Atopic eczema and dermatitis

Eczema and dermatitis are really just different words for the same condition. The main characteristics are of an inflammation of the skin, usually associated with dryness, with skin scales present. The rash is very often itchy, and although it can happen anywhere on the body, common sites include the scalp, behind the knees and the sides of the elbows. It is in the same class of illnesses as asthma and hayfever, and if you or your family members have these conditions, you will be more likely than others to develop eczema.

There are many possible causes or triggers. Essentially, eczema is a type of allergic reaction, where the body responds inappropriately to an external factor, such as a chemical irritant, or something internal, such as stress. There can be many potential triggers. It is useful to reduce your exposure to the most common ones. Read on to find out about what you can do.

What treatment is available
Moisturising creams, without perfume, or colouring are useful for all sorts of eczema. These counteract dryness, and help to break the itch-scratch-itch cycle. There are various sorts available, but essentially, the water-based creams are easier to put on, and less greasy. However, they do not work as well as the thicker oil-based creams and ointments. The latter are best at keeping the skin moist and supple. This is the essential cornerstone to the successful treatment of eczema. There is no reason to buy expensive fragrant creams. Many people use a relatively thin moisturiser in the summer and switch to a thick, oily cream in the winter.

Bath oils and shower gels are also available.

For more severe eczema, and where the skin is inflamed and itchy, steroid creams are extremely effective. They reduce the inflammation, and are quite safe as long as you follow the instructions given by your doctor.

If you have trouble sleeping, a doctor may prescribe antihistamines, which reduce the itchiness and can cause drowsiness.

If you find that your eczema suddenly gets worse, it may be because it has got infected. There may be cracks developing in thickened areas of your skin, and there may be patches of yellow crusting and weeping. If this happens, see the nurse or your doctor as you will probably need some antibiotic treatment.

In general, if your eczema is suddenly getting a lot worse it may also be because you need different or stronger creams. You should see your doctor for advice.

How long will it last
Babies and young children often get eczema, but many grow out of it. Otherwise eczema is a condition that will stay with you. It cannot be permanently ‘cured’, but it can be kept under control, so that it causes the very minimum of discomfort. It may come and go, being worse at certain times than others, or it can go away and not cause any problems for years.

Self help measures
Many things can cause eczema to flare up. It is important to try to find out what makes your eczema worse. This list gives some of the more common factors to be aware of.

House dust mites
The allergen produced by the house dust mite is now believed to be one of the most important triggers of eczema, asthma, and allergic rhinitis. One of the best things you can do is to concentrate on measures to reduce their numbers in the house. For details on how to do this follow this link.

Water and creams
Do not shower or bath more than once a day. Shower or bath in warm, not hot water. Use an emollient designed for use with water, such as Oilatum.

Avoid the over-use of soap. Use a mild soap with a skin-friendly pH-value. Skin should be dabbed rather than rubbed dry.

Apply a moisturiser while skin is still a bit damp. If you are using steroid creams, allow the moisturiser to soak into the skin for about 10 minutes and then apply the steroid cream to the areas affected by the rash.

Almost any washing products can worsen your eczema. Use non-biological, non-perfumed products. Avoid fabric conditioners.

Wear light clothes made of cotton to reduce irritation. Avoid woollen, synthetic or rough textured clothes.

Foods and eczema
The part played by food allergy in causing eczema is controversial. Some experts say that there is limited evidence connecting food allergy with eczema, with the exception of cow’s milk in babies and small children. However anecdotally, there are many sufferers who say that their symptoms have improved after excluding certain foods.

Trying to find the foods that may aggravate your skin is difficult, but one way is to eliminate certain foods, one at a time and watch to see what happens to your skin. If there is going to be some improvement it should happen within six weeks. Don’t try to diagnose food allergy in this way with children without the advice and support of an experienced professional.

Foods that have been reported to trigger eczema include cows milk, eggs, nuts (especially peanuts), fish, citrus fruits, chocolates, additives, wheat and yeast.

Almost any furry or feathered animal can trigger eczema. It is not the fur itself, which causes the problem, but flakes of skin (dander) which irritate some peoples skin. Not having these pets at all is often the best decision, but otherwise you should restrict your pets to parts of the house which are easily cleaned and you should ban them from the bedroom.

Grass and tree pollens commonly cause hayfever, but they can often aggravate eczema. You may find that exposed parts of your skin are worse between the months of March to July. If this is the case try to reduce exposure to pollen by keeping windows shut in your car and home, especially in mid-morning, and late afternoon. Avoid freshly mown grass.

Other measures

  • Air the home, and turn the heating down.
  • Do not over-indulge in sunbathing. Excessive exposure to sun rays can cause dry skin, wrinkles and skin cancer.
  • Metals in contact with the skin can trigger a reaction at that site or elsewhere. This is commonly seen with watchstraps, or jewellery.
  • Avoid smoky rooms.
  • Keep your nails short.

Further information

The Allergy Foundation. An excellent site that gives general information about allergies

The National Eczema Society. They are dedicated to the needs of people with sensitive skin and eczema

This article published on
01 July 2005

Next review date 7/1/2013


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