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What is eczema?
Reviewed by Dr Victoria Lewis, specialist registrar in dermatology
Crusts
The fluid that oozes from inflamed skin is rich in protein. When this dries out in contact with air the protein is left behind as a crusty deposit. Often this occurs in conjunction with infection, when the infected crusts typically have a golden colour.
A similar crusting is seen in the infectious skin condition called impetigo, which is commonly seen in children of primary school age as it is easily passed on by touching.
In impetigo treating the infection eliminates the problem, but it is of course only part of what's required in eczema. Often doctors refer to infected eczema as being 'impetiginised'.
Grades of eczema
A useful extra way to classify eczema is based on the degree of activity and for how long the eczema has been active.
Acute eczema would therefore be an area that recently flared up and would be red, probably also have blisters and possibly some oozing or crusts.
Chronic
Infected
With experience one can usually discern the golden crust of infection and pick up the other clues that suggest infection.
'Chronic' properly means long-standing. Once the initial phase of activity has died down a bit of skin that has been eczematous for a while is dry, scaly, thickened and cracked.
At any stage of eczema it can become infected. This won't always be obviously different from acute eczema unless there are pus-filled blisters.
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