What is eczema? Doctor's advice on treatment, diet and different types of the condition

Eczema is a skin condition that bothers millions of people throughout the UK every day

IT can be painful and embarrassing, but what really is eczema?

 

MILLIONS of people in Britain suffer from the skin condition eczema, but very few people understand exactly what it is. 

With red itchy patches covering suffer's bodies, it's an uncomfortable skin inflammation also occasionally known as dermatitis. Express.co.uk has asked all the questions you've ever needed to know the answer to including whether or not you can catch eczema and why it comes and goes. 

Following on from our female fertility explainer - and everything you need to know about sunburn - expert dermatologist Dr Emma Wedgeworth has all the answers to the questions, and Allergy UK has top tips. 

What is eczema?
Eczema is a red, dry, itchy skin condition.  It can affect any part of the body, but commonly affects the creases of the arms and legs. 

 

Atopic dermatitis, or ezcema on the neck and face of a woman

What are the causes of eczema? Allergy UK explains the causes of atopic eczema. 

• Abnormal immune and nervous system activity: Individuals with AEDS may have abnormal amounts of IgE antibody in their blood. This results from over-activity of some types of immune cells in the body, and under-activity of other cell types. 
• Food allergy and food intolerance: AEDS may be provoked and worsened by certain foods in food-allergic patients. Approximately 15% of AEDS in children is caused by foods, but less than 5% of AEDS in adults is food-related. 
• Aeroallergens: Some patients with the IgE-associated variety of AEDS suffer from worsening of their skin symptoms after contact with certain airborne allergens, such as house dust mite, pollens, or animal hairs, and improve after appropriate allergen avoidance strategies are introduced.
• Skin barrier and bacteria: Skin is a physical barrier that protects the internal structures and organs of the body, and it is thought that eczema may result from impairment of this barrier function. In AEDS, the skin loses its moisture content and becomes dry and scaly.
• Psychological factors: The prolonged process of coping with chronic disease, for both the individual with AEDS and the individual's family, can itself be a source of stress, and worsening of eczema has been shown to follow emotionally stressful events.

What treatments are available?
There is a wide range of treatments available for eczema, but treatment depends on the severity of the eczema.  Unfortunately, we have no cure, so the focus is on managing the eczema, which is generally done very successfully. 

Mild eczema can be treated by avoiding irritants, such as harsh soaps and shower gels and by using a regular unperfumed moisturizer. More severe eczema may need steroid creams or other medicated creams, which need to be prescribed by your doctor.  

Very severe eczema needs specialist treatment by a dermatologist.  We sometimes use UV light therapy or very strong tablets, which change the way the immune system works.

 

The condition can affect anyone young or old

Why do people get eczema?Generally when we talk about eczema, we are talking about atopic eczema.  Atopic eczema occurs in people who have a genetic tendency towards dry, sensitive skin. 

Think of your skin as a brick wall; this brick wall is what acts as a barrier to the environment. If the bricks are slightly misshapen or the cement isn’t strong enough, the brick wall is not as tough as it should be. 

This means that more water can get out, leading to dry skin, and that environmental irritants in the environment can get in.  We know that people who have eczema have a weaker barrier function.  

Combine that with an overactive, hypersensitive immune system in the skin and it results in eczema.  There are other types of eczema, for example contact allergic eczema, which is a result of allergies to substances such as metals or fragrances, but atopic eczema is the most common one we see.

I have it, does that mean my children will have it too? If eczema, asthma or hayfever run in your family, your child will have a higher chance of getting eczema than families who don’t suffer from these conditions. But it is certainly not inevitable.

If you do have a history of eczema, make sure that your protect your childs skin from a very early age.  Avoid soaps and shower gels and use a daily regular moisturizer.  Protecting the skin barrier like this, may actually prevent some children from developing eczema.

 

Is it contagious? No, you can’t catch eczema .  However, it is common to see it run in families, because of a genetic tendency. 

Where is it common to have eczema? Eczema can affect any area of the body, but it is common in the creases of the arms and legs, on the hands and on the face.

Can you eat foods to get rid of eczema? Probably not. There is no really good evidence that certain foods get rid of eczema. Some studies have suggested that fish oils can be beneficial, but I normally advise a healthy, well balanced diet.  Some people can find that certain foods may trigger the eczema, but it’s important to get specialist advice before cutting out foods, particularly in children.

Are there different types? Is it more common in certain ages? Yes. Atopic eczema is a tendency within people and is often associated with asthma, hayfever and food allergies. This is more common in children. 

In the UK, more than 1 in 5 children suffer from this type of eczema.  In many cases, this will get better as the child gets older.  

Contact eczema results from allergies to substances such as nickel, perfumes and other ingredients.  Seborrhoeic eczema causes dry flaky skin on the scalp, eyebrows and around the nose.  This is associated with a sensitivity to a yeast in the environment.

 

Eczema can be incredibly itchy and then sore after it's been scratched

Why - for some people - does it come and go in stages? Is there a trigger?Eczema has a natural tendency to go up and down.  However, there are a number of different triggers, such as viral infections, stress and change of season.

Some people suffer at night - is there a reason for this? Itching is always worse at night.  During the day, we have lots of distractions, which dampen down the itch signals to the brain.  At night, there are less distractions, so the signals tend to be much stronger.  In addition, sometimes the heat at night can trigger the symptoms of eczema.

Should I go to my doctor? Yes. It is definitely worth making sure you have the right diagnosis and that you are doing everything you can to improve your skin

How bad can it get? Can it be seasonal? Unfortunately it can get extremely bad.  I see some terrible cases of eczema which cause suffering for the patient and their whole family.  Luckily, we can help in the vast majority of cases. Your skin barrier function is affected by weather conditions.  Low humidity and indoor heating can dry your skin out even more. Many of my patients find their eczema is worse in the winter.

Does it hurt? Can it ever be painful or weep? It can be very painful, particularly if infected.  Eczema skin is not as good at protecting itself against germs and bugs so I frequently see infected skin.  If your skin has become more painful, it is important to seek medical attention.

 

The condition can affect anyone young or old

How long does it take to clear up?
It really depends.  Eczema is a chronic condition.  For children we say that 50% will clear by the age of 5 and 70% by the age of 7. However, some people have a lifelong tendency to eczema.

Dr Emma Wedgeworth's top tips for coping with eczema? 

• Start simple. Avoid irritants such as soaps and shower gels and use an emollient based wash.  
• Use a regular daily moisturizer which is unperfumed.  You may find you need a thicker ointment in the winter months.  If this isn’t enough,have a very low threshold for seeing your doctor.  
• People are often very scared about using steroid creams, but used carefully, under supervision, they can be safe and effective.  Most eczema can be safely managed, so don’t suffer in silence!

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