Author: Eyram Diaba

Eczema is a chronic skin condition causing redness, itching, dryness, and inflammation. In this comprehensive guide we will provide you with everything you need to know about eczema, from its causes and symptoms to the best treatment and prevention strategies.

By the end of this guide, you’ll have a clear understanding of:

• The different types of eczema
• What triggers flare-ups
• How to treat eczema with medical and home remedies
• Preventive measures to reduce flare-ups

What is Eczema?

Eczema, also known as atopic dermatitis, is a condition that causes the skin to become dry, itchy, inflamed, and irritated. It is not contagious, but it can significantly impact a person’s quality of life, leading to discomfort and, in severe cases, skin infections.

How Common is Eczema? 

• Worldwide: Eczema affects about 15-20% of children and 2-10% of adults globally. (WHO)
• Africa: Studies suggest that eczema prevalence in African countries varies between 4% and 25%. (NCBI)

Types of Eczema

Eczema is not a one-size-fits-all condition; there are several types, each with its unique characteristics:

1. Atopic Dermatitis (Most Common Type)

• Symptoms: Dry, itchy, and inflamed skin; common in babies and children.
• Triggers: Genetics, allergens, irritants, and a weakened skin barrier.

2. Contact Dermatitis

• Symptoms: Redness, irritation, and blisters after contact with an irritant or allergen.
• Triggers: Soaps, fragrances, detergents(like your washing powder), and certain metals (like nickel).

3. Dyshidrotic Eczema

• Symptoms: Small, itchy blisters on hands and feet.
• Triggers: Stress, allergies, and exposure to metals like cobalt or nickel.

4. Nummular Eczema

• Symptoms: Round, coin-shaped spots of irritated skin.
• Triggers: Dry skin, insect bites, or skin injuries.

5. Seborrheic Dermatitis

• Symptoms: Scaly, greasy patches on the scalp, face, and chest.
• Triggers: Hormonal changes, stress, and yeast overgrowth.

6. Stasis Dermatitis

• Symptoms: Swelling and skin discoloration on the lower legs.
• Triggers: Poor circulation, varicose veins, and blood flow issues.

What Happens in the Skin When You Have Eczema? 

Eczema is like a glitch in your skin’s defense system. Normally, your skin acts as a strong barrier, keeping moisture in and harmful stuff like bacteria, allergens, and irritants out. But in people with eczema, this barrier is weak and leaky, leading to dryness, irritation, and inflammation.

Here’s a simple breakdown of what happens:

1. Weak Skin Barrier:

• Imagine your skin is a brick wall. In eczema, some of the “bricks” (skin cells) and “cement” (natural oils) are missing. This means moisture escapes too easily, and irritants can sneak in.

2. Overactive Immune Response:

• Your immune system mistakes harmless things (like dust, soaps, or even stress) as threats and attacks your skin.
• This leads to redness, swelling, itching, and rashes.

3. Inflammation and Itching:

• The immune response releases chemicals that make the skin even more irritated.
• This causes intense itching, which makes people scratch—damaging the skin further and worsening the cycle.

4. Bacteria and Infection Risk:

• Because the skin barrier is weak, bacteria and germs can enter more easily, increasing the risk of skin infections.

5. Chronic Flare-Ups:

• Eczema doesn’t stay the same every day. Some things—like stress, cold weather, or scented products—trigger flare-ups, making symptoms worse.

In summary, eczema is a combination of weak skin, an overactive immune system, and inflammation.

Common Causes & Triggers of Eczema

While the exact cause of eczema isn’t fully understood, researchers believe it results from a combination of genetics and environmental triggers.

1. Genetic Factors

• If one or both parents have eczema, asthma, or hay fever, their child has a higher risk of developing eczema.
• A mutation in the filaggrin gene, which helps maintain a healthy skin barrier, has been linked to eczema.
• You destroy your skin barrier when you
  • Overuse  exfoliants and chemical peels
  • Use strong cleansers
  • Use alcohol based products on your face
  • Frequent washing with hot water (depletes moisture)
  • prolonged sun exposure 
  • Dehydration
  • Poor sleep
  • Excessive Caffeine 

2. Environmental Triggers

• Allergens: Pollen, pet dander, dust mites, and mold.
• Irritants: Harsh soaps, detergents, and fragrances.
• Climate: Extremely hot or cold weather, humidity, and dry air.
• Stress: Emotional stress can weaken the immune system, worsening eczema symptoms.
• Hormones: Hormonal changes during pregnancy, menstruation, or menopause can trigger flare-ups.

