Eczema - triggers and treatments
What is Eczema?
ECZEMA is a longterm, dry itchy skin condition. It is triggered by irritants (such as soaps and detergents) and allergens (such as house dustmites, moulds and some foods). It is NOT contagious.
Eczema varies from person to person. One person may have a only a few small patches of dry skin, another may have numerous large areas of very sore, red and itchy skin.
The cause of eczema is not known although genetic factors do play apart. Atopic eczema occurs in about 8 out of 10 children where both parents have the condition and in about 6 in 10 children where one parent has it.
Eczema affects 1 in 5 children and 1 in 12 adults in the UK - so you are not alone. Most cases first develop in children under 5 and in the majority of cases the flare-ups have either gone completely by the mid-teens or are much less of a problem.It is unusual to develop eczema after 20.
Why does Eczema occur?
In a healthy person, the outer layer of the skin forms a strong, flexible barrier that regulates water loss and prevents irritants and allergens entering. This layer is kept soft and supple due to its water and fat content. When you have eczema, this skin barrier can be defective. There are reduced fats which are essential for healthy skin and the outer layer becomes thinner. Gaps open up between the cells allowing irritants and allergens to enter. This is what triggers an eczema flare up.
What are the symptoms?
The main symptom is itchy skin.
In mild cases the skin is dry, scaly, red and itchy. In more severe cases there may be weeping, crusting, cracking and bleeding.
Scratching can cause inflammation, delay healing and lead to infection. It can also make the itching worse, triggering an itch-scratch cycle - so the more you scratch, the more you itch. Having to scratch so often can be very distressing for people with eczema and have a negative impact on sleep. This in turn can have an impact on the whole family. Children with eczema can also have problems with low self-esteem and may even suffer bullying.
Where does it appear?
Eczema can appear on any area of the body and may typically flare up two or three times a month.
Babies and infants with eczema tend to have it on the cheeks and scalp, on the limbs, sometimes the trunk, but rarely the nappy area.
Older children and adults have more eczema in the creases and folds of the skin such as inner elbows and backs of knees.
What are the triggers?
Many things can cause an eczema flare up and these include
- soaps and detergents
- toiletries and perfumes
- rough clothing, man-made fibres
- extremes of temperature
How to treat Eczema with emollients
Emollients contain fats that are designed to hydrate and soften the dry outer layers of skin with eczema. Emollients should form the basis of your dry skin and eczema management and should always be used, even when the eczema is clear. It is tempting to stop using emollients when you have no symptoms, but continuous use will help to reduce the risk of future flare ups. You should use emollients as a leave-on moisturiser and for washing, showering and when taking a bath in order to avoid the irritants in detergents and soaps.
How to use emollients correctly to manage your dry skin and eczema
The message is "moisturise, moisturise, moisturise"! Use emollients frequently and generously and as a replacement for soaps and detergents.
Apply in the direction of the hair growth to maximise effects but do not rub into the skin too vigorously as this can have the same damaging effect as scratching.
How much should you use?
The National Eczema Society recommends that you should use 250-500g of emollient cream every week to keep eczema symptoms at bay.
- Scalp - 3.5-7g per day
- Trunk - 38g per day
- Both hands - 2-4 g per day
- Face - 1-2g per day
- Both arms or legs - 28g per day
- Groin and genitalia - 1-2g per day