Coping With Eczema

Eczema is the word used to describe a number of itchy skin conditions. The most common is atopic eczema, also known as atopic dermatitis (atopic is used to describe long-term allergic diseases – people with atopic eczema have often had it from childhood).

Other types of allergic eczema include contact dermatitis, for example as a reaction to nickel, and autoeczematization, which is a reaction to an infection and heals when the original infection clears up.

Some children may grow out of eczema around the age of five or six, but for others it may continue into adolescence and adulthood. It can get worse around puberty.

What Causes Eczema?

The cause of atopic eczema isn’t completely clear, but it can be triggered by exposure to allergens. Children with eczema often also have asthma and hay fever. There does seem to be a genetic tendency – children of parents with allergies are more likely to have allergies, including atopic eczema.

Symptoms of Eczema

Atopic eczema causes a red and itchy rash that often appears crusty and can crack and bleed. It is most common around the back of the knees and the crooks of the elbows, but can appear on any part of the body, including on the face.

Treatments for Eczema

The simplest treatment is keeping the skin moisturised using a non-scented cream or lotion, as well as a barrier cream, which stops allergens getting to the skin. If it is clear which allergen is triggering the eczema, avoiding it will reduce the attacks of eczema. Stopping the skin getting too dry can avoid new eczema breakouts.

Cool baths (especially with unscented moisturising agents and emollients), swimming and using cool, damp cloths on the skin can also reduce the itching. Applying a moisturiser within three minutes of a bath or shower will trap extra moisture in the skin.

Scratching thickens the skin and makes the eczema and the itching worse. Antipruritic creams reduce the itching, and so break the itch-scratch cycle. Soft, light and non-itchy clothes and bedding will help reduce the itching, and some children, especially the younger ones, might find wearing gloves to bed stops them scratching too much.

Corticosteroid creams and ointments (topical corticosteroids) can control the itching and rash in eczema. However, these can also thin the skin if used too much, so it’s important only to use them when necessary.

Creams containing pimecrolimus and tacrolimus suppress the immune response where they are applied, and can have a dramatic effect in atopic eczema. UVA and UVB light treatments can help some children with eczema.

Antihistamines can reduce itching, and antibiotic creams and tablets will treat any skin infections that arise.

Things to Avoid

Avoid using harsh or scented soaps and detergents on the skin when bathing or showering – try aqueous creams and gentle moisturising body washes. Use these in small amounts and only as necessary, and avoid using rough face cloths and loofahs, or rubbing too hard with the towel.

In some children, atopic eczema is triggered by food allergies, and avoiding these foods may reduce the attacks of eczema. Restricting a child’s diet should only be carried out under the supervision of a doctor, nurse or dietician. Stress can make atopic eczema worse.

Why Is Eczema Increasing?

The number of cases of eczema is increasing. One reason behind may the ‘hygiene hypothesis’. This suggests that children’s immune systems are reacting against harmless allergens because our lives are now so clean and free of disease that immunity doesn’t have the chance to develop normally.