Nail & Skin Disorders

Under the Microscope: Eczema

Eczema is a chronic condition that is characterized by red, itchy, swollen rashes on the skin.


What is it? The most common form of eczema, more accurately called atopic dermatitis, appears as a red, swollen rash. Depending on the stage, the rash could appear scaly or thick; it could appear moist or leak fluid; it may even contain small, raised bumps. Clients will complain of itching, a classic tell-tale indicator of eczema. Small rashes may appear around the eyes and lips, but most flare-ups are on the inside of elbows, the backs of the knees, or the underside of the hands.

How do you get it? The form of eczema identified as atopic dermatitis is believed to be the result of an allergen. An allergen is anything that triggers an allergic reaction. Often this form of eczema is hereditary; the client may have suffered from it since childhood. However, it is possible to develop eczema as an adult. Allergens can come from food, animals, the sun, the cold, or any number of environmental factors. During a flare-up, a person’s immune system is working overtime to try to combat a foreign substance.

How is it treated? Treatment of eczema works best along a two-prong approach. The first is to strengthen the body’s immune system through supplements. Healthy eating, regular exercise, and adequate rest also help build a healthy immune system. The second approach is to pinpoint the source of the allergen and get rid of it. Sometimes, however, it’s impossible to identify the trigger. In this case the only thing left to do is to treat the rash. Warm soaks, creams, light therapy, cotton material against the skin, and antihistamines are all useful treatments. Proper moisture is crucial to reduce the itch of eczema, so creams should be applied immediately after a warm soak, and the skin should be kept hydrated throughout the day. Creams can be natural, such as calendula cream, or they can be by prescription, such as cortisone or steroid creams.

What can a tech do? The condition is never contagious and techs can choose to hold the client’s hands or feet as they would any other client. A second option is to offer a gentle treatment during the service. Soak the client’s hands or feet in a warm bath. Apply a gentle, unscented lotion to her skin after the soak. Wrap her hands/feet loosely in a cotton cloth, leaving the toes or fingernails exposed. Perform the service on the exposed digits, holding the towel when you need to move the hands and feet. Since a flare-up indicates an overly sensitive immune system, application of nail products could worsen the eczema rash, because nail products are known allergens. Let the client know about the increased risk with exposure to product.

What else? Eczema can strike the nails as well as the skin. On the nails, the condition can present itself as severe dry skin or as a red, itchy rash. Techs may not recognize eczema on the nail in its earliest stages, mistaking it for a case of common dry skin. However, as the condition worsens, eczema will be evident both by the red, scaly look of the skin and by the client’s complaint of severe itch and irritation.


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