Eczema

What is eczema?

Eczema is a common chronic inflammatory condition affecting the skin. It is also known as atopic eczema or atopic dermatitis and affects people of all ages. Eczema is usually first seen in babies and young children.

Types of eczema

There are several types of eczema but the most common type is atopic eczema. Atopic eczema mostly affects children under the age of one, but it can also develop for the first time in older children and adults. It is closely linked with allergies and asthma, and often runs in families.

This type of eczema is usually a long-term condition, although those affected can see significant improvements as they get older, and it can even clear completely.

Other types of eczema include:

• Dyshidrotic eczema
  Commonly found on the hands, and characterised by tiny blisters over the skin which are very itchy

• Contact dermatitis
  Occurs when the skin comes into contact with a substance that irritates it

• Seborrhoeic eczema/dermatitis
  Characteristically found along the eyebrows, scalp line, ears and sides of the nose

• Discoid eczema
  Usually forms as circular patches on the skin

• Varicose eczema
  Often triggered through problems with blood flow and commonly found on the lower legs

What are the symptoms of eczema?

Typical eczema symptoms include:

• Dry, cracked, scaly skin

• Itching

• Redness

• Thickened skin where the rash usually appears

• Discoloration of the skin

While eczema can occur anywhere on the body, the most common areas are the backs of the knees, inside elbow creases and on the hands. More so in children, it’s also common to get eczema on the face and neck.

Sometimes, eczema rashes may become infected. If this occurs you may develop weeping patches of skin or yellow crust or patches to the eczema. The skin may also become swollen.

What causes eczema?

The exact cause of eczema is not known.

But, the most common form of eczema – atopic eczema – seems to be closely linked to people who also suffer with allergies, asthma or hay fever. Atopic eczema often runs in families too, so there may be a genetic predisposition.

There are many ‘triggers’ for an eczema flare-up. These include:

• Soaps, household cleansers and laundry detergents

• Cold weather

• Stress

• Certain fabrics (commonly wool and polyester)

• Fragrances

• Cigarette smoke

If you see a GP about your eczema, they may ask you to keep a food diary to try to determine whether a specific food makes your symptoms worse.

Most of the time you will not need an allergy test, but sometimes they can be helpful in identifying whether a food is triggering your symptoms.

How to treat eczema

Eczema is often a chronic illness. Sometimes children do grow out of eczema, but many adults will have eczema flare-ups throughout their lives. The most common treatment is regular application of emollients (moisturisers). These should be applied liberally and on a daily basis – even when you’re not having a flare-up.

Hands are often ‘problem areas’ because of the number of times a day we need to wash our hands, and the use of soaps or chemicals in cleaning or washing up products. Make sure you use emollients after each time you wash your hands if this is an issue for you.

If emollients alone are not sufficient to control an eczema flare-up, then a topical steroid cream can be trialled. A mild steroid cream can be bought over the counter from a pharmacy, and stronger creams are available with a prescription from a GP.

It’s best to try and prevent an eczema flare-up occuring in the first place, so try to identify your ‘triggers’ so you can avoid them. And make sure to avoid scratching, which will irritate the skin and make any flare-up worse.

Eczema in babies and children

1 in 5 babies and children have atopic eczema in the UK. The most common symptoms are dryness, itchiness and redness to the skin. Eczema often develops in babies during the first few months, but tends to improve as they get older. For some children with more severe eczema, their symptoms will continue as an adult.

Atopic eczema in babies and children can be mild, moderate or severe and a treatment plan will depend on the severity. Identifying and avoiding the main triggers for eczema helps manage symptoms for most babies and children. Always speak to a GP if you have any concerns.

When to see a GP

If you have symptoms of atopic eczema and need advice on how to manage it, a GP can help. They can usually diagnose eczema by taking a look at your skin and asking about your symptoms, how long you have had skin irritation and family history of eczema. A GP will also be able to suggest ways to manage and reduce your eczema symptoms.

You should also seek medical advice if:

• you’re unsure on the diagnosis or type of eczema you may have

• emollients are failing to improve an eczema flare-up

• your eczema looks infected

• your eczema is affecting your daily life