What is it and how do I manage it?
Eczema is a well-known dry, inflammatory skin condition. Although it is mainly seen as a problem in children, it can affect people of all ages. You may find that, even if you have ‘grown out’ of childhood eczema, it can come back when you are an adult. Although the exact cause of eczema is not known, your genetics play a role, so you may find it runs in your family.
What you might not realise is there are many different types of eczema that can affect different body parts. The good news is that eczema is not contagious, but you may have times when it is worse than others – this is known as a flare-up.
If you have eczema, your skin is different to the skin in healthy people. It may not produce as much fats and oils, which makes it harder to trap moisture in your skin. This weakens your skin barrier leading to dry, irritated, cracked skin. Eczema skin is more prone to irritation and allergic reactions, making your skin red and inflamed.
Eczema can be itchy, making you scratch – and further damaging your skin in the process. This itch-scratch cycle can then continue to make your eczema worse.
Types of Eczema
There are a number of different causes and types of eczema, but the most common are:
Atopic eczema (atopic dermatitis)
Contact eczema (contact dermatitis)
Dyshidrotic eczema (pompholyx eczema)
Discoid eczema (nummular eczema)
Seborrhoeic eczema (seborrhoeic dermatitis)
Varicose eczema (stasis, venous or gravitational eczema)
General symptoms of eczema
Not everyone has the same symptoms or signs of eczema. It depends on the type. Your symptoms can range from mild to severe and can depend on the cause. You may have a combination of the following symptoms:
Eczema triggers and factors
Eczema triggers can vary from person to person and depend on the type of eczema. Here are some of the most common:
Weather and temperature
How to manage eczema
As well as avoiding triggers that can make your eczema flare-up, there are many different ways you can manage your eczema.
Emollients are moisturizers that can help with dryness and itching. They can come in many forms including creams, lotions, ointments or sprays. Emollients should be applied to the skin regularly, sometimes even multiple times a day. The area of coverage and frequency will change depending on your symptoms and condition, the severity and which product you are using. Always refer to the label for proper use. Having well moisturised skin can help create a barrier which can prevent flare-ups.
Applying emollients regularly can help keep you manage your eczema by:
- Leaving an oily film over the surface of the skin, helping to retain water underneath
- Helping to maintain a healthy skin barrier
- This, in turn, helps protect the skin from damaging irritants and allergens.
Itchiness is a common eczema symptom, so finding a way to manage this itch is important. In fact, some emollients contain extra ingredients to help control itchiness. Ingredients such as oatmeal have anti-itch properties, or lauromacrogols, which relieve itch through a local anaesthetic action.
As regular soaps and cleansers can irritate the skin and cause dryness, it’s also important to consider washing with an emollient too. There are special emollients that can be used for washing just as you would use soap, or you can apply your leave-on emollient as a soap substitute. Be prepared though – while emollient soap substitutes clean effectively, they don’t lather up like regular soap. You can also add emollients to your bath.
Mild steroids creams and ointments can be bought from your pharmacy to help relieve contact dermatitis and mild-to-moderate eczema. These help manage flare-ups in atopic eczema by altering the body’s responses to inflammatory reactions. Always check the label for how to use the product correctly and safely; always check who can use the product as many over the counter steroids having limitations regarding age and pregnancy.
It’s important to know that steroids are applied differently to emollients:
- Apply very thinly and to just the affected area
- Apply once or twice a day for a maximum of 7 days
- Only apply to certain parts of the body and not to the face, eyes, broken or infected skin, genital areas or the bottom
- If you are pregnant or breastfeeding, you should speak to your doctor before using a steroid cream.
Always carry on using your emollient alongside your steroid but leave about 20-30 minutes between applying each one. If it’s the first time you have used a steroid cream - as with any new medicine - speak to your pharmacist or doctor first to find out if it’s the right choice for you. They will also be able to give you tips on how to apply correctly.
If you find that using a mild steroid cream for a week doesn’t bring your eczema under control, see your doctor. They’ll be able to prescribe stronger steroids that may be more effective for you.
Antihistamines can be used to help relieve severe itch in atopic eczema and contact dermatitis. Although they are available in a number of different formats (such as tablets, capsules, syrups or creams), tablets or syrups are most likely to be recommended. Non-drowsy antihistamines, such as cetirizine or loratadine, are recommended if you have atopic eczema with severe itch or urticaria. Ask your pharmacist or doctor for advice on taking an antihistamine that is right for you. If these do not work, or if you are using antihistamines for a prolonged amount of time, please go and talk to your doctor for guidance.