Symptoms of Eczema

Eczema symptoms vary from person to person and can range from mild to severe.

Common Symptoms Include:

1. Itching: Often intense and worse at night.
2.  Dry, cracked skin: Can become rough and scaly.
3. Red or inflamed patches: Common on the face, hands, elbows, and knees.
4. Blisters or oozing skin: More common in severe cases.
5.  Thickened skin: Prolonged scratching can lead to lichenification (thick, leathery skin).

How to Treat Eczema

1. Medical Treatments

Doctors often recommend the following treatments for eczema (Note they can have pretty severe side effects if not taken under the guidance of a doctor):

• Topical Steroids (Corticosteroids): Reduce inflammation and itching.
• Moisturizers & Emollients: Maintain the skin barrier and prevent dryness.
• Antihistamines: Help relieve itching and improve sleep.
• Calcineurin Inhibitors (Tacrolimus, Pimecrolimus): Used for sensitive areas like the face and neck.
• Oral Medications: In severe cases, immunosuppressants like cyclosporine may be prescribed.

2. Home Remedies & Natural Treatments (These are not scientifically proven but they have been reported to help). 

• Oatmeal Baths: Helps soothe itchy, inflamed skin.
• Coconut Oil: Contains anti-inflammatory and antimicrobial properties.
• Aloe Vera Gel: Hydrates and calms irritated skin.

3. Lifestyle Adjustments to Manage Eczema

Eczema can be managed effectively with lifestyle modifications that reduce flare-ups and maintain skin health. Here’s how:

A. Use Fragrance-Free Soaps and Lotions

Fragrances and harsh chemicals in skincare products can trigger flare-ups.

Instead:

• Opt for hypoallergenic, fragrance-free cleansers and moisturizers.

• Look for products labeled “dermatologist-recommended” or “for sensitive skin.”
• Apply a thick moisturizer immediately after bathing to lock in moisture.

B. Wear Loose-Fitting, Cotton Clothing

Tight or synthetic fabrics can irritate sensitive skin and worsen symptoms.

Instead:

• Choose soft, breathable fabrics like cotton and bamboo.
• Avoid wool and polyester, which can cause friction and itching.
• Wash new clothes before wearing them to remove potential irritants.

C. Avoid Long, Hot Showers

Hot water can strip the skin of its natural oils, worsening dryness and irritation. To protect your skin:

• Take lukewarm showers for no longer than 10-15 minutes.
• Pat the skin dry with a soft towel—do not rub.
• Apply moisturizer within 3 minutes of drying off to seal in hydration.

D. Keep Your Home Dust-Free

Dust mites, pet dander, and mold are common environmental triggers. To reduce exposure:

• Sweep and dust regularly to minimize allergens.
• Use air filters to remove airborne irritants.
• Wash bed sheets, pillowcases, and blankets weekly in hot water to eliminate dust mites.

E. Manage Stress and Get Enough Sleep

Stress and lack of sleep can weaken the immune system and trigger flare-ups. To manage stress:

• Practice mindfulness, yoga, or deep breathing exercises.
• Create a consistent bedtime routine to improve sleep quality.
• Engage in light exercise like walking or stretching to relieve tension.

F. Stay Hydrated and Eat an Anti-Inflammatory Diet

Hydration and nutrition play a crucial role:

• Drink plenty of water throughout the day to keep skin hydrated.
• Eat foods rich in omega-3 fatty acids (salmon, flaxseeds, walnuts) to reduce inflammation.
• Avoid processed foods, excessive sugar, and dairy (if it worsens your eczema).

Preventing Flare-Ups

While eczema cannot always be prevented, these steps can help reduce flare-ups:

1. Maintain Proper Skincare

• Apply a thick moisturizer twice daily.
• Use a gentle cleanser (avoid soaps with sulfates).

2. Manage Stress Levels

3. Diet & Nutrition

• Eat anti-inflammatory foods (e.g., salmon, turmeric, leafy greens).
• Stay hydrated to keep skin from drying out.

Final Thoughts 

For some, eczema improves with age. However, many people continue to experience flare-ups throughout adulthood.

Eczema can be challenging, but with the right skincare routine, lifestyle changes, and medical treatments, you can effectively manage symptoms and prevent flare-ups.

Additional Resources

📌 Watch: Eczema Skincare Tips

📌 Listen: Eczema Podcast on Spotify

Peptic Ulcer Disease (PUD) is a common digestive condition that causes painful sores in the lining of the stomach or the upper part of the small intestine (duodenum). These ulcers can lead to symptoms such as burning stomach pain, bloating, nausea, and in severe cases, internal bleeding.

