Coping with eczema
Eczema - commonly known as dermatitis - is a
group of skin conditions that can affect anybody
of any age.
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Did you know?
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.
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The severity of the disease can vary. In mild
forms the skin is dry, hot and itchy, whilst
in more severe forms the skin can become broken,
raw and bleeding. Although it can sometimes look
unpleasant, eczema is not contagious. With treatment
the inflammation of eczema can be reduced, though
the skin will always be sensitive to flare-ups
and need extra care.
How common is eczema?
The National Eczema Society estimates that up to 20 per cent of all schoolchildren
are affected by eczema, however, in nearly half of these children, the disease
will improve by the time they are 15 years of age. About one in twelve adults
have some form of the disease.
What are the causes of eczema?
The causes of eczema are many and varied, and depend on the particular type
of eczema that a person has. The first, atopic eczema, is thought to be a
hereditary condition, and can be passed down through generations. It would
seem that people with atopic eczema are sensitive to allergens in the environment,
which are harmless to others, e.g. dust mites and animal hair and skin. Associated
atopic conditions include asthma and hayfever.
Other types of eczema are caused by contact
with irritants, such as chemicals and detergents,
or allergens such as nickel and yeast growths.
In later life, 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.
Treatment
The first step in the effective treatment of eczema is a correct diagnosis.
If you think you may be suffering form eczema, visit your pharmacist or GP
who will be able to make an accurate diagnosis.
There is currently no cure for eczema although
research continues to shed new light on the condition.
However, there are many ways to minimise the
discomfort and distress which eczema can bring,
the foundation of which is an effective skin
care routine. A wide range of treatments is available,
either over the counter at the pharmacy, or on
prescription from a doctor.
Many complementary therapies are available,
which some people find helpful. In addition,
there are ways of minimising environmental allergens
commonly found in the home.
Emollients
Emollients are necessary to reduce water loss from the skin, preventing the
dryness normally associated with eczema. By providing a seal or barrier,
the skin is less dry, itchy and more comfortable. Emollients are safe to
use as often as you need and are available in various forms: ointments for
very dry skin or creams and lotions for mild to moderate or 'wet' eczema.
Some are applied directly to the skin, whilst others are used as soap substitutes
or can be added to the bath. The range of emollients available is enormous
and it may be necessary to try several before the most suitable one is found.
Testing a small amount on the skin first is advisable, as some emollients
contain substances, which you might be sensitive to.
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 eczema. Topical steroids
come in four different strengths, mild, moderately potent, potent and very
potent. The milder steroid creams are available over-the-counter while the
stronger creams are available with a prescription from the GP. The strength
of steroid cream recommended for mild eczema depends on the age of the patient,
the severity of the condition and, the size of the area and part of the body
to be treated.
Topical steroids are applied thinly to the affected
area, as directed by the prescribing doctor,
and are used until the 'flare up' subsides and
the condition is under control again. Your eczema
should be reviewed regularly if topical steroids
are being applied. It is important to use only
the steroid cream prescribed for yourself and
not to lend or borrow (what may be) an unsuitable
cream from someone else. Many people have concerns
regarding the use of topical steroids and their
side-effects, but as long as they are used appropriately
and as directed by your doctor, the likelihood
of side effects is very rare. Reported side-effects
have been largely due to the use of very potent
steroid preparations over long periods of time.
Oral steroids
If eczema is very severe, and other treatments have not worked, your dermatologist
might consider oral steroids. These can have possible side-effects and the
doctor should monitor you closely if you are taking oral steroids.
Other treatments that your doctor may discuss
are anti-histamines to reduce inflammation and
wet wrap bandaging to soothe dry itchy skin.
Ultra Violet light treatment and stronger medication
may be considered for very severe eczema.
Alternative Therapies
Evening primrose oil is now commonly used and other treatments such as aromatherapy,
relaxation and homeopathy are available, although their effectiveness are
not confirmed.
Diet
The role of diet in the management of eczema has not been proven, however,
dietary changes can be quite helpful in babies and young children. If you
do try modifying your child's diet, seek advice first from a dietcian, or
a nutritional therapist, in order to ensure that the child continues to receive
adequate nutrients.
Remember
It should be stressed
that what works for one person will
not always work for another. Eczema
is a highly individual condition, which
is why it is so difficult to find a "cure-all".
Discuss your treatment programme with
your GP, dermatologist or pharmacist.
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Helpful advice
- Regularly vacuum, damp dust and air bedding
to get rid of dust mites - if you can, get
someone else to do it for you
- Wear cotton clothing
- Put cotton sheets on the bed to keep the
skin cool and allow it to breathe
- Use a non-biological washing powder and avoid
fabric softeners
- Children's nails should be kept short to
stop them scratching
- At night-time, cotton mittens over children's
hands can be helpful in stopping them scratching
and hurting themselves
Relevant links
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