to soften and strengthen my skin;
  • For itchy skin: I apply a cold treatment to stop me from scratching and aggravating a flare-up.