Eczema

Eczema or dermatitis as it is sometimes called, is a group of skin conditions which can affect all age groups.

The severity of the disease can vary. In mild forms the skin is red, hot and itchy, whilst in more severe forms the skin can become broken, raw and bleed. Constant scratching can also cause the skin to split, leaving it prone to infection. Eczema is not contagious. With treatment the inflammation of eczema can be reduced, although the skin will always be sensitive to flare-ups.

There are several types of eczema, the main ones being atopic eczema, allergic contact dermatitis and irritant dermatitis.

Atopic eczema

Atopic eczema is the most common type of eczema and is linked with hayfever and asthma. The tendency to develop atopic eczema is inherited but it is strongly influenced by environmental factors. Atopic means extra sensitivity to substances (allergens). The most common allergens are house mites, pollen, cat/dog fur and sometimes foodstuffs. The areas affected include skin creases such as the fronts of elbows and wrists and backs of knees. However, any areas of the skin may be affected. The common area for babies to be infected is the face.

Allergic eczema

This type of eczema develops when the body's immune system reacts against a substance in contact with the skin. The allergic reaction often develops over a period of time through repeated contact with the substance. For example, an allergic reaction may occur to nickel, which is often found in earrings, belt buckles etc. In order to prevent repeated reactions it is best to avoid contact with anything that you know causes a rash.

Irritant contact eczema

In this type of eczema, it is the frequent contact with an everyday substance such as detergents and chemicals that are irritating the skin. It most commonly occurs on the hands of adults and can be prevented by avoiding the irritants and keeping the skin moisturised.

Treatment

There is currently no cure for eczema, although there are many ways to minimise the discomfort and distress caused by eczema. The three main goals of treatment are healing the skin and keeping it healthy, preventing flare-ups and treating symptoms as they occur.

A wide range of treatments are available from your Numark Pharmacy. Treatment is based on the use of emollients (moisturisers) including soap substitutes, both oils and general moisturisers and topical steroids for flare-ups.

Emollients

Emollients reduce water loss from the outer layer of your skin by covering it with a protective film. This keeps the water in the skin where it is needed and also helps to keep infections and other harsh substances out. Emollients are safe to use as often as is necessary and are available in various forms: ointments for very dry skin, creams and lotions for moderate/dry skins.

Some are applied directly to the skin whilst others are used as a soap substitute or can be added to the bath.

Topical steroids

When eczema is under control, only emollients need to be used. However, in flare-ups, when the skin becomes inflamed, a steroid cream may be needed. Steroids act by reducing inflammation and are used in most types of treatments.

For most people with mild to moderate eczema, treatment with a mild steroid for one to two weeks is enough to treat a flare-up. You may need to step up to a stronger steroid if there is no response but always use the lowest strength that works.

Topical steroids should be applied thinly to the affected area on unbroken skin. Many people have concerns regarding the use of steroids and their side effects. As long as steroids are used appropriately the likelihood of side effects are very rare, nevertheless, you should not use steroid creams for conditions outside those indicated on the leaflet.

Antihistamines

Sedative antihistamine tablets may sometimes help to reduce the itch of eczema at night and give a good night's sleep. They can make you feel drowsy the next day so take care if you are driving or if you are treating a child going to school.

Antihistamine creams are not effective in eczema and should be avoided as the ingredients in them can make the eczema worse.

Other things you can do to help relieve eczema include:

• Avoid using normal soap as it may dry the skin; use a soap substitute
• Use a good hypo-allergenic moisturiser to keep your skin hydrated
• Cotton clothing and bedding keep the skin cool and allow it to breathe
• Use a non-biological washing powder and avoid fabric softeners
• Keep children's nails clean and short. Cotton mittens over children's hands can be helpful

For further advice on eczema consult your Numark Pharmacist.

This page last updated on 5th April 2009