Eczema

What is eczema?

Eczema is a common skin condition that affects both children and adults. It’s also known as atopic eczema, atopic dermatitis and allergic eczema.

If you have eczema, your skin doesn’t keep the moisture in very well, so it becomes dry and easily irritated. This causes chemicals to be released, which worsens your irritation and makes you want to scratch. Scratching only makes your skin more itchy, and so the cycle repeats itself. This can be very frustrating.

What are the symptoms of eczema?

The most common type of eczema involves areas of red, dry, itchy skin, most commonly found in the creases of your elbows, behind your knees and on your wrists and ankles. These symptoms can affect both adults and children. Children with atopic eczema may have weeping, crusted dermatitis on the face and neck.

What causes eczema?

Nobody knows exactly what causes eczema, but it can run in families. If you have atopic eczema, you may also have other allergic conditions, for example, hay fever or asthma.

What triggers eczema?

A trigger is anything that might make your eczema symptoms worse. Some common examples include:

• chemicals, artificial colours, preservatives, perfumes or soap
• sand, carpet, woollen or prickly fabrics
• viral infections
• heat
• stress

Triggers vary from person to person, so not all of these things will affect every person with eczema. Identifying your personal triggers will help you manage your eczema.

How is eczema diagnosed?

Your doctor will diagnose eczema by talking to you and examining you. They might also refer you for allergy tests to help with the diagnosis and guide your treatment. Your doctor will help you identify what triggers your eczema.

How is eczema treated?

While there is no cure, eczema is treatable. Steroid creams are the most common prescription treatment that your doctor may recommend during eczema flare-ups.

Here is some general advice for managing your eczema:

• Protect your skin by applying a moisturiser or emollient at least twice every day, including during periods between flare-ups when your eczema is under control. Thick moisturisers or ointments are best.
• Wet dressings can help cool, protect and rehydrate your skin.
• Treat flare-ups by using ointments or creams prescribed by your doctor. You may need intermittent courses of steroid creams. Your doctor will recommend weak steroids for eczema affecting the face, underarms and groin areas, and stronger steroids for other areas. Be careful to use the cream exactly as your doctor recommended. You don’t need to worry about side effects of steroid creams, as these are rare in both children and adults, as long as you use them as prescribed.
• Control itching by using antihistamines, a cold compress for the affected area and trying not to scratch. Sometimes your doctor may also recommend steroid creams to control the itching, used less intensively than during a flare-up.
• Control infection by using antibiotics to treat infection, if prescribed by your doctor.

Some dermatologists might also use ultraviolet light (PUVA) and some strong oral medicines to reduce inflammation if your eczema is severe.

You may find that your eczema improves as you get older.

How can I prevent eczema flare-ups?

Once you know what triggers your eczema, your doctor may be able to help you develop an eczema action plan. This is your personal guide and checklist for how to manage your eczema and prevent it from flaring up.

Some things your doctor may recommend include:

• moisturising daily — even when your skin is healthy, and avoid any chemical additives in moisturisers that may trigger your eczema
• avoiding your triggers
• avoiding things that can damage or dry out your skin, like soap or bubble bath
• making sure your baths and showers aren’t too hot
• rinsing off chlorine from swimming pools straight after swimming
• avoiding overheating
• not wearing woollen fabrics directly on your skin