01 Apr 2010

Eczema (dermatitis)

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Eczema is an inflammatory skin condition that usually appears in childhood. It is inherited and is not contagious.

Also called

Atopic Dermatitis

Affected areas

The rash tends to occur on the face and on the backs of the arms and legs in babies.

Children and adults generally experience the symptoms in the folds of the elbows, knees and ankles, and sometimes on the face, neck and head.

Symptoms

A dry, scaly, red and itchy rash is the main characteristic of eczema affected patches of the skin, sometimes accompanied by fluid-filled blisters. There are several variables that can influence when and where the symptoms occur and how severe they may be.

  • Scratching the affected area may cause cracking and weeping which in turn can lead to infection
  • Symptoms are changeable, and the rashes may improve or worsen on a regular basis
  • Symptoms tend to decline with age so many people are only affected by eczema during infancy and childhood. In adults, symptoms often recede during middle age. It's rare for elderly people to be affected
  • The association between atopic eczema and other allergic conditions is strong, and it can be common for sufferers and their immediate family to experience hay fever, asthma and/or food allergies as well. Whilst these issues do not always occur in childhood, they may be experienced later in life

Causes

A skin dysfunction in which the skin barrier is unable to be repaired properly is the cause of Atopic Eczema.

Genetic in nature, eczema-susceptible patients have a less than optimal content of water and oil in their skin which can consequently become dry, scaly and easily irritated.

With the skin's barrier is not operating effectively, allergens are able to penetrate the surface and trigger the immune system, causing the affected skin to become red and itchy.

Scratching can exacerbate the situation by increasing inflammation and may introduce an infectious organism (usually Staphylococcus aureus) that can cause the affected area to become infected.

Contributing factors may include:

  • Dry skin

  • Environmental allergens, such as dust mites, grass pollens and pet hair can contribute to eczema flare-ups when inhaled. Eczema sufferers commonly also have a dust mite allergy and even if they don't experience the condition initially, many sufferers become allergic to them later

  • Some substances including perfume and synthetic or woollen fibres can irritate the skin of those prone to eczema

  • Food allergies aren't a cause of eczema, but may trigger or aggravate the condition, especially in children. Dairy products, soy protein, seafood, nuts and seeds, eggs, and wheat are the foods most associated with the condition. These allergies, in most cases, are resolved in later childhood

  • Over-heating of the body can be a factor as can abrupt changes in temperature or humidity

  • Stress can also cause or aggravate an eczema outbreak

Natural therapies

Eczema has been found to be caused in part by imbalances in the body’s ratio of omega-3 and omega-6 fatty acids, and particularly by relatively low levels of the omega-6 fatty acid gamma-linolenic acid (GLA). The issue may be related to a reduced ability to convert linoleic acid into GLA.

  • Taking evening primrose oil supplements (a rich source of GLA) may help in correcting the low levels that have been found in sufferers of atopic eczema and dermatitis
  • Fish oil (which is rich in omega-3 fats) has anti-inflammatory actions, and can help to bring relief to inflammatory disorders including eczema and dermatitis
  • Zinc's involvement in essential fatty acid metabolism means that taking zinc supplements may help to relieve minor skin disorders such as dermatitis or eczema
  • Research on probiotic strains including Lactobacillus reuteri and Lactobacillus rhamnosus GG has found that taking probiotic supplements may decrease the severity of rashes in children. When a family history of allergies is present, women may help alleviate their baby’s eczema risk by taking these supplements during late stages of pregnancy and whilst breastfeeding
  • A combination of B-group vitamins, vitamin C and relaxing herbs (such as passionflower) may help with stress-related outbreaks

Diet and lifestyle

  • Because of eczema sufferers' susceptibility to other allergic conditions (such as hay fever and asthma) professional treatment to support the integrity of the skin’s barrier and minimise the introduction of potential allergens through the skin is recommended. This may also help to reduce the risk of further allergic health problems
  • Consult your doctor to find out if ultraviolet light therapy, corticosteroids and antibiotics may be needed to help manage eczema
  • Consult with your healthcare professional to identify any environmental, dietary or other allergens that may be contributing to your skin problem. Skin prick and blood tests, or the use of an exclusion diet followed by food challenges are all methods used to identify the allergens. Please note that allowing children to undergo an exclusion and challenge diet without medical supervision is not appropriate and should be avoided
  • When considering dietary restrictions due to allergens, make sure all nutritional requirements are met. It is best to consult a healthcare professional to assist you with making these decisions
  • Avoid animal fats and increase your consumption of fish and other omega-3 rich foods like flaxseeds and walnuts. This may help your body maintain an optimal balance of essential fatty acids
  • Bathe in lukewarm water using hypoallergenic soap-free cleansers as regular soap and hot water may aggravate your eczema. When towelling off after your bath, pat your skin dry; try not to rub it
  • Apply thick, hypoallergenic moisturising cream or lotion immediately after bathing to keep your skin moist and supple. You should also use the same moisturisers after swimming
  • Swimming in chlorinated pools may exacerbate eczema but swimming in the sea may improve your symptoms. In both instances it is important to avoid getting sunburnt or over-heated as this may aggravate the condition
  • Getting over-heated in other circumstances can be detrimental too as can abrupt changes in body-temperature. Wear several layers of light clothing so you can remain comfortable as the temperature changes throughout the day and use several light cotton blankets for similar temperature control at night. It's also best not to keep your home too warm in winter.
  • Exercising in hot conditions, with accompanying temperature change and perspiration, may trigger your eczema or cause itchiness
  • Exposing the skin to chemicals of any kind should be avoided. It is best to choose hypoallergenic laundry detergents and wear gloves when using chemicals or detergent (wear cotton gloves inside the rubber ones). Make-up and cosmetics should be specially formulated to be hypoallergenic, but even then, keep the face make-up free as often as possible. It is recommended to perform a patch test on an inconspicuous area of your skin before using new products
  • Keep the home well-ventilated and clean to help reduce the likelihood of mould developing. Vacuum frequently and change bedding regularly, this will help keep the home free of irritants such as dust mites and animal hair
  • Good personal hygiene will help lessen the risk of infection and the likelihood of scratching skin affected by eczema. Wearing gloves or mittens (especially at night time) may help to prevent children from scratching and damaging the skin. Keep fingernails closely clipped so that any scratching is less likely to damage the skin
  • Stress related flare-ups can be avoided by taking active steps to help you cope better. It is worth considering strategies including meditation, yoga, regular (but not excessive) exercise, and cognitive behaviour therapy

Important notes

  • If your or your child's eczema becomes infected, consult your doctor, as antibiotics may be required. Rashes that are weeping or crusted, or that don't respond to normal treatment are symptoms to watch out for. It is also not uncommon for fatigue, a fever and a general sense of feeling unwell to occur.

Eczema is an inflammatory skin condition that usually appears in childhood. It is inherited and is not contagious.