What is eczema?
Eczema is a condition characterised by patches of red, itchy skin. It is also known as dermatitis (a word mean inflammation of the skin). There are various types of eczema, including discoid and varicose, however the most common form is atopic eczema. It is common in people who have allergies.
Typically, patches of atopic eczema occur in areas of the body where there are folds of skin (the knees, elbows, neck and areas of the face). Eczema can be identified by skin that is itchy, red and dry. In more severe cases it can become sore, cracked and even bleed. Atopic eczema also comes and goes, getting worse when your skin is subjected to triggers or allergens. For more information about eczema, click here.
Though there is no cure for eczema, there are various types of eczema treatment that can help keep the condition under control.
What types of eczema treatment are there?
There are generally three different aspects involved in eczema treatment:
Some people may find that by merely adapting their lifestyle (e.g. avoiding certain triggers or allergens, changing their diet) and using emollients, they can avoid bad flare-ups of eczema. Others may require regular use of medicines and specialised eczema treatments.
One of the best things you can do to ease your eczema is to avoid triggers that make it worse and lead to flare-ups. This may involve environmental factors, or a change of diet - although you should always consult your GP before making drastic changes to what you eat. You should also avoid scratching eczema, no matter how itchy it is! Constantly scratching eczema patches can thicken the skin and leave it vulnerable to bacteria, leading to infection.
Emollients are the standard eczema treatment, typically used by all eczema sufferers. Emollients are moisturising creams, lotions or ointments that are applied to dry skin to seal in moisture.
- Ointments are best for very dry skin, as they contain the most oil.
- Lotions are better for skin that is less dry, as they contain more water and less oil than ointments.
- Creams are a halfway point between ointments and lotions.
There are many different emollients available, and a huge number can be bought in pharmacies without a prescription. Popular over-the-counter emollients include E45 and Oilatum. Typically, emollients should be used at least once a day. The purpose of emollients is to keep the skin soothed, and prevent inflammation, which is why they should be used regularly. However, after using one emollient for a long period, it may become ineffective, or may even start to irritate your skin. In this case, your GP or pharmacist will be able to prescribe or recommend another type.
- use a large amount
- avoid rubbing the emollient in - instead, you should smooth it into your skin in the same direction that your hair grows
- re-apply emollient every two to three hours if you have very dry skin
- apply emollient on damp skin after bathing - do not wait for your skin to dry first
- avoid spreading infection by not sharing emollients, and washing your hands before use
Emollients should be used at all times - when your skin is good, and when it is inflamed.
There are two main types of medicine used in the management of eczema flare-ups: topical corticosteroids and antihistamines.
As with emollients, topical corticosteroid creams and ointments are a kind of eczema treatment applied to the affected areas of the skin - unlike emollients, however, they should be used sparingly. Commonly used topical corticosteroids include Betnovate and hydrocortisone.
Corticosteroids are also available in tablet form. These are only taken to help treat severe eczema and they are used far less frequently than topical creams and ointments.
Using topical corticosteroids
- only apply during a flare-up
- first apply an emollient and wait 30 minutes for this to soak into the skin
- apply the recommended amount of corticosteroid cream or ointment - do not use more than you are directed to
- stop using topical corticosteroids as soon as the flare-up has cleared
Antihistamines can also be taken to treat the allergic reaction underpinning your eczema. Your doctor may prescribe you sedating or non-sedating antihistamines if you have severe itching (sedating antihistamines are useful if itching prevents you from sleeping).
Treatments for severe eczema
Sometimes the treatments listed above will not help to control your eczema. In this case, you may be referred to a specialist who can offer the following types of eczema treatment:
- phototherapy, where areas of affected skin are exposed to UV light
- bandaging of the skin with medicated dressings
- medicines to suppress your immune system
- alitretinoin, a medicine used specifically for severe hand eczema
In some cases, people with eczema may just require more guidance about how to correctly use their treatments, or how to avoid triggers that can set off flare-ups.
In the event that your eczema becomes infected, your doctor may give you a course of antibiotics such as flucloxacillin.
Patches of inflamed skin can easily become infected if they are scratched too much, or if the inflammation is so severe the skin becomes cracked. It is also easy to spread bacteria through the application of creams, lotions and ointments - for this reason, you should always make sure to apply them as cleanly and carefully as possible. Topical antiseptic lotions can also be used to treat infection-prone areas of skin.