The dermis is composed of two layers of connective tissue, the papillary layer and the reticular layer. This superficial layer is positioned just beneath the epidermis and contains blood, nerves fibers, lymphatic capillaries, hair follicles, sweat glands, touch receptors, and sebaceous glands (otherwise known as oil glands) for lubricating skin and hair. The hypodermis (also called the subcutaneous layer) is composed of connective tissue and adipose (fat) tissue, which functions as a protective cushion and fat storage for the skin. (Functions, 2019). Adipocytes, or fat-storing cells, serve as energy reserves and insulation for the body to prevent heat loss and are located directly below the dermis. Inflammation needs to be managed and is usually treated with common anti-inflammatory medications, including corticosteroids and (NSAIDs) non-steroidal anti-inflammatory drugs. NSAIDs such as naproxen, ibuprofen, and aspirin can be taken to alleviate pain caused by inflammation. However, NSAIDs are only intended for short-term use because of harmful side effects. Consequently, the most reported side effects of NSAIDs are gastrointestinal symptoms, including stomach ulcers, heartburn, stomach pain, gas, bloating, nausea, diarrhea, constipation, and kidney damage. Another treatment for skin inflammation is corticosteroids, a class of steroid hormones, such as cortisol ointment or cream that may be prescribed. (Nordqvist, 2017). In contrast to corticosteroids and NSAIDs, recent research has identified many botanically-derived antioxidants that have anti-inflammatory properties. Curcumin is one of the most naturally potent compounds. This yellow phenolic compound is a constituent of turmeric and is present in curry. (Thangapazham, n.d.). Botanically derived compounds rich in antioxidants and possessing anti-inflammatory activities include cannabis, apples, green tea, wine, chamomile, devils’ claw, hyssop, turmeric, and ginger. Certain foods can aggravate inflammation and should be avoided. These include fried foods, margarine, French fries, white bread, pastries, soda, lard, sugary drinks, and red meat. (Nordqvist, 2017).
Keratinocytes and melanocytes are two cells that help to protect the skin. Keratinocytes are cells that produce the protein keratin. Keratin is the same fibrous substance that gives hardness and water-resistant properties to skin, hair, and nails, and is located in the stratum corneum or the horny layer of the skin. (Functions, 2019). Keratinocytes contribute to protecting the skin from ultraviolet radiation (UV) by initiating interaction with melanocytes, which are melanin-producing cells, located in the lower layer of the epidermis. Melanin is a light-absorbing pigment, which is responsible for skin color. (James, Berger, & Elston, 2011). What is inflammation? Inflammation is a defense mechanism in the body that recognizes wounds, damaged cells, pathogens, trauma, and irritants, and stimulates the healing process. (Nordqvist, 2017). According to research by Nordqvist, inflammation is caused by many physical reactions triggered by the immune system in response to a physical injury or an infection. Inflammation is often characterized by discomfort, restricted mobility (stiffness), and even pain, depending on the severity of the inflammation. The pain of inflammation has been described as constant, throbbing, pulsating, stabbing, and squeezing, due to the swelling that pushes against sensitive nerve endings. There are two types of inflammation, acute and chronic. Acute inflammation starts quickly, lasting a few days and can result from UV radiation exposure, allergens, or contact with a chemical. Acute inflammation can be identified by five signs, including: redness, pain, swelling, heat, and immobility. These five signs only apply to inflammation of the skin. Long-term inflammation (chronic) can also occur, lasting for several months and even years, causing significant tissue damage, scarring, and thickening of connective tissue. Chronic inflammation refers to long-term inflammation and is caused by pathogens that the body cannot break down foreign bodies; viruses that remain in the body; or even an autoimmune disorder that attacks healthy tissue. (Nordqvist, 2017). Any disease ending in the Greek suffix-itis, is used to denote inflammation; thus, dermatitis is inflammation of the skin. Skin conditions, also called cutaneous conditions, describe any medical condition that affects the integumentary system. This organ system encompasses the body, including, skin, hair, nails, related muscles, and glands. According to the National Eczema Association, 18 million adults have atopic dermatitis, and 31.6 million people in the U.S have some form of eczema. Atopic dermatitis, commonly known as eczema, is a prevalent, inflammatory skin disease, characterized by a dry, itching, scaling, oozing rash that sometimes causes pain and physical discomfort. Eczema is a term used to describe several types of skin conditions with similar symptoms that cause the skin to become inflamed or irritated. The exact cause of eczema is unknown; however, according to researchers, it is likely caused by genetics, a faulty immune system, and environmental factors. Eczema usually manifests in the form of a rash, which is not transferrable, nor is it curable, and is more prevalent in females than males. According to the author Kronemyer (2017), multiple studies have demonstrated that atopic dermatitis is more prevalent in blacks than whites. Additionally, eczema patients are likely to suffer from post-inflammatory hyperpigmentation, which is common in darker skinned patients. Treating darker skin with topical steroids can result in hypopigmentation changes in the skin.
WHAT IS ECZEMA?
The term atopic dermatitis and eczema are often used interchangeably, referring to a group of inflammatory conditions affecting the face, neck, creases of the elbows, behind the knees, and on the hands and feet. Some clients will outgrow the condition, while others will continue to struggle with it throughout adulthood. Often, the client will experience flare-ups, also known as “triggers,” and then suddenly, the client’s skin will improve. Eczema can be both acute and chronic. Chronic eczema in a client is long-lasting, around three months or longer, and the skin appears itchy, cracked, rough, discolored, and dull. Acute eczema, on the other hand, is characterized by abnormal changes in the skin that have just started, and can be identified by redness, blistering, intense itching, tenderness, and heat. There are many different types of eczema; however, for this course, we will mainly focus on the five most common eczema conditions: ● Allergic contact dermatitis : Also known as allergic eczema, this is a form of contact dermatitis and is an itchy rash on the skin that develops after having direct contact with substances that trigger an allergic reaction. When the skin’s natural barrier is weakened, it is less able to protect a person against irritants and allergens. Healthy skin helps retain moisture and protects from bacteria, irritants, and allergens. Unfortunately, an
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