Word on Health

Word On Eczema

Our thanks to the National Eczema Society (NES)  for the information we've posted below.  For more detailed information please visit their website by clicking here www.eczema.org or call their freephone helpline on 0800 089 1122

Eczema: An Introduction  Eczema, or contact dermatitis as it is sometimes called, is a group of skin conditions which can affect all age groups but is primarily seen in children.  In the United Kingdom, up to one-fifth of all children of school age have eczema, along with about one in twelve of the adult population. Those who “grow out” of their eczema during early childhood may see it recur again in later life. One in twelve adults have eczema - eczema and contact dermatitis account for 84-90% of occupational skin disease.

It is a highly individual condition which varies from person to person and comes in many different forms. It is not contagious so you cannot catch it from someone else. The word eczema comes from the Greek word “ekzein”, which means “to boil.”

In mild cases of eczema, the skin is dry, scaly, red and itchy. In more severe cases there may be weeping, crusting and bleeding. Constant scratching causes the skin to split and bleed and also leaves it open to infection.

Despite its prevalence in our society, poll after poll shows that public ignorance and misconceptions remain adding to the impact of the condition. It is not an outcome of poor personal hygiene nor is it contagious.

With treatment, the inflammation of eczema can be reduced, though the skin will always be sensitive to flare-ups and need extra care.

The causes of eczema are many and varied and depend on the particular type of eczema that a person has. Atopic eczema is thought to be a hereditary condition, being genetically linked. It is proposed that people with atopic eczema are sensitive to allergens in the environment which are harmless to others. In atopy, there is an excessive reaction by the immune system producing inflamed, irritated and sore skin. Associated atopic conditions include asthma and hayfever.

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.

Different types of eczema have different causes and treatments. Sometimes eczema is referred to by the area affected (e.g. hand eczema). However, more than one type of eczema can affect the same area of the body. Click here to visit the National Eczema Society website to find out more about the different types of eczema.  

Treating eczema – a stepped approach. The recommended first-line (basic) treatments for most cases of eczema are emollients and topical steroids. Paste bandages and wet wraps may be a helpful addition for some people, particularly where scratching is a major problem. Sedating-type antihistamines may be useful in helping with sleeping at night (they do not help the itch in eczema). Long-term use is not recommended.

When there is an inadequate response to appropriate strengths of topical steroid, or if these are not tolerated, especially on areas of delicate skin, topical calcineurin inhibitors – the cream pimecrolimus (Elidel) or the ointment tacrolimus (Protopic) – may be useful.

Treatments for more severe eczema, or ‘additional treatments’, include phototherapy, oral steroids, oral immunosuppressant drugs and a biologic drug.

The National Eczema Society advise that before progressing to additional treatments it is essential to check that there is no other explanation for the eczema being uncontrolled. The following are examples of questions that should be considered by your doctor, but it is not an exhaustive list:

  • Have all topical therapies (with extensive education) been used to the highest dose possible that is safe? (For topical steroids, the quantity and potency should be taken into consideration, plus age, body site and the extent of the condition. For more information on topical steroids, including information on the amount to use based on the Finger Tip Unit (FTU), please see our Topical steroids factsheet.)
  • Have all irritants and allergens been identified and avoided to the extent practicable?
  • Has infection been controlled? (This may be bacterial, e.g. Staphylococcus aureus and/or viral, e.g. herpes simplex.)
  • Is the eczema diagnosis correct? (Sometimes other diseases can exist alongside or be confused with eczema.)

For more on this click here.

About triggers. Establishing a good skin care routine is essential, but you will also benefit from identifying and avoiding things (there may be several) that trigger an eczema flare. Unfortunately, there is currently little clinical evidence to confirm which of the commonly suspected triggers really do produce flares.

Nevertheless, the experiences of people with eczema and the clinical observations of dermatology doctors and nurses point to a number of possible culprits. If the neck or face are affected, consider airborne allergens such as house-dust mite, pollen, perfume, chemicals, etc.

Visit the National Eczema Society website click here  to find out more about different triggers and factors that can affect eczema, and how to manage or minimise your exposure to them.

For more information, help, and support visit the National Eczema Society (NES) website www.eczema.org or call their freephone helpline on 0800 089 1122

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All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.