Medical News Today: What to know about papular eczema

By | January 22, 2019
Papular eczema is a skin condition that causes a rash of small, itchy bumps to develop on the skin. These bumps are called papules.

Eczema refers to a range of related skin conditions. When eczema looks like small lumps rather than a rash, doctors may refer to the condition as papular eczema.

This article will explain what papular eczema is, who is most likely to experience it, and how people can treat it.

What is papular eczema?

Transient acantholytic dermatosis which is a papulovesicular dermatosis or papular eczema. Image credit: Tvbanfield, 2009
Papular eczema causes small, itchy bumps on the skin.
Image credit: Tvbanfield, 2009

Eczema is a group of skin conditions that affect more than 30 million people in the United States. The most common type of eczema is atopic dermatitis. Some people may have both atopic dermatitis and papular eczema.

Like other types of eczema, its symptoms are linked to inflammation and faulty immune system responses.

There is currently no cure for papular eczema, but people can use treatments and home remedies to manage their symptoms and reduce flares. In some cases, a doctor may recommend systemic, or body-wide, treatments such as tablets.

However, papular eczema may not respond to treatments as well as other forms of the condition.

Symptoms

The symptom that makes papular eczema different is the way the eczema rash looks. Rather than appearing red and flaky, the rash comprises small lumps.

Papules can look similar to pimples but without the pus. They may appear on the torso, arms, or legs. Papular eczema can be very itchy.

Other symptoms are the same as other forms of eczema and may include:

  • a scaly rash
  • dry, cracked skin
  • skin infections
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Causes and risk factors

Eczema affects everyone differently. Papular eczema is more likely to affect African-American people or people with darker skin.

Scientists do not yet know what causes eczema, but they believe that a person’s genes play a role. If someone has eczema, asthma, or hay fever in their family, they are more likely to develop eczema.

People with eczema may have a problem with a gene that creates a protein called filaggrin. This plays a role in building a protective barrier on top of the skin.

A weakened barrier means that moisture can get out and bacteria, viruses, and other irritants can get in. This is why people with eczema tend to have dry skin that is prone to infections.

Eczema is an autoimmune condition. This means that it is a result of the immune system working too hard.

Irritants can trigger the immune system and cause eczema outbreaks. Some triggers that cause the immune system to overreact include pollution, laundry detergent, and pollen. The triggers, however, are different for different people.

Treatment

Bottles of oil on wooden table
Lotions and oils can help moisturize skin prone to papular eczema.

While there is no cure for eczema, people can use a range of treatments and remedies to ease their symptoms, depending on the type and severity of the condition.

  • Over-the-counter treatments. These include creams that can ease itching and prevent infection. They are available without a prescription.
  • Prescription products. A doctor may recommend a prescription cream or ointment, such as steroids, PDE4 inhibitors, topical calcineurin inhibitors, and skin barrier creams.
  • Phototherapy. Doctors may recommend phototherapy if a person has more severe eczema. They use a machine to emit ultraviolet B light onto the skin. This helps reduce itching and inflammation, increases vitamin D production, and helps the skin fight bacteria.
  • Biological medications. Often called biologics, a doctor will give these medicines as an infusion. They work by targeting parts of the immune system that cause inflammation.
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Home remedies

Many people with eczema have dry skin, which can lead to eczema flare-ups. Use a moisturizer after every bath or shower to prevent dry skin and flare-ups.

Try applying a generous layer of fragrance-free product over the skin within 3 minutes of bathing or showering. Apply creams using downward strokes of the palms of the hands.

Some people find that using complementary or natural remedies can help them manage flare-ups. These remedies include:

Coconut oil

Many people use coconut oil for eczema. Coconut oil can moisturize the skin and reduce the symptoms of dry skin conditions.

Applying virgin or cold-pressed coconut oil to damp skin may also reduce the amount of Staphylococcus bacteria on the skin. This can reduce the chances of developing an infection.

Aloe vera gel

People can also try aloe vera gel for eczema. Its antibacterial properties may help reduce skin infections.

Apple cider vinegar

Diluted apple cider vinegar could also help with eczema by balancing the skin’s acidity levels and killing bacteria.

Sunflower oil

In adults, applying sunflower oil to the skin can help the skin’s barrier retain moisture. People can use it twice per day on damp skin. People who are allergic to sunflower seeds should avoid this remedy.

Cardiospermum

Using ointments containing extracts of the tropical cardiospermum vine may reduce inflammation and itching and kill bacteria on the skin.

Prevention

Soap bar in a wooden dish next to lotion
Some soap products may trigger eczema flares.

People cannot prevent papular eczema, but they can prevent flare-ups from occurring or becoming worse.

Ways to prevent eczema flares include regularly moisturizing after baths and showers and wearing soft cotton clothing that is loose-fitting.

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People can also prevent eczema flares by identifying and avoiding exposure to triggers. These are different for everyone but may include allergens such as:

Other irritants that can trigger eczema flares include:

  • some metals, particularly nickel
  • cigarette smoke
  • some soaps and detergents
  • certain fabrics, such as wool and polyester
  • antibacterial ointments and personal care products
  • disinfectants that contain formaldehyde
  • some shampoos
  • dyes and temporary tattoos

Stress and hot or cold weather can also trigger eczema for some people.

Outlook

Papular eczema is less common than other forms of eczema. People with darker skin are more likely to experience eczema papules.

Eczema in general is most common in children. Some sources say that over half of all children who have eczema will outgrow the condition by the time they reach their teenage years.

In general, eczema tends to clear up within 10 years in over 80 percent of children who have it, and within 20 years in up to 95 percent of children who have it. Eczema is more likely to persist if a child develops the condition between the ages of 2 and 5.

Eczema can return in some adults, most frequently on the hands.

Some of the treatments in this article are available for purchase online.

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