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Eczema Advice

Eczema Advice

THe UK’s Leading Eczema Advice

Eczema is a range of skin disorders that cause inflammation and irritation. Atopic dermatitis, often known as atopic eczema, is the most prevalent kind. The term “atopic” describes a person’s proclivity for allergic diseases such as asthma and hay fever.

Eczema affects approximately 10% to 20% of infants and 3% of adults and children in the United Kingdom. By the time they become ten, most youngsters have outgrown it. Some people will experience symptoms on and off for the rest of their lives.

Although there is no cure, most patients may manage their symptoms with medication and avoid irritants. Eczema is not contagious, therefore you can’t pass it on to someone else.

Symptoms

Everyone’s eczema appears differently. Your flare-ups will not always occur in the same location.

Eczema is usually always itchy, regardless of whatever region of your skin is affected. Itching might occur before the rash appears. It’s also possible that your skin is:

  • Red
  • Dry
  • Cracked
  • Leathery

Symptoms In Babies

The itching rash in babies can cause an oozing, crusting condition, mainly on the face and scalp. Their arms, legs, back, and chest may also be affected.

Symptoms In Children

The rash commonly appears in the crease of the elbows, behind the knees, on the neck, or on the wrists or ankles of children and teenagers. The rash becomes dry and scaly.

Symptoms In Adults

The rash typically appears on the backs of your knees, wrists, hands, and feet.

Your skin will most likely be dry, thick, and scaly. These regions in fair-skinned persons may start off crimson and later turn brown. Eczema can influence skin pigmentation in darker-skinned persons, making the affected area lighter or darker.

Diagnosis

Eczema cannot be detected by any ‘one’ test. Your doctor will most likely diagnose it by examining your skin and asking you a few questions.

Your doctor may prescribe allergy testing to look for irritants or triggers, as many people with eczema also have allergies. Allergy testing is very common in children with eczema.

If your doctor diagnoses you with eczema, you should ask them the following questions:

  • What is the most effective approach to moisturise my skin?
  • Do you need to prescribe something or may I use over-the-counter products?
  • Is it necessary for me to purchase specialised soaps, lotions, and laundry detergent? How effective are fragrance-free or sensitive-skin products?
  • Are there any foods I should avoid to avoid flare-ups?
  • Are there any fabrics I should stay away from? What are fabrics that I should use more often?
  • Do pets aggravate symptoms?
  • Can I still work out if sweating makes things worse?
  • What happens if my symptoms don’t improve or if scratching my skin causes an infection?
  • Is it true that stress causes flare-ups?
  • Is it common to go for long periods of time without symptoms?
  • Is there anything I can do to treat my skin so that I don’t have another flare-up?

Types

These are the most common forms of Eczema:

 

When people say “eczema,” they usually mean something like this. This is the most common type, affecting more than 7% of all adults in the United Kingdom. It’s also linked to other allergy conditions such as asthma and hayfever, and it usually begins in childhood.

This happens to almost everyone at some point in their lives. When your skin comes into contact with something that creates a rash, this happens. Irritation or an allergic reaction can be caused by the trigger. Each person’s triggers are different, and they differ between the two forms of contact dermatitis:

The most prevalent type is irritant dermatitis, which is more closely associated with persons who have atopic dermatitis. Skincare products, soaps and detergents, nickel jewellery, and industrial chemicals like solvents and cement are also potential triggers.

When your skin comes into contact with anything you’re allergic to, allergic dermatitis flares up. Poison ivy, nickel and other metals, scents and beauty products with fragrances, rubber, latex, and the preservative thimerosal are all common allergies. For some folks, sunshine is required to elicit a response.

This type is less prevalent but more difficult to treat. It causes little blisters to appear on the palms of the hands, the soles of the feet, and the sides of the fingers. Sweating or irritants such as metals can cause it.

This type of eczema usually manifests itself as one or two itchy spots on the nape of the neck, an arm, or a leg. Other types of eczema, such as atopic or contact dermatitis, or just very dry skin are risk factors. However, it has been connected to mental health disorders such as anxiety and obsessive-compulsive disorder (OCD). Women between the ages of 30 and 50 are more likely to contract it than others.

After a skin injury such as a burn or an insect bite, this coin-shaped dermatitis sometimes occurs. If you or a family member suffers from atopic dermatitis, allergies, or asthma, you’re more prone to get nummular eczema.

