What is eczema?
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
It is estimated that about one in 10 people
are affected by eczema at some point in their lives.
What are the symptoms of eczema?
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.
What are the different types of eczema?
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’
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.
How is eczema diagnosed?
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.
How is eczema treated?
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
Other treatments that your doctor may
- 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.
How can I prevent flare-ups?
- 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
- Try to avoid stress as this can often cause
- 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.