Eczema (˘ek’-s  -m  )

n. A noncontagious inflammation of the skin, characterized mainly by redness, itching, and the outbreak of lesions.

What It Is

If your client complains of unbearable itching on her hands, feet, or other part of her body, she may be suffering from eczema. Eczema is a chronic skin condition that causes itchy, rash-covered skin. In most sufferers, the severity of the condition tends to increase and decrease in cycles.

Eczema often runs in families. It’s not unusual for eczema sufferers to also have asthma and/or hay fever, which are also inherited. Eczema generally develops in children by the age of five and often worsens during growth spurts, especially during puberty. In most cases, eczema will subside and often disappear by the early 20s. But it’s estimated that 50% of people with eczema will suffer from it to some degree throughout their lives.

Although eczema can develop anywhere on the body, it’s most commonly found on the face, scalp, hands, and areas where the skin folds, such as behind the knees, under the arms, and in the creases of the elbows.

Eczema of the proximal nail fold can result in irregular ridges on the surface of the nail plate. As the eczema heals and the cuticle re-attaches and becomes healthy, the nail plate will begin to grow smooth again.

Symptoms

Eczema sufferers usually have dry, flaky, red rash-covered itchy skin. If left untreated, eczema can become infected and develop into crusty scabs and blisters that are itchy, painful, and oozing. The oozing occurs when people scratch the rash-covered skin, leaving it raw and open to bacterial infection.

Causes

Although its exact cause is not known, eczema is believed to be an allergic trait that is acquired at birth.

What is known are the triggers for this condition. Soaps and body cleansers — especially those that are strong or highly scented — harsh laundry detergents; irritating clothing — especially wool and acrylics — hot water; sunburn; cold, dry conditions; and hot, humid conditions can all trigger an outbreak of eczema. Other factors, such as animal hair and dander, dust, cleaning solvents, and emotional stress, can also trigger an outbreak.

How to Treat It

While there is no known cure for eczema, the symptoms can be reduced. Applying emollients to keep the skin moist and well-lubricated throughout the day is important, but it’s especially important after washing, bathing, or swimming. Products should contain mineral oil or petroleum jelly, and be applied immediately after drying off.

Along with avoiding as many triggers as possible, there are several treatments for eczema. Applying creams and lotions with tar and coal tar extracts and bathing with oatmeal-based products will help keep initial-stage eczema from flaring to a more serious stage. If the condition does worsen, treatments can be prescribed.

Corticosteroids are topical steroid ointments and creams that are often effective at clearing up or reducing severe eczema. The lower-strength varieties, which can be found over the counter, can be safely used for months at a time. Higher-strength topical steroids can be prescribed by a doctor for short periods of time.

Oral antihistamines can help alleviate the itching and help prevent the scratching that further inflames the eczema.

Some nail technicians may not feel comfortable working on clients with eczema because the skin can overreact to any mild trauma.

However, you can do services on clients between outbreaks. Advise clients with foot eczema to keep their feet cool and dry and to wear cotton socks. For clients with hand eczema, advise them to wear rich moisturizing creams to keep their hands softened. They might also want to wear gloves to do housework or at any time their hands will be in contact with chemicals or other irritants.

Considerations for Nail Techs

Skin with eczema is sensitive and should be treated gently. Even exposure to plain water is irritating to hand eczema. Avoid using exfoliants on clients with eczema. Also try to avoid fragrances, irritating ingredients such as glycolic acid, retinol, and any detergents.

Bland emollients are soothing. Water-based lotions are not as helpful as heavy creams and greasy ointments. The water in lotions evaporates, leaving the skin nearly as dry as before.

Since oatmeal-based products can be soothing to eczema sufferers, think about offering a manicure or pedicure with an oatmeal soak, lotion, or mask.