Eczema is one of the most common noncontagious inflammatory skin diseases in the general population. If you are suffering from eczema, you are no stranger to the excruciating and tormenting itch, disfigurement, sleeplessness and the dark cloud of despair that looms during flare-ups.
Those of us who are living with the disease know there is no cure for it. We have all frantically hopped from one doctor to another, only to be frustrated and somewhat desperate for a "miracle" pill or ointment.
And just when you thought the worst is over, you realize that there are other things to deal with, like recurrence and unwanted scars. Is there hope for eczema and scarring? Let’s find out below.
Eczema or dermatitis is an inflammatory skin condition that can occur at any age, from infancy to old age. Like a complicated puzzle, researchers, doctors and patients still struggle to understand why it develops.
The exact cause of eczema is still unclear, but it is linked to the immune system’s overactive response to an irritant, such as pet dander, pollen, dust mites, cosmetics, fragrances, detergent and other cleaning products.
The most common type of eczema is called atopic dermatitis, but there are other types of eczema with different causes and treatment requirements:
- Contact dermatitis is triggered by contact with foreign substances such as soap, cosmetics, jewelry and plants.
- Dyshidrotic dermatitis causes fluid-filled blisters on the hands and feet.
- Nummular dermatitis is characterized by coin-shaped lesions that can be itchy and scaly.
- Seborrheic dermatitis causes flaking of the scalp.
- Stasis dermatitis is associated with poor circulation in the legs and varicose veins.
- Neurodermatitis is characterized by rough, itchy spots in areas that are frequently scratched (neck, scalp, trunk).
Dealing with Eczema Scarring
It is possible to "grow out" of eczema and be symptom-free for decades. If properly treated, your skin usually goes back to normal without scarring. Some scars fade away in time, but a few patients may develop dark patches or unwanted scars.
Scratching Makes It Worse
Intense scratching can cause the skin to crack and bleed, putting your skin at an increased risk of infection. Open wounds will heal on their own, but they can lead to scarring.
I had my first eczema rash when I was six — red, painfully itchy, crusty and weepy — you name it. An unbearable itch would often attack while I was at school. I would scratch it raw until my white cotton socks turned bloody red.
While my skin has now cleared up, the years of scratching left a giant scar on the top of my foot. At one point in my life, I accepted the reality of never being able to wear those cute red pumps with my scar on full display.
The Emotional and Psychological Impact
For patients afflicted with this condition, it presents an extreme burden of personal suffering and impaired quality of life. So much attention that is focused on the body can make an eczema sufferer feel self-conscious and anxious.
An ordinary gaze may be regarded as stigmatizing or intrusive. One may be constantly on guard to prevent exposing their rash to the scrutiny of their peers.
Here are some of the emotional and psychological difficulties of having severe eczema and scarring:
- Feelings of being flawed or damaged
- Sleep deprivation
- Impaired school/work performance
- Withdrawing socially or becoming isolated
- Feelings of guilt or self-hate
- Being angry and resentful of the limitations caused by the disease
- Feeling frustrated by repeat appointments without improvements
I’m in my late 30s and my eczema scars don’t bother me anymore. Although, in hindsight, I could have been more proactive in minimizing scarring. Fresh scars are easier to treat, but it’s not too late to do something about existing scars.
It is important to find a doctor who can empathize with your feelings and the burdens imposed by the disease. Other coping strategies that can help:
1. Realize that it is not your fault. The development of eczema is a complex interplay of genetic predisposition and environmental factors. It has nothing to do with poor hygiene. It is not contagious. You will not transmit it by being in close contact with another person.
2. Learn to be comfortable with your scars but consider if revealing or hiding your scar will help in your recovery.
3. Don’t isolate yourself. Verbally expressing your feelings to your family or a counselor can prevent you from acting it out in a counter-productive way.
4. Understand that some people will be curious about your scars. In times like this, your mental well-being is more important. It is not your responsibility to satisfy a stranger’s curiosity. If you are not comfortable discussing it, you can be honest without going into much detail. Here’s an example: "I have eczema. It comes and goes, so it often leaves a scar."
5. As much as possible, focus on the good. Having a scar is relatively better than having an active lesion. Your skin is no longer itchy, painful and bloody. Between eczema and scars, it is very difficult to treat eczema, but there are many effective ways to reduce the appearance of scars.
How to Get Rid of Eczema Scars
Although it may take some time, scars from rashes and lesions will gradually fade over time. If your scar is bothering you, you must consult a dermatologist or an aesthetic physician (plastic surgeon). They will analyze the type of scar you have and suggest treatment options that will work best for you.
Scars are complex and different scars require different treatments. Some scars appear as raised white patches on skin, while others are different. Your doctor may recommend one or more of these treatments:
- Silicone gel sheet or ointment: these treat hypertrophic (raised) and atrophic (depressed) scars. The gel sheet is said to be more effective than the silicone ointment.
- Polyurethane dressing: this is a moist and flexible dressing that reduces the color, hardness and size of a raised scar.
- Light treatments: laser therapy is a safe and effective way of improving the appearance of hard-to-treat scars. Repeat treatments may be necessary to get impressive results.
- Corticosteroid injections: this treatment can help fade scars while reducing itch and pain. It is often combined with other therapies such as a pulsed-dye laser.
- Topical treatments: creams and ointments with chamomile and Vitamin A or E may also be used with minimal improvements.
Can It Be Prevented?
The best way to prevent scars is to not scratch your rash. Terribly difficult, I know. It’s important that you work hard to find the right eczema treatment regimen that will help you manage it as well as possible. Take appropriate care of your skin. Continue to regularly use a gentle moisturizer on the affected area, even if there is no active lesion. Be mindful of your eczema triggers to prevent a recurrence.