Inflammatory Skin Conditions

Itchy, red and unsightly inflammatory skin conditions such as hives, eczema or psoriasis can be frustrating to live with. Learn about the signs and how to manage these common conditions.

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Beyond the itch, inflammatory skin conditions can cause discomfort, embarrassment and frustration among sufferers. Skin conditions such as eczema and psoriasis cause redness, flaky skin, itchiness and even pain.

Another common skin condition is hives, medically known as urticaria. Hives tend to come and go, but can also be a chronic problem.

Read on for more about some types of inflammatory skin conditions and tips on how they can be managed. 

Hives 

Hives are a sudden outbreak of raised, red and itchy areas of skin. These rashes can be of varying shapes and sizes, and may appear as large patches, rings, or small bumps on the skin. 

One distinct feature of hives is that they tend to be transient, flaring up suddenly, changing size and even location rapidly all over the body. 

Sometimes, the rash can appear around the eyes or lips, causing swelling. These rashes may last for several minutes to hours, but tend to come and go, without leaving any lasting scars or marks. 

Although a hives outbreak appears alarming, the condition is typically harmless. 

Triggers of Hives 

Hives occur when something triggers the body to produce an antibody called histamine. Histamine is normally released when there is an allergic reaction to a substance, food or insect bite. 

When histamine is released, blood vessels in the skin dilate (become wider) and become leaky. This causes an accumulation of fluid in the tissues and the skin to swell. 

Hives can be triggered by food or drug allergies, alcohol, viral infections, insect bites as well as physical stimuli, exercise, cold weather, exposure to light or friction on the skin. 

In many cases, the cause of hives is unknown. Hives can be controlled with antihistamines and in some chronic cases, oral steroids may be prescribed.

Hives tips: 
Avoid scratching the rash 
Avoid triggers such as sudden temperature changes, excessive scrubbing or identified "trigger foods" 
Take antihistamines in the event of a hives episode. If the problem does not get better, seek medical advice

Psoriasis 

Psoriasis, which can also cause redness and itching, is a different type of skin inflammation. 

“Psoriasis is characterised by well-defined patches of raised reddish skin that are often covered with white scales,” Dr Jamie Wee, Associate Consultant, Dermatology, JurongHealth said. 

The chronic condition is an immune-related disease that commonly starts in adulthood but can affect any age group. 

“The cause of psoriasis is complex and multifactorial. An important factor is again genetics; the condition often runs in families and inherited from an affected parent,” he explained. 

Psoriasis rashes tend to be raised and covered with silvery ‘scales’ of skin. This happens when the normal cycle of the skin growth is hastened. 

Typically, your skin cells grow gradually and flake off about every four weeks to expose new skin cells underneath. 

In psoriasis, new skin cells move to the surface of the skin in a matter of days rather than weeks, building up to form thick itchy patches of skin called plaques. 

It is believed that psoriasis happens due to an abnormal reaction from the body’s immune system, leading to inflammation and flaking of the skin. 

Psoriasis symptoms may disappear, known as remission, even without treatment, but then get worse and flare up when exposed. 

Psoriasis tips:
Moisturise regularly to soothe the inflammation 
Avoid skin injuries as wounds to the skin can cause psoriasis patches to form 
Manage stress and anxiety to avoid a flare-up 
Avoid medicine such as nonsteroidal anti-inflammatory drugs (NSAIDs), beta-blockers and lithium

Eczema

With eczema, Dr Wee said, the skin is dry, itchy and can be red. It is most commonly seen in children, but can affect people of all ages including the elderly.

“There is an increased risk of eczema in those who have family members who suffer from eczema, a history of rhinitis (hay fever), or asthma,” he added.

The condition is also common in people in certain occupations that involve "wet work" such as frequent handwashing or exposure to certain chemicals. Elderly people with age-related dry skin or conditions that affect the veins in their legs are also more prone to eczema.

“There are a number of factors that play a role in the development of eczema,” Dr Wee said. “An important factor is the functioning of the skin barrier, which keeps the skin moist and keeps out allergens. A defective skin barrier, which leads to dry skin, is a problem that can be inherited.” 

Prompt recognition of eczema and treatment can prevent eczema from becoming more severe, he added.

Subtypes of Eczema

There are several subtypes of eczema:
Atopic eczema — the most common subtype of eczema and is often seen in people with hay fever or asthma. It typically starts in childhood and affects about two in 10 schoolchildren in Singapore. The signs include rashes that are itchy, red, dry and scaly. These rashes can also cause the skin to become wet, weepy or painful.
Asteatotic eczema — typically affects older people and causes cracking of the skin. 
Discoid eczema — another form of eczema which presents as circular scaly patches. Environmental eczema can also be caused by exposure to irritants or allergenic substances

Treating Eczema

Combat dry skin, the biggest risk factor for eczema, with regular moisturising
Steroid creams are needed to tackle redness and itching 
Avoid long hot showers; use lukewarm water when showering 
Use gentle, soap-free shower cleansers; avoid scrubbing the skin 
Maintain good health with adequate rest, exercise and a healthy, balanced diet 
Do not smoke; smoking is detrimental to skin health 
Manage stress well; eczema can get worse during stressful periods 

By Cheryl Sim, in consultation with Dr Jamie Wee, Associate Consultant, Dermatology, JurongHealth. Original article titled "The Angry Itch" was first published in OneHealth magazine, Issue 6, 2015. 

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