Eczema

What Is Eczema?

The words eczema (which comes from the Greek word meaning ‘to boil’) and dermatitis (meaning inflammation of the skin) are often used interchangeably to describe several conditions that cause the skin to become dry, itchy, inflamed or irritated.

There are a number of different types of eczema but the term is most often used to refer to atopic eczema (also called atopic dermatitis).

The word atopic refers to hypersensitivity reactions to something in the environment.

Atopic eczema is a very common, non-contagious, chronic (long-term) inflammatory skin condition. If you have atopic eczema, your skin barrier function (which prevents water loss and protects against allergens and irritants) is impaired or weakened. This makes the skin dry out and become more vulnerable to infections by bacteria and viruses.

 

Causes Of Eczema?

While the exact cause is not known, certain factors are thought to be important in its development, these include an inherited (genetic) predisposition to have a weakened skin barrier, as well as altered inflammatory and allergy responses. Atopic eczema most frequently begins in infancy but may also develop for the first time in adulthood. It affects approximately 1 in 5 children and 1 in 10 adults in Ireland.

For most children affected, the disease is mild. However, often those who have seemingly outgrown the condition will continue to have life-long sensitive skin and may have recurrences of eczema following long symptom-free spells.

Atopic eczema can run in families and frequently occurs alongside other atopic conditions, including hay fever and asthma.

Although there is no cure for eczema yet, treatment are available to manage the condition.

 

Symptoms?

Symptoms include red, dry, itchy skin, which can sometimes weep, become blistered, crusted and thickened. However, the appearance of eczema and the locations of the body affected can vary greatly depending on the age of the person affected.

The main symptom is an intense itch. Scratching only provides temporary relief, and leads to more itching and scratching (the itch-scratch cycle), which can worsen eczema and make the skin more vulnerable to infection. Scratching in response to itch can cause some of the changes seen on the skin in eczema.

The intense itch is very uncomfortable, can be severe enough to interfere with sleep, and negatively impact on the quality of life of the person affected, as well as his/her family. Some people with more pronounced eczema can also experience social embarrassment due to the visibility of their condition.

Typically atopic eczema goes through phases of being severe, then less severe. During a ‘flare up’, when eczema is very active, symptoms such as redness, dryness and itch worsen, while at other times, symptoms settle.

 

Triggers

Irritants and allergens
Atopic eczema can be triggered or aggravated by exposure to a number of environmental irritants or allergens. Common irritants include soap, bubble bath, shampoo, laundry detergents, fragrances, clothing that feels ‘itchy’ next to the skin (e.g. wool), changes in temperature, or allergens like animal dander, the house dust mite or pollen, but sometimes no cause can be identified.

Stress
Emotional stress can aