- What is eczema?
- What are the symptoms of eczema?
- What are the different types of eczema?
- How is eczema diagnosed?
- How is eczema treated?
- How can I prevent flare-ups?
Eczema (also called dermatitis) is a group of skin complaints that can affect all age groups and can occur anywhere on the body. It is an inflammatory response of the skin to either an external or internal factor. There may also be a combination of factors causing the problem.
It is estimated that about one in 10 people are affected by eczema at some point in their lives.
The appearance of eczema varies according to the specific type of eczema involved; however, intense itching is often the first symptom for all types of eczema. Other symptoms may include:
- Redness of the skin
- Weeping skin
- Scaling, crusting or dry skin
- Fissures (broken skin)
- Vesicles (small blisters)
- Pain or tenderness
- Thickening and scaling of the skin.
Atopic eczema is the most common form of eczema and is frequently associated with asthma and allergic rhinitis. In this condition, the body produces too much of a type of antibody, which reacts to various allergens such as dust or pollen, causing inflammation and itchiness. It is particularly common in young children and infants, many of whom outgrow the condition. There is a strong genetic component to this condition.
Contact dermatitis causes redness and itching on skin that has come into direct contact with an irritant or allergen. It can either result from frequent contact with an irritant to the skin, or from an immune reaction against an allergen, which often develops over a period of time. This type of eczema gets more common with age and is also associated with certain occupations that involve close proximity with chemicals – such as hairdressing or nursing.
Seborrhoeic dermatitis mainly affects the scalp, where it appears as dandruff in adults – however, it may also spread to the face, ears and chest. It can also occur in babies, where it appears as greasy, yellow scales; however these are not uncomfortable or itchy and the problem normally resolves within months.
Varicose eczema is caused by poor circulation and is more common in middle-to later years of life. It affects the ankles and lower legs, which become speckled, itchy and inflamed.
Discoid eczema most commonly occurs in adults, appearing as coin-shaped areas of red, irritated skin on the trunk or lower legs. It can be considered as an adult form of atopic eczema.
Pompholyx (also known as dishydrotic eczema) is characterised by intensely itchy vesicles on the hands, fingers and soles of the feet.
Juvenile plantar dermatosis is caused by friction of the sole of the foot with an ill-fitting synthetic shoe or trainer. It has become more common in recent years with modern footwear.
Lichen simplex is characterised by thickening of the skin, caused by rubbing and scratching over a prolonged period. It may begin with a localised itch, such as an insect bite, that becomes intensely irritated when scratched. Most commonly found on lower limbs and nape of neck.
Eczema craquelé is also known as asteatotic eczema – it causes large, dry scales in older people, giving a ‘crazy-paving’ appearance.
Light-sensitive eczema – this is a rare form of eczema caused by sunlight. It can also be caused by taking certain medication or using certain cosmetics.
Your doctor will carry out a thorough examination of your skin and ask you about family history of eczema and other allergic conditions, such as asthma. If allergic contact dermatitis is suspected, you may be referred to a hospital dermatology clinic to conduct either a ‘patch test’ or ‘skin prick test’ to test for allergens. Some GPs may provide this service themselves.
In the patch test a number of patches containing common allergens are applied to the skin, and then removed after a number of days to see if there has been a reaction. In the skin prick test, the doctor applies a small drop of allergen to the skin with a needle. If the person is sensitive to the particular allergen, a weal appears.
The tests enable the doctor to establish any substances that may be provoking the allergic response and these allergens can then be avoided.
Certain types of eczema may clear up on their own or can be resolved by avoiding particular triggers. For many sufferers however, eczema is a lifetime condition that has to be carefully managed and monitored. While eczema cannot be cured, it can be controlled.
A good knowledge of the condition combined with a willingness to develop daily skincare routines or take prevention measures is the key to controlling eczema. Moisturising the skin is the mainstay of treatment, and this can be achieved with the use of emollients. These are oil-based products, which act to soften and soothe the skin. They are available as moisturisers, soap alternatives, bath additives, emulsifying ointments and shower gels. It may take time to establish which type of product suits you.
Other treatments that your doctor may prescribe include:
- Topical steroid creams or ointments – these reduce inflammation and may be used to treat flare-ups
- Antibiotics may be used to treat eczema that has become infected
- Antihistamine tablets can sometimes be used to relieve itching at night-time
- In severe cases, oral steroids and other immunosuppressant therapies – such as cyclosporine, may be used.
- A steroid-free topical ointment called tacrolimus has been recently made available in Ireland, and may be prescribed for moderate or severe eczema, if other treatments have failed.
- If the eczema is due to an allergic reaction, avoid triggers – such as pets, pollen or certain foods.
- Include emollients in your daily routine to keep the skin moisturised: take a daily emollient bath to moisturise skin and relieve itch and apply moisturiser creams several times a day – it may be useful to carry a small tub of emollient with you in your schoolbag, handbag or car, to apply throughout the day.
- Avoid soap and commercially-prepared shower or bath products, which may dry the skin.
- Limit contact with any chemicals that may irritate the skin – such as detergents, cosmetics, household cleaners etc. Wear rubber gloves to protect your hands if you will be coming into contact with irritants.
- Try to avoid stress as this can often cause flare-ups.
- Avoid scratching and keep nails clean and short to avoid eczema becoming infected.
Visit the irishhealth.com Eczema Clinic for more information on all types of eczema.
Reviewed: November 29, 2006
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