This occurs in parts of your body where there are several oil glands. It’s called dandruff when it’s on your scalp. Seborrheic dermatitis is most likely caused by a strong allergic reaction to a large number of Malassezia yeast on the skin. It’s also associated with a variety of other diseases and skin disorders, including psoriasis, acne, and rosacea.

This type affects patients with impaired blood flow, which is most common in the lower legs. These plaques aren’t tied to defective genes like some other types of eczema. Being overweight and not getting enough exercise are two lifestyle choices that increase the risk.

Causes & Risk Factors

Eczema is caused by an unknown factor, according to experts. Things that may increase your chances include:

  • A reaction of the immune system to something irritating
  • Issues with your skin’s barrier that allow moisture to escape and pathogens to enter
  • Other allergies or asthma hsitory in the family

Complications

Some people’s itchy rash flares up in response to things like:

  • Fabric that is rough or coarse
  • Too hot or too cold?
  • Soap and detergent are examples of household items.
  • Dander from animals
  • Colds or respiratory illnesses
  • Stress
  • Sweat

Is Eczema Contagious?

No. Eczema is not contagious and cannot be passed on to others. Eczema does not indicate that your skin is sick or that it is contagious. Because eczema frequently runs in families, some people may believe it is contagious. Eczema, on the other hand, can be caused by a number of factors, including a defective skin barrier, your immune system, your genes, the environment, and other variables.

Eczema can still cause skin infections due to scratching or cracking. Your skin’s barrier against bacteria and other pathogens may be compromised as a result.

When to call a doctor

If you notice any of the following:

  • Fever, redness, warmth, pus, or blisters are all indicators of an infection.
  • Your eczema changes or worsens unexpectedly.
  • Treatments are ineffective.

Treatment

Atopic eczema treatments can help to alleviate symptoms. Although there is no cure, many children’s symptoms improve as they grow older.

The following are the most common atopic eczema treatments:

  • Emollients (moisturisers) – used on a daily basis to keep the skin from drying out
  • Creams and ointments containing topical corticosteroids are used to minimise swelling and redness during flare-ups.

Additional treatment options include:

  • Topical pimecrolimus or tacrolimus for eczema in sensitive areas that haven’t responded to other treatments.
  • Antihistamines are prescribed for extreme itching.
  • To allow the body to recuperate underneath bandages or customised bodysuits

A dermatologist (skin specialist) can provide more potent treatments.

This page describes the numerous treatments for atopic eczema.

Home remedies

There are things you can do on your own to help reduce your symptoms and prevent more difficulties, in addition to the treatments described above.

Try to reduce the damage from scratching

Eczema is itchy, and scratching the affected regions of the skin can be very enticing.

Scratching, on the other hand, frequently harms the skin, which can lead to more eczema.

Chronic scratching causes the skin to thicken and form leathery patches.

Deep scratching also causes blood and puts your skin in danger of infection or scarring.

When possible, try to avoid scratching. Instead, you might gently rub your skin with your fingers.

Anti-scratch mittens can help your child with atopic eczema stop scratching.

To avoid skin injury from unintended scratching, keep your nails short and tidy.

To avoid harm from scratching, keep your skin covered with light clothing.

Avoid triggers

A doctor will work with you to figure out what’s causing the eczema flare-ups, however, it could get better or worse for no apparent cause.

You can try to avoid your triggers once you’ve identified them.

For instance:

  • If certain textiles bother your skin, stick to soft, fine-weave garments or natural materials like cotton instead.
  • If heat makes your eczema worse, keep your home cold, especially your bedroom.
  • Use soap alternatives instead of soaps or detergents that may irritate your skin.

Although some persons with eczema are allergic to house dust mites, eliminating them from your home is not recommended because it is difficult and there is no proof that it helps.

Learn more about allergy prevention.

Dietary changes

Eggs and cow’s milk, for example, can aggravate eczema symptoms.

However, you should consult your doctor before making any big dietary changes.

Cutting these foods from your diet may not be healthy, especially for young children who require the calcium, energy, and protein that these foods provide.

You may be sent to a nutritionist if your doctor suspects you have a food allergy (a specialist in diet and nutrition).

