Eczema
What is eczema?
Eczema (aka atopic dermatitis) is a common range of chronic inflammatory skin condition where patches of skin can become inflamed, red, scaly, and itchy. When the skin’s barrier is damaged, it can dry out easily and allow moisture to escape.
With eczema, it is harder to repair damage to the skin barrier, making it prone to irritants or allergens which can trigger the skin to release chemicals that make the skin itchy.
Eczema rash is most common in infants (affecting 1 in 3 Australian children), however anyone of any age can be affected. Approximately 10-15% of the Australian population experience eczema.
Eczema can be uncomfortable, however a combination of treatments and lifestyle changes can help manage it effectively and avoid flare ups.
What causes eczema?
The exact cause of eczema is not fully understood, however a combination of genetics, the immune system and triggers are thought to play a role.
One important thing to remember is that eczema is not contagious and cannot be caught or passed on from another person. It is believed that eczema is triggered when an overactive immune system is exposed to irritants (either inside or outside the body) and responds aggressively by producing inflammation which causes red, itchy skin.
Some people with eczema carry a mutation of the gene responsible for ‘filaggrin’ production - a protein needed for maintaining the skin’s protective barrier. Without sufficient filaggrin, the skin’s ability to build a strong, protective barrier is compromised and can cause dry, scaly and infection-prone skin.
Risk factors
Several risk factors can increase the likelihood of developing eczema, including genetics (e.g. family history of eczema or other allergic conditions). Eczema is also more likely to develop in children than adults, particularly those who also suffer hay fever or asthma. While a number of factors can contribute to eczema, it’s important to avoid triggers.
What are the symptoms of eczema?
Eczema affects every person differently, ranging from mild to severe. An eczema rash can occur anywhere on the body, but is most common on the arms, hands, feet, on the bend of elbows and knees, and scalp.
For some, the itch can be so severe that a person will scratch their skin until it bleeds, further irritating and inflaming the skin, and making eczema worse. This is known as the ‘itch scratch cycle’.
Common eczema symptoms to look for include:
Intense itching
Sensitivity and dryness
Red and scaly patches (often around elbows and the bends of knees)
Inflamed or discoloured patches (sometimes red or brownish-gray in colour)
Rough, leathery, or thickened patches of skin
Small raised bumps that ooze fluid when scratched (this may signal infection)
What are common eczema triggers?
A big part of managing eczema comes down to avoiding irritants that flare it up.
Eczema affects everyone differently, and can vary in what exact triggers flare up a person’s eczema.
Common triggers to avoid include:
Fragrances
Metals, such as nickel
Household cleaners and detergents (due to chemical ingredients that dry out skin)
Certain soaps, body washes, shampoos and cleansers
Certain fabrics - scratchy (e.g. wool) or synthetic (e.g. polyester)
Hot or humid climates (heat can aggravate the itch and cause more scratching)
Sweating or raised body temperature
Animal fur
Upper respiratory infections
Stress - stress can flare up eczema, but eczema itself can also be a source of stress
How to treat eczema
As eczema is a chronic condition, you cannot ‘get rid of eczema’ permanently – or ignore it and hope it clears up itself. However, there are lots of ways to effectively control and avoid it.
As with most things, prevention is always better than a cure – so knowing and avoiding your triggers, where possible is best. If you do experience an eczema flare up, a combination of medication and lifestyle changes can help to better manage the condition.
Treatment options
Over-the-counter (OTC) oral antihistamines may help to relieve itching by blocking the allergic histamine response
Topical steroid creams and ointments may be used short-term to relieve itching and scaling, but should be used under GP or pharmacist advice
Topical or oral antibiotics may be prescribed for any secondary infections
Oral corticosteroids may be prescribed by a GP in severe cases
Light therapy may help reduce or clear up eczema
Moisturise frequently – ask your pharmacist to recommend a number of thick creams and moisturisers suited to sensitive and eczema-prone skin
When treating any inflammatory skin conditions, it’s important to speak with your GP or pharmacist first to ensure treatment options may be suitable for you.
