Eczema
What is Eczema
Eczema is an itchy inflammation of the skin, associated to a varying degree with other features such as: redness of affected areas of skin
generally dry skin, which is often thickened in the areas that have been scratched
lumps or blisters in affected areas
signs of superficial infection, such as weeping or crusty deposits.
Atopic: the ‘allergic’ type often seen in people who also have hay fever or asthma.
Allergic contact: due to skin contact to a substance to which the individual is sensitive. The same substance does not cause eczema in a person who is not sensitive to it.
Irritant contact: due to skin contact with irritating chemicals, powders, cleaning agents, etc. Contact with such a substance is likely to cause eczema in any person, although a degree of individual variation still exists.
Discoid: appears as discrete islands of eczema on a background of normal skin.
Seborrheic: in infants appears in the nappy area and the scalp. In adults, also appears on the scalp and in the skin creases between the nose and sides of the mouth. It can be caused by an increased sensitivity to yeast living on the skin.
Others: a miscellaneous group including eczema of the legs caused by varicose veins and pompholyx – an intensely itchy form located on the hands and composed of small or (sometimes) large blisters.
Eczema in practice
Eczema is a common condition. Atopic eczema affects about 10 to 20 per cent of schoolchildren and 3 to 5 per cent of adults in the UK, and it’s getting more common.
Eczema affects people with dry and rough skin (keratosis pilaris) and may be caused by a variety of allergens. It often starts in early childhood, around three months of age, and tends to run in atopic families.
An increase of between two- and five-fold has been seen over the past 30 years, for reasons that are far from clear.
It is unusual to be able to identify and eliminate a single agent causing the skin reaction, and most of the time we have to settle for improving the condition rather than getting rid of it altogether.
What are the causes of Eczema?
Possible causes include:
Food allergy, which plays an important role in children under one year but not in adults
Cow’s milk, hen’s eggs and peanuts are the foods most likely to exacerbate infantile eczema
House dust mites tend to aggravate eczema in older children and adults
Pet dander exposure, such as to cats, dogs and other furry animals, may play a role
Certain bacteria may cause sudden, severe outbreaks of eczema
Eczema symptoms
In mild cases, eczema is nothing more than a slightly irritating patch of sore skin, but in severe cases extensive areas of skin may become inflamed and unbearably itchy.
Some people with these symptoms develop problems such as depression with low self-esteem, and have difficulty coping at school or work.
People with eczema are also more prone to herpes, skin fungal and wart infections.
Up to half of all babies with widespread atopic eczema will later develop asthma and rhinitis as the eczema improves. This phenomenon is referred to as the ‘allergic march’.
Eczema treatments
Completely avoid the substance that triggers the eczematous rash and treat any existing rash with medium potency steroid ointments and moisturising emollients.
Atopic eczema is usually a little more difficult to treat and you may need to try a number of different treatments, or a combination of treatments, before finding which one works best for you.
People with atopic eczema should bath regularly using liberal amounts of emollients (moisturising creams, ointments, lotions and bath oils) to soften and hydrate the skin. Ointments work much better than creams on dry eczematous skin, but are greasy
If you have atopic eczema you may find the following useful:
Take lukewarm baths with emollients, but don’t stay in the water too long
Pat the skin dry with a towel – never rub eczematous skin dry
Avoid soap, detergents and shampoo – use aqueous cream instead of soap
Wear cotton fabrics next to your skin – avoid wool and polyester
Wear loose rather than tight-fitting clothes
Clip your fingernails and don’t scratch or rub your skin
Avoid sports that make you sweat a lot
Try to stay calm and relaxed because stress can make eczema worse
www.bbc.co.uk/health/physical_health/conditions/in_depth/allergies/allergicconditions_eczema
Our Advice
Constant use of emollients such as unscented creams and bath oils is the best prevention of an eczema flare-up.
Treat the flare-up as soon as you can, ask our pharmacist for the best product for you or your child.
Synthetic clothing e.g. polyester and elastane worsen eczema. Try to wear cotton clothing.
Avoid the use of soap. Use aqueous cream as a soap substitute.
Avoid perfumed products and cosmetics and use a non-biological washing powder.
Lanolin and wool fat can worsen some people’s eczema.
Avoid physical contact with any trigger factors, e.g. pets, washing up liquid.
At times of high anxiety eczema usually flares up.