They can assist you to figure out how to avoid the foods you’re allergic to while still getting enough nourishment.

You could also be referred to a hospital expert such as an immunologist, dermatologist, or paediatrician.

Before making any adjustments to your typical diet while breastfeeding a baby with atopic eczema, seek medical counsel.

Emollients

Emollients are hydrating therapies that are applied directly to the skin to prevent water loss and provide a protective layer.

They’re frequently used to treat dry, scaly skin diseases like atopic eczema.

They may also have a minor anti-inflammatory effect, which can help lessen the frequency of flare-ups you encounter.

If you have mild eczema, consult a pharmacist for emollient recommendations. Consult your doctor if you have moderate or severe eczema.

Choosing an emollient

Emollients come in a variety of forms. Consult a pharmacist for recommendations on which emollients to use. It’s possible that you’ll have to try a few to discover one that works for you.

It may also be recommended that you apply a combination of emollients, such as:

  • A cream for extremely dry skin
  • A moisturising cream or lotion
  • An emollient that can be used in place of soap
  • Use one emollient on your face and hands and a different one on your body.

The amount of oil in lotions, creams, and ointments is what distinguishes them.

Because ointments contain the most oil, they can be extremely greasy, but they are the best at maintaining moisture in the skin.

Lotions have the least quantity of oil and are therefore less greasy, but they are also less effective. Creams fall somewhere in the middle.

If you’ve been using a certain emollient for a long period, it may eventually lose its effectiveness or irritate your skin.

If this is the case, you might choose a different product. Other solutions can be discussed with a pharmacist.

The best emollient is one that you enjoy using on a daily basis.

How to use emollients

Even if you’re not feeling symptoms, have your emollient on hand.

Many people find it beneficial to store separate emollient supplies at work or school, or to have one tub in the bathroom and another in the living room.

How to use the emollient:

  • Use a lot
  • Smooth it into the skin in the same direction that the hair grows, rather than rubbing it in.
  • To preserve the moisture in your skin after a bath or shower, gently pat it dry and apply the emollient while it’s still wet.

If possible, apply an emollient at least twice a day, or more frequently if your skin is really dry.

Apply liberal amounts of emollient more regularly during a flare-up, but remember to treat inflamed skin with a topical corticosteroid as well, as emollients alone will not be adequate to control it.

Avoid dipping your fingers into emollient pots; instead, use a spoon or pump dispenser to limit the risk of infection. Also, never give your emollient to anyone else.

Topical corticosteroids

A GP may prescribe a topical corticosteroid (given directly to your skin) if your skin is sore and inflamed, which can lessen inflammation within a few days.

Depending on the severity of your atopic eczema and the areas of skin affected, topical corticosteroids might be administered in various strengths.

They can include:

  • Extremely mild (such as hydrocortisone)
  • moderate (such as betamethasone valerate and clobetasone butyrate)
  • strong (such as a higher dose of betamethasone valerate and betamethasone diproprionate)very strong (such as clobetasol proprionate and diflucortolone valterate)

If you need to use corticosteroids frequently, see your doctor on a regular basis so they can make sure the medicine is working and you’re getting the proper dose.

How to use topical corticosteroids

To control your eczema, don’t be scared to apply the remedy to the affected areas.

Follow the guidelines on the patient information booklet that comes with your medicine unless your doctor tells you otherwise.

This will specify the amount of money to apply.

Most people only need to use it once a day because there is no evidence that using it more frequently is beneficial.

When applying a topical corticosteroid, remember to:

  • Use your emollient first, and wait at least 30 minutes for it to absorb into your skin, or apply the corticosteroid at a separate time of day (such as at night)
  • Apply a topical corticosteroid to the afflicted region in the indicated quantity.
  • Continue to apply it for another 48 hours after the flare-up has passed to treat the inflammation beneath the skin’s surface.

Your doctor may occasionally recommend using a topical corticosteroid less regularly but for a longer period of time. This is meant to keep flare-ups at bay.

Weekend treatment is when a person who has previously gotten control of their eczema applies a topical corticosteroid to the difficult spots every weekend to keep them from becoming active again.

Side effects

When you use topical corticosteroids, you may experience a brief stinging sensation.