Lifestyle changes
Avoid common irritants (e.g. rough fabrics and harsh soaps)
Reduce stress – try relaxing activities such as breathing exercise, yoga, meditation or listening to music
Prioritise sleep
Cold or lukewarm showers or soaking in a bath for 15-20 minutes may help relieve some itching
Moisturise damp skin after every shower
Avoid intense exercise during flare ups, as sweat can trigger itching
If you’re itchy, try rubbing rather than scratching the skin to avoid breaking the surface
Children's eczema
If your child has been diagnosed with eczema, talk to your Pharmacist or GP about treatments that can help. These points may also be helpful to remember:
Get curious about what triggers their flare ups and take steps to avoid or limit exposure to those things. If you notice triggers are specific or allergy-related, consider allergy testing to determine individual triggers.
Some common aggravating factors include overheating, bubble bath, prickly materials such as wool, grass, sand and over-chlorinated pools.
Moisturise at least once a day, especially immediately after bath time. Check in with your child about recognising when they need to apply moisturiser and encourage them to ask for this as often as they need.
If your child is unsettled by the itching, cold compresses applied to the area can help the itchiness settle.
Apply moisturiser with clean hands and regularly trim and clean your child's fingernails. This helps avoid the spread of bacteria into broken or irritated skin.
Because heat is a common trigger, a practical way to quickly address your child's comfort level is to dress them in cotton layers, which are easy to add and remove. Don't worry about them "catching a cold" from being under dressed - this is not how cold are caught.
Avoid woolens or clothing with embroidery, frills, tags, seams as the "prickly" sensation can worsen eczema. Turn to soft cottons, silk for both clothing and bed linen.
Understandably, when your child is at school or in the care of others, it's important they have a "go to team" support.
Baby eczema
Eczema is a common condition in infants before they reach 12 months old. As in adults, it may cause a baby’s skin to become red, dry and itchy.
It can be particularly difficult to manage itching in babies, given at times it can be impossible to stop a child itching, which in turn can worsen an eczema rash.
While it can be distressing as a parent, there are many ways to help keep eczema under control and bring your baby some comfort.
Signs and symptoms to look out for in babies include:
Crusty, patchy flakes on the baby’s skin
A dry, red rash that appears on the face, scalp, body, arms, legs or behind the ears
Restlessness at night, as a result of the itch
Eczema rashes in the creases of the elbows and knees, wrists and ankles
Where does it appear?
It can depend on age. For example, as toddlers learn to walk, eczema is frequently noted in the creases of the elbows and knees. Baby dribble can increase eczema around the mouth and chin, while children rubbing at their skin and licking lips can also exacerbate it.
Adults who haven’t experienced atopic dermatitis for some time may find that their work or home duties lead to flare ups on the hands and fingers.
It’s important to avoid triggers (see above) where possible. Here is a couple of suggestions you can try at home to treat baby eczema and bring extra comfort to your little one:
Avoid triggers: Identify and avoid your baby’s triggers. Common triggers include harsh soaps and detergents, fragrances, sweat, excess saliva, and rough or non-breathable fabric.
Bath time routine: Bathe baby in lukewarm water using a sensitive soap-free wash and gently pat dry with a clean towel. Immediately moisturise damp skin to help lock extra moisture in and maintain baby’s skin barrier.
Moisturise: Thick creams and ointments used frequently can help to lock in extra moisture.
Medicine: Oral antihistamines and topical steroid creams may reduce the feeling of itchiness, so baby is less likely to scratch and break the skin’s surface . Always check with your pharmacist or GP to ensure medication is suitable for your baby.
Wet wraps: For severe eczema flare ups in babies, some GP’s may recommend a wet wrap/ dressing2where a prescription steroid cream is applied to the body before wrapping with gauze or cotton for several hours. Any wet wrap therapy should be discussed first with your GP and monitored closely under medical supervision.
Mittens: Another way to help stop babies scratching might be to put mittens on their hands, so tiny nails can’t damage the irritated skin.
At MediADVICE, our pharmacists are here to recommend different treatments and sensitive skin products that may help to avoid irritants and better manage your eczema.
We stock a wide range of products for different skin conditions and general skin health. Ask your local MediADVICE pharmacist today for more information.
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Disclaimer
General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.