Eczema

Eczema is a condition that causes the skin to become itchy and inflamed. A rash develops that may appear purple, brown or grey in darker skin tones and red in lighter skin tones. It is possible to have more than one type of eczema – each form of eczema has its own set of triggers and treatment requirements.^1a,b

Learn here all about eczema, and how to best manage your symptoms.

What is eczema?

Image: Atopic dermatitis eczema^2a

There are many different types of eczema, by far the most common being atopic dermatitis.^3a

Eczema is a common allergic skin condition, and half of patients with moderate to severe eczema also suffer from asthma, hay fever, and food allergies.^2b,3b
Eczema usually begins in early childhood and can persist into adolescence and adulthood.^2c,3c
No cure has been found for eczema – treatments can relieve symptoms and help prevent flare-ups.^4a

Symptoms

Symptoms vary from person to person but can include:

Dry skin
Itchy skin
Thickened, cracked and scaly skin
Raw, sensitive and swollen skin from scratching

Where on the body can eczema occur?

In children and infants it usually occurs on the:^2d

scalp
knees
elbows
cheeks

In adults it usually occurs on the:^2d

creases of the wrists
elbows
knees
ankles
face and neck

What causes eczema?

When the skin is healthy, it performs an especially important function – it retains moisture and acts as a barrier to protect you from bacteria, irritants and allergens.^4c

Eczema is related to a gene variation that affects the skin’s ability to function in this protective manner; this allows the skin to be affected by various environmental factors, irritants and allergens.^4c

Eczema is thought to be caused by a “leaky” skin barrier. This means water escapes leaving the skin dry. Some people have this leaky skin gene passed down from parents or it is driven by factors in the environment.^2h

Eczema “flares” may be caused by:

pollen
house dust mite
animal dander
detergents
soaps

Who suffers from eczema?

Children and adults with a family history of eczema, allergies or asthma have increased risk of suffering from eczema during childhood and into adulthood.^4d

People with eczema can often also suffer from the following problems:^4e

Triggers

It is important to try to identify and avoid the triggers that irritate the skin and worsen eczema symptoms. Triggers that can worsen the skin reaction include:^2f

Stress
Soaps
Detergents
Chemicals
Dust
Pollen
Smoke
Fragrances
Certain fabrics
Certain foods (eggs, milk, soy and wheat)

Itch-scratch cycle^2e

rubbing or scratching the skin causes more irritation, and therefore, additional itching.

Treating eczema

The ultimate goal of treatment is to improve quality of life and ensure participation in school, work, sport and social activities.^2g

Tips to prevent eczema flares:^4a

When there is a lot of redness and swelling, applying creams or ointments that help reduce the inflammation are useful. Topical creams, ointments and lotions are applied directly to the skin.²ⁱ

Topical steroids

Steroids are anti-inflammatory medications used on the red and swollen areas of the rash^2j
Topical steroids come in different strengths^2j
A stronger or more potent steroid may clear the rash quicker but cannot be used in senstive areas like the face or underarms^2j
Topical steroid preparations that are available over the counter are less potent those requiring a prescription.^2j
Topical steroids are usually used as a first option^2j

Other treatment options include:

Immune modulating creams^2k
Antihistamines tablets and syrups (not creams)^2l
Wet Wraps: This therapy is used for people with severe or difficult to manage eczema. For this therapy, the patient would soak their skin in warm water for 15-20 minutes, pat it dry and apply a topical medication to the affected area. Then, a slightly wet dressing is applied to the area, followed by a dry wrap material such as a bandage, or cloth. Wraps are used for 2-6 hours and should be done with guidance from a healthcare professional.^2m
Antibiotics if skin is infected^2m
Allergy injections: An allergist / immunologist could suggest allergy injections as a treatment. This is when a small dose of what a patient is allergic to is injected under the skin in the arms and are currently approved for the treatment of asthma and allergic rhinitis.²ⁿ
Other stress-relieving therapies^2m