They may also cause, in rare circumstances:

  • Skin thinning – especially if strong steroids are taken in the improper regions, such as the face, for an extended period of time (for example, several weeks)
  • Skin lightening – frequently after months of using very strong steroids, but most eczema lightening is a “footprint” of past inflammation and has nothing to do with therapies.
  • Acne (spots) – increased hair growth in teenagers, especially when applied to the face.

When you stop taking the medication, most of these adverse effects will go away.

If you use a powerful topical corticosteroid, you may experience more negative effects:

  • For several months
  • In delicate areas including the face, armpits, and groyne
  • In vast quantities

To control your symptoms, the weakest effective treatment should be recommended.

Antihistamines

Antihistamines are medications that prevent the effects of histamine, a chemical found in the blood.

They can help with the irritation that atopic eczema causes.

They can be either sedating or non-sedating, causing sleepiness.

A non-sedating antihistamine may be recommended by your doctor if you experience extreme itching.

If itching during a flare-up interferes with sleep, your doctor may prescribe a sedating antihistamine.

Because sedating antihistamines can cause drowsiness the next day, it’s a good idea to let your child’s school know they won’t be as alert as usual.

Bandages and wet wraps

A doctor may prescribe medicinal bandages, clothes, or wet wraps to wear over eczema-affected skin in some circumstances.

These can be applied over emollients or with topical corticosteroids to decrease itching, promote healing, and keep the skin from drying out.

Corticosteroid tablets

Corticosteroid tablets are rarely used to treat atopic eczema these days, but they are sometimes prescribed for 5 to 7 days to assist manage extremely severe flare-ups.

Longer treatment regimens are generally avoided due to the possibility of major side effects.

A GP would likely refer you to a specialist if they believe your disease is severe enough to benefit from repeated or prolonged therapy with corticosteroid tablets.

Seeing a specialist

A GP may send you to a dermatologist if you have a skin condition (dermatologist).

You could be referred if you:

  • Your doctor is unsure which form of eczema you have.
  • Your eczema is not responding to standard treatment.
  • Your eczema is interfering with your daily activities.
  • It is unknown what is causing it.

A dermatologist could be able to help you with:

  • Testing for allergies
  • A complete examination of your current treatment plan – to ensure that you’re utilising enough of the appropriate items at the right times
  • Topical calcineurin inhibitors, such as pimecrolimus and tacrolimus, are lotions and ointments that suppress your immune system.
  • Topical corticosteroids that are quite potent
  • Wet wraps or bandages
  • Phototherapy is the use of ultraviolet (UV) radiation to treat inflammation.
  • Immunosuppressant tablets, such as azathioprine, ciclosporin, and methotrexate, are used to suppress the immune system.
  • Alitretinoin is a medication used to treat severe eczema in adults that affects their hands.
  • Dupilumab is a medication used to treat individuals with moderate to severe eczema after other therapies have failed.
  • If dupilumab fails to work or has serious side effects, baricitinib, an alternative to dupilumab, may be advised.

A dermatologist may also be able to recommend you for psychological counselling if you feel you need it, as well as additional support to help you use your treatments effectively, such as demonstrations from professional nurses.

Complementary therapies

Although some people may find complementary therapies like herbal medicines to be beneficial in treating their eczema, there is little proof that they are effective.

If you’re thinking about trying complementary therapy, talk to your doctor first to make sure it’s right for you.

Make sure you continue to take any other medications your doctor has prescribed.

Eczema Flare-up Prevention

A few pointers can help you avoid outbreaks or keep them from worsening:

  • Frequently moisturise your skin.
  • Avoid drastic temperature or humidity changes.
  • Try not to overheat or sweat. Itching can be reduced by staying cool and keeping your environment comfortable.
  • Take care of yourself and manage your stress. Exercise regularly. It can aid with stress management and circulation.
  • Wool and other scratchy materials should be avoided.
  • Use gentle washes, detergents, and solvents.
  • Keep an eye out for meals that may cause symptoms and attempt to avoid them.
  • In your bedroom, use a humidifier.
  • If you have a family history of eczema, it’s recommended to nurse your infant exclusively for the first three months of life, or longer if feasible. Breast milk should be continued for at least 6 months (ideally a year) after your infant is introduced to solid foods, according to Pure Medical’s doctors. Pet hair, mites, and mould are all potential allergies that should be avoided by babies.
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