Eczema Up Close: Myths and Uncommon Complications

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Dispelling myths and exploring unexpected complications of eczema

Over 30 million Americans live with eczema, yet many people with the condition may not be aware of some of the unexpected but often serious complications that are connected to eczema. We’ll take a look at some the myths that still persist, and some of the less well-known complications that surround this skin condition and some of the things you can do to avoid these problems.


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Myth: It’s just a skin problem. It’s no big deal

Although eczema is a skin disease, its impacts on patients’ quality of life and the overall health go beyond the skin. Because this condition compromises the skin barrier, which is the largest organ in the body and a crucial element in our immune systems, patients should be aware that there are certain complications they’re at higher risk for developing.


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Eczema and increased risk of heart disease

Studies have found a link between severe eczema and heart disease. Adults who have active, severe eczema were found to be at higher risk for developing cardiovascular diseases, including heart attack and stroke, when compared to the general public. Researchers reported that people with eczema had a 70 percent chance of increased heart failure. Adult patients with severe eczema may want discuss additional screenings for heart disease with their doctor.


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Myth: vaccines cause eczema

No, vaccinations do not cause eczema and dermatologists encourage people who have eczema to get vaccinated. However, people with eczema who have had an extreme allergic reaction to eggs should talk to their doctor about alternatives for two vaccinations; the measles, mumps and rubella (MMR) vaccine and the influenza vaccine. People who have eczema should also avoid any contact with the live smallpox vaccine.


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Unexpected complication: people with eczema tend to have staph bacteria on their skin

Between 60 to 90 percent of people with eczema have staph bacteria on their skin, which may develop into an infection and worsen their skin condition. Researchers have found that eczema patients often have a type of Staphylococcus (staph) living on their skin. Certain strains of staph – specifically Staphylococcus aureus — are linked to eczema flare-ups and may cause more severe symptoms. People with healthy skin, tend to carry a mix of strains of bacteria on their skin.


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Eczema, staph and the influenza vaccination

Some studies have found that people with eczema whose skin was colonized with Staphylococcus aureus had a reduced immune response from the influenza vaccination. Research showed their immune systems didn’t fully benefit from the vaccine when it was injected into the skin. However, when the vaccine was injected into the muscle, it was just as effective.


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Influenza shot can be injected into a muscle instead

Patients with moderate to severe eczema should ask their doctor about getting the flu vaccination injected into an intramuscular site.


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Live smallpox vaccine can lead to serious infection

People who have eczema – or had it (even years ago)-- should avoid getting the live smallpox vaccine and avoid skin-to-skin contact with anyone who had that vaccine for about 30 days after it’s administered. For most people this isn’t a problem, as smallpox was wiped out decades ago and the vaccine is no given to the general public. But some people who serve in the military and some researchers and lab workers who might be exposed to smallpox may be vaccinated against it.


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Rare complication: eczema vaccinatum

For people with eczema, the live smallpox vaccine can cause a rare but serious infection called eczema vaccinatum (EV). This infection is caused when the live virus in the smallpox vaccine reproduces and spreads beyond the inoculation site, causing a crusting skin rash throughout the body, as well as fever and edema (or swelling). It can be life threatening. Because of this, the live smallpox vaccine shouldn’t be given to people who are in close contact with anyone with a history of eczema.


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Myth: eczema is contagious

No, you can’t pass eczema on to other people. However, eczema and the scaly rash it causes can compromise your skin barrier and make it easier for you develop skin infections. Those infections may be contagious – especially to other people with eczema, other skin conditions or compromised immune systems.


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Eczema herpeticum

Eczema herpeticum is an infection usually caused by the herpes simplex 1 virus or “oral herpes” – the virus that causes cold sores to appear around and inside the mouth, but can also appear on other places on the body. People with eczema and other inflammatory skin diseases are more susceptible to this infection, which can cause clusters of small blisters that are red, purple or black and are itchy and painful. It’s often accompanied by a high fever, swollen glands and overall feeling unwell. This infection can be very serious, especially when it spreads over wide areas of skin.


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Slowed growth rate for children with severe eczema

Severe eczema has been linked to slower growth rates in about 10 percent of children. Some children have been shown to have a slower growth rate than children without eczema.  The exact cause of this is still up for debate.


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Possible causes for growth to be impaired for children with severe eczema

One possibility is that chronic stress and sleep disturbances — caused by constant scratching – impair the normal growth hormone cycle of some children. Another possibility is that children with eczema often have food allergies, which may restrict what food they eat and affect their nutrition levels.


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Topical steroids to treat eczema may cause delayed growth

Another concern is that corticosteroids, which are often used to treat eczema, may delay or slow the growth of some children with severe eczema. Young patients who are treated for long periods of time using corticosteroids (often applied topically, but sometimes orally) should have their growth monitored closely.