The good news is that peptic ulcers are treatable. With the right medical therapy, lifestyle changes, and preventive measures, you can heal ulcers and prevent complications. In this guide we will walk you through the best treatment options and how to manage PUD effectively.

Understanding Peptic Ulcer Disease

Your stomach produces acid to help digest food, but this acid is so strong that it could damage the stomach lining. To protect itself, the stomach has a special mucus layer that acts like a shield.
Peptic ulcer disease happens when something weakens this shield, allowing acid to burn and create open sores (ulcers) in the stomach or the first part of the small intestine (duodenum).

The two most common reasons for this are:

1. Frequent use of NSAIDs (painkillers like ibuprofen or aspirin) – These medications reduce the stomach’s ability to produce protective mucus, leaving the lining exposed to acid.
2. H. pylori infection – This is a type of bacteria that can survive in the stomach’s harsh environment. It damages the protective mucus layer, making the stomach lining more vulnerable to acid.

Other factors like stress, spicy foods, and smoking can make symptoms worse but don’t directly cause ulcers. 

When the acid erodes the stomach lining, it can lead to epigastric pain (which can feel like chest pain), bleeding, and in severe cases, perforation (a hole in the stomach).

Types of Peptic Ulcers

Peptic ulcers are open sores that develop in the lining of the stomach or the upper part of the small intestine due to excessive acid exposure. They are classified based on their location:

1. Gastric Ulcers

• These ulcers form in the lining of the stomach.
• Symptoms often worsen after eating because food triggers acid production, irritating the ulcer.
• More common in older adults

2. Duodenal Ulcers

• These ulcers develop in the first part of the small intestine (duodenum).
• Symptoms tend to improve after eating but worsen a few hours later or at night when the stomach is empty.
• More common in younger adults.

    3. Esophageal Ulcers

• These ulcers occur in the esophagus due to acid reflux or chronic irritation from medications or alcohol.
• Symptoms include pain while swallowing, heartburn, and chest pain.

4. Stress Ulcers

• These ulcers develop due to severe stress, such as critical illness, trauma, or major surgery.
• Often found in hospitalized patients, especially those in intensive care.

5. Refractory Ulcers

• These are ulcers that do not heal despite treatment.
• Causes include continued H. pylori infection, excessive NSAID use, or underlying conditions like Zollinger-Ellison syndrome (a rare disorder causing excessive acid production).

Understanding the type of ulcer helps in choosing the right treatment plan for faster healing and symptom relief.

How to Treat Peptic Ulcer Disease

1. Medical Treatments for Peptic Ulcers

The primary goal of treating PUD is to heal the ulcer, relieve symptoms, and prevent complications.

a) Treating H. pylori Infection

If an H. pylori infection is responsible for your ulcer, your doctor will prescribe a combination of antibiotics to eliminate the bacteria.

• Triple Therapy (Standard Treatment)
  • Proton Pump Inhibitor (PPI) (e.g., omeprazole, lansoprazole, pantoprazole) – Reduces stomach acid.
  • Two Antibiotics (e.g., clarithromycin + amoxicillin or metronidazole) – Kills H. pylori.
  • Duration: Typically 10-14 days.
• Quadruple Therapy (For Antibiotic-Resistant Cases)
  • PPI + Bismuth subsalicylate (Pepto-Bismol) + Metronidazole + Tetracycline.
  • Used when standard therapy fails.

After treatment, a follow-up test (such as a stool antigen test or breath test) is needed to confirm that H. pylori has been eradicated. This is why it’s important that your treatment is directed by a doctor.

b) Medications to Reduce Stomach Acid

Even if H. pylori is not present, reducing stomach acid is essential for ulcer healing. The following medications are commonly prescribed:

• Proton Pump Inhibitors (PPIs) – These are the most effective acid-suppressing drugs, allowing the ulcer to heal faster. Common PPIs include:
  • Omeprazole (Prilosec)
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Pantoprazole (Protonix)
• H2-Receptor Blockers – These drugs also reduce stomach acid but are slightly less effective than PPIs. Examples include:
  • Ranitidine (Zantac)
  • Famotidine (Pepcid)
  • Cimetidine (Tagamet)
• Antacids – These provide quick relief by neutralizing stomach acid but don’t promote ulcer healing. Common antacids include:
  • Calcium carbonate (Tums)
  • Magnesium hydroxide (Milk of Magnesia)
  • Aluminum hydroxide (Maalox)
• Protective Agents (Mucosal Protectants) – These coat the stomach lining, acting as a barrier against acid. Examples include:
  • Sucralfate (Carafate) – Forms a protective layer over the ulcer.
  • Bismuth subsalicylate (Pepto-Bismol) – Has antibacterial properties against H. pylori.

c) Discontinuing NSAIDs

If NSAIDs caused your ulcer, stopping or reducing their use is crucial. If you need pain relief, your doctor may recommend:

• Switching to acetaminophen (Tylenol) instead of NSAIDs.
• Using low-dose NSAIDs with a PPI for stomach protection.

However be aware that these also carry their risks. You should let your doctor explore the cause of your pain so the source of it can be treated and you can avoid being reliant on painkillers.

2. Lifestyle and Dietary Changes

In addition to medication, making the right lifestyle choices can speed up healing and prevent future ulcers.

a) Eat a Stomach-Friendly Diet

While diet alone doesn’t cause ulcers, certain foods can worsen symptoms. Here’s what you can eat and try to avoid:

• Foods That Help Heal Ulcers
  • High-fiber foods (oats, apples, carrots)
  • Probiotic-rich foods (yogurt, kefir)
  • Lean proteins (chicken, fish)
  • Healthy fats (olive oil, avocado, nuts)
• Foods to Avoid
  • Spicy foods (may worsen irritation)
  • Acidic foods (tomatoes, citrus fruits)
  • Fried and fatty foods
  • Caffeinated and carbonated drinks
  • Alcohol

b) Reduce Stress Levels

Stress doesn’t directly cause ulcers but can worsen symptoms. Managing stress can promote healing:

• Practice deep breathing or meditation.
• Exercise regularly (walking, yoga, cycling swimming).
• Get enough sleep (7-9 hours per night).

c) Quit Smoking and Limit Alcohol

• Smoking slows down ulcer healing and increases recurrence.
• Alcohol irritates the stomach lining and can make ulcers worse

3. Home Remedies for Peptic Ulcer Disease

While medical treatment is essential for peptic ulcers, some natural remedies may help soothe symptoms and promote healing. These remedies are not a substitute for doctor-prescribed treatments but may provide additional relief:

• Honey
  • Honey has natural antibacterial properties and may help fight H. pylori, one of the main causes of ulcers.
  • It also helps with wound healing, which may aid in ulcer recovery.
• Aloe Vera Juice
  • Aloe vera has anti-inflammatory properties and may help soothe the stomach lining.
  • Some studies suggest it can reduce acid production and help with acid reflux symptoms.
• Probiotics (Yogurt, Fermented Foods, Supplements)
  • Probiotics introduce good bacteria that help restore balance in the gut.
  • Some studies show probiotics may reduce H. pylori levels and improve ulcer healing.
• Cabbage Juice
  • Cabbage is rich in vitamin C and has been used as a natural ulcer remedy.
  • Some studies suggest it may promote healing by strengthening the stomach lining.
• Turmeric
  • Contains curcumin, which has anti-inflammatory and antibacterial effects.
  • May help reduce acid secretion and improve gut health.
• Ginger
  • Has been traditionally used to aid digestion and reduce nausea.
  • Some studies suggest it may help fight H. pylori and reduce stomach irritation.

PLEASE NOTE

• While these remedies may help, they should not replace medical treatment.
• Consult your doctor before trying these remedies, especially if you’re taking ulcer medications or any other medications
• Avoid excessive use

When to See a Doctor

• Seek medical attention immediately if you experience:
•  Vomiting blood (bright red or coffee-ground appearance).
• Black, tarry stools (a sign of bleeding).
• Severe stomach pain that doesn’t go away.
• Unexplained weight loss.

These could indicate complications like bleeding, perforation, or obstruction, requiring urgent treatment.

Final Thoughts

• Avoid excessive NSAID use – Take with food and use the lowest effective dose.
• Get tested for H. pylori if you have a history of ulcers.
• Maintain a balanced diet with gut-friendly foods.
•  Manage stress through relaxation techniques.
• Quit smoking and reduce alcohol intake.

Peptic ulcers are painful but treatable. With the right combination of medication, lifestyle changes, and dietary adjustments, most ulcers heal within 4 to 8 weeks.

If you suspect you have an ulcer, consult a doctor for a proper diagnosis and treatment plan. Early treatment can prevent serious complications and help you get back to living pain-free.

Additional Resources 

H. pylori Testing & Diagnosis – CDC

The surprising cause of stomach ulcers – Rusha Modi

Understanding Stomach and Duodenal Ulcers