Whilst it’s safe to say that Eczema is well documented and that treatments for it are readily available, it is good to know you can get free, confidential advice about eczema. This is provided by the National Eczema Society, who this week are running a charity drive. As a charity, the National Eczema Society relies on public donations to fund their helpline.
Whether you’re too embarrassed to visit your doctor, are in need of reassurance that your eczema isn’t something more serious, or you just need an understanding ear, the Eczema Society are ready to take your call. With an estimated 5 million eczema sufferers in the UK alone they certainly have their work cut out for them, so please give generously to help them continue their good work. You can find the National Eczema Society website here.
So what is eczema?
In the broadest sense eczema (also know as dermatitis) is a dry skin condition typically accompanied by intense itchiness. Sufferers will often need to fight the urge to constantly scratch away at affected areas. If left untreated the act of continual scratching can cause the skin to split and bleed, which in turn can lead to infection.
With no known cure, eczema can affect all age groups, with the highest concentration of cases affecting children. Worried parents can take some solace in the fact that children can ‘outgrow’ eczema, although in some cases it can return again in later life.
Eczema can take several different forms;
By far the most common form of eczema, especially for children, ‘atopic’ refers to a tendency within the family to develop eczema, asthma and/or hay fever. Atopic eczema carries with it the common irritable itchiness mentioned above. It can occur in isolated patches or all over the body.
Atopic eczema can flare up and calm down with skin tending to remain dry throughout. It’s important to note that flare ups can be triggered by environmental factors in a similar way to allergies. Triggers can come from a number of different sources ranging from soaps or detergents to exposure to dust-mites. Being watchful and eliminating the risks of triggers can go a long way to reducing the occurrence of flare ups. One of my boys, for example, gets particularly bad eczema during summer months when he’ll naturally get more sweaty. When he’s at home we aim to keep the house as cool as possible which goes some way to helping.
Also referred to as occupational skin disease, contact eczema is caused by contact with an irritant or exposure over a long period to (otherwise) harmless substances which cause an allergic reaction. Contact eczema most commonly affects the hands or face but can also appear anywhere on the body. Adults who suffered atopic eczema as a child may experience contact eczema.
Redness, dryness, skin burns, blistering and intense itchiness are all symptoms of this form. As with atopic eczema, identifying the irritating factors and avoiding exposure to them can help. Mild irritants can include diluted acids, solvents and cement. Allergic reactions can be caused by exposure to preservatives found in cosmetics and hair dyes, perfumes and nickel – found commonly in jewellery, the studs of jeans and zips.
This form of eczema affects areas of the body which naturally become more greasy. For adults seborrhoeic eczema will commonly start on the scalp spreading to other areas, it can also be found in the armpits, under the breasts and around the groin. Affected areas become irritable and inflamed and shed dandruff-like flakes of skin.
Seborrhoeic eczema can be fairly common for infants under one year old. Often starting in the nappy area and spreading across the body, affected areas will appear red, patchy and inflamed. Small skin flakes can also appear which will rub off easily. Fortunately it’s very uncommon for childhood seborrhoeic eczema to cause discomfort and your baby should be largely unfazed by it.
The yeast pityrosporum ovale is found on the skin of sufferers with seborrhoeic eczema. Medical science has yet to prove whether this is the cause or an accompanying factor, it thrives however in particularly sweaty areas of the body, so extra care in cleansing these areas can be of benefit.
Distinguished by the appearance of disc -shaped patches, discoid eczema tends to manifest itself on the lower legs or forearms. These patches will start off bumpy and dry. After a matter of days the discs will begin to ooze fluid and become extremely itchy and crusted. After this, the discs clear up and the skin dries and flakes. It is very rare for the discoid form of eczema to attack children.
Although there is no defining cause for discoid eczema, sufferers in general will have drier skin and are more likely to have experienced eczema as a child.
Gravitational eczema is most common in older people, especially women. Those who have a blood clot in the legs, have poor circulation, varicose veins or are overweight are most at risk. In severe cases the skin can form weeping crusted areas which, if left untreated, can form into varicose ulcers.
This form of eczema almost exclusively affects people over the age of 60. Initially appearing as pinkish, raised grooves on the shins. Asteatotic eczema will generally affect the legs, although there are cases of it showing in the upper arms, lower back and thighs. This form of eczema can cause great discomfort, becoming very sore and itchy.
Although again the exact cause is unknown, asteatotic eczema sufferers tend to have a lower level of oils in the skin. Contributing factors can be over- cleansing/drying of the skin, low humidity and hot baths.
The prominent defining factor of pompholyx eczema is that it will only affect the hands and feet, although it can attach itself to other eczema forms around the body. Blisters appear on the sides of the fingers, the palms and the soles of the feet. The affected areas flare up, becoming extremely itchy. Blistering can break, causing weeping and later peeling skin as these areas dry.
Interestingly it is speculated that emotional tension may be a cause of pompholyx eczema with other possible factors including overheating and excessive sweating. Some evidence also suggests that this form of eczema, like contact eczema, can be triggered by allergic reactions to metals such as nickel or chromate.
Given there’s no known cure for eczema the only possible avenues of treatment focus on prevention and relief from the symptoms. As dryness is common to all eczema forms, the use of emollients is a fundamental preventative treatment. Here’s a link to our selection of emollients;
Emollients are specialised moisturisers which keep the skin soft and supple by replacing lost water, fats and oils. For many eczema sufferers continual and unsparing use of emollients will go a long way to keeping the symptoms at bay. Often finding the right emollient for you or your child can be a case of trial and error but you can consult your pharmacist or doctor for more information. The National Eczema Society also produce a fact sheet on emollients which you can download from this page:
Another way to keep the skin moisturised is to use emollient additives when washing. Emollient oils can be added to bath water and there are also emollient soaps and shampoos which can be used in place of conventional products. For a list of the emollient bathing products we offer, please click this link:
From my own experience, using emollient oil at bath time is a good cost effective way to combat eczema, as only a small amount needs to be added to bath water.
Whilst we’re on the subject of bathing, a recommended treatment for seborrhoeic eczema in adults is the use of medicated shampoos. If used in the early stages, these will help stave off the yeast infection. By far our most popular medicated shampoo is Alphosyl which you can view here:
When eczema flares up, you can also use corticosteroids to help reduce inflammation and itchiness. Corticosteroids, like emollient creams, are added directly to the skin in problem areas. They come in a range of different strengths and could have negative side effects if used incorrectly. We highly recommend you seek advice from your doctor when choosing which corticosteroid to use. For a list of the corticosteroid (steroid) creams we offer please click this link:
Beyond these treatments, there are a number of different methods you may wish to investigate. For some eczema sufferers, an investigation into diet and the exclusion of certain foods has helped. There are also many complimentary medicines on the market. Although sound medical advice will tell you complementary medicines are by no means an absolute cure, a combination of complementary medicines combined with pharmaceuticals has, in some cases, been of benefit. Always veer on the side of caution when choosing complementary alternatives as ‘natural’ doesn’t always necessarily mean safe. Do your research and avoid anything containing ingredients that you are aware might cause allergic reactions.
I think it’s important to add in closing that eczema sufferers, young and old, can and do live fulfilling, happy lives. Being sensitive to how the world affects your eczema is crucial but don’t let knowledge of this force you into missing out on all the rich experiences of life; we can’t live our lives in a bubble after all!
Find out what works best for you and stick with it in your daily routine, you may need to spend extra time attending to your eczema but I’ve seen people spend hours on just their hair. These people aren’t ‘special’ or ‘different’ and neither are you!
Good luck to you all