What is eczema?
The term eczema encompasses various inflamed skin conditions. In mild forms it manifests as dry, hot and itchy skin, whilst in more severe forms the skin can become broken, raw and bleeding. Although it can sometimes look unpleasant, eczema is not contagious.
Who gets eczema?
Eczema affects all age groups. In the UK up to one fifth of UK schoolchildren have eczema and one in twelve adults. The condition is becoming more common with an increase of between two- to five- fold seen in the past 30 years.
What causes eczema?
Atopic eczema, the 'allergic' type, is the most common form in childhood and is part of a family of other conditions including hayfever and asthma. It's thought to be a hereditary condition. People with atopic eczema are sensitive to allergens in the environment which cause an excessive reaction by the immune system producing inflamed, irritated and sore skin. Other types of eczema are caused by irritants such as chemicals and detergents, allergens such as nickel, and yeast growths. In later years eczema can be caused by blood circulatory problems in the legs. The causes of certain types of eczema remain to be explained, though links with environmental factors and stress are being explored.
Other than atopic eczema, what are the different types?
Allergic contact dermatitis: the immune system reacts against a specific substance, an 'allergen'. The house dust mite is a common allergen as is nickel, found in jewellery, jeans studs and other clothing, eg bra straps.
Irritant contact dermatitis...
The skin inflames due to direct contact with an irritant such as detergent, solvent and other chemicals.
Infantile seborrhoeic eczema...
Also known as cradle cap, this manifests as a greasy, scaly scalp in babies under one and often clears up without treatment.
Adult seborrhoeic eczema...
Manifests as a mild dandruff but can spread to face, ears and chest. The condition typically affects adults aged 20-40 and is believed to be caused by a yeast growth.
Poor circulation affects the skin around the ankles making it speckled and inflamed. Those in their middle to later years are usually affected.
Coin-shaped areas of red skin appear suddenly on the trunk or lower legs which can become itchy or weep fluid.
How can eczema be treated?
The first step in effective treatment of eczema is a correct diagnosis. With treatment the inflammation can be reduced however skin remains sensitive to flare-ups and only rarely can eczema be said to be curable.
Maintaining the barrier function of the skin with proper moisturising is the most important element of eczema treatment. Moisturising creams, ointments and bath oils can be prescribed by the GP and should be used even when the condition appears to be clear.
Topical steroids can be effective when used to treat atopic eczema. Used correctly they are safe and effective medicines. Elidel cream and Protopic ointment are two new treatments which do not contain steroids and are not associated with their potential side effects.
Cotton gloves worn at night can reduce the damage caused by scratching and short courses of sedating antihistamines are sometimes prescribed to reduce severe itching during flare-ups, which also help the patient sleep.
Chronic eczema often become infected by bacteria which may require treatment in the form of an antibiotic, antifungal or antiviral.
If topical therapies prove insufficient light treatment may be prescribed or a course of corticosteroid tablets taken by mouth.
Contact the National Eczema Society or call their helpline (Mon-Fri, 1pm-4pm) on (0870) 241 3604.