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Eczema

Woman with eczema scratching her arm

Eczema is a skin condition also known as dermatitis (meaning “inflammation of the skin”). Mild eczema is typically characterised by red, itchy, scaly skin. In more severe cases, the skin can weep, crust and even bleed - this is worsened by persistent scratching.

Eczema is a very common condition. Eczema.org estimates that in the UK, 1 in 5 children and 1 in 12 adults have eczema. Luckily, eczema is a condition that many people grow out of when they reach adulthood. And for people for whom it is a persistent problem, there are a range of treatments and approaches that can make it more manageable.

What causes eczema?

There are several different types of eczema including:

  • discoid (circular or oval patches of eczema, most common in adults)
  • varicose (eczema that occurs on the legs, particularly if swollen veins are present)
  • seborrhoeic (red, scaly patches on the face and scalp)
  • dyshidrotic (causing tiny blisters on the palms)
  • contact dermatitis (triggered by the body coming into contact with a certain substance)

The most common type of eczema is atopic. “Atopic” is a word used to refer to people who have a particular sensitivity to certain allergens. Atopic eczema tends to be a problem for people who have other allergies, or conditions such as asthma. Atopic eczema also tends to run in families - evidence suggests that if both parents have atopic eczema, there is an 80% chance that their child will be a sufferer as well.

It is generally understood that this kind of eczema is caused by a mixture of a genetic predisposition, and environmental factors such as those listed below.

Allergens

Dust mites, pet hair and pollen are common allergens that can worsen eczema. Some people may also react to certain foods, such as nuts, wheat and cow’s milk.

Irritants

Harsh soaps and detergents, certain types of fabric and dust can irritate the skin. The weather can also play a part - environments that are too hot, damp, cold or dry can worsen your skin.

Hormonal changes

Some women find that their eczema gets worse at certain times during their menstrual cycle. It is also common for pregnant women to go through flare-ups.

Lifestyle

Stress is known to be related to eczema, however the stress may in some cases actually be caused by a worsening of your skin and not vice versa. Exercise is always recommended for a healthy lifestyle, but sweat can worsen eczema symptoms. On the other hand, over-washing can also exacerbate eczema as soap dries out the skin.

What are the symptoms of eczema?

Many people will have eczema symptoms all the time, but will find that they flare up and become worse depending on the triggers listed above. Atopic eczema tends to appear in the folds of the skin, including behind the knees, inside the elbows, around the eyes and under the arms.

Mild eczema tends to occur in small patches, and makes your skin:

  • itchy
  • red
  • dry
  • sometimes cracked

Severe eczema can cause more extreme symptoms, including:

  • widespread dryness
  • constant itching
  • skin that oozes fluid
  • bleeding

Symptoms will become more severe during a bad flare-up, leading to very itchy, sore skin that is weeping or swollen. If there are openings in the skin it can become infected with bacteria such as Staphylococcus aureus. Scratching your skin a lot makes it more susceptible to this kind of infection.

Is eczema the same as psoriasis?

No. Psoriasis is a condition related to the immune system that causes the build-up of skin cells. Eczema is an inflammation of the skin brought on by being sensitive to certain triggers. Psoriasis is usually recognisable by its plaques: raised, shiny red patches of skin covered in silvery scales. Eczema is generally recognisable by the inflamed quality of the skin.

It is generally not possible to suffer from both psoriasis and eczema at the same time, due to the biology of the skin. Both conditions, however, can be effectively treated with the use of emollients, and topical creams and ointments.

What treatments are there for eczema?

There is no cure for eczema, but there are certain treatments that can make the condition more manageable. Typically, these include emollients (moisturisers) used daily, and topical corticosteroids such as hydrocortisone and Betnovate RD (these are generally used during a flare-up).

Other treatments include:

  • antihistamines for severe itching
  • oral corticosteroids, to reduce inflammation
  • antibiotics, to treat any infection of the skin
  • medicines and creams which suppress the immune system (such as hydrocortisone and Betnovate)

In general, the best way to keep your eczema under control is to get an understanding of the triggers that cause your skin to worsen, so you can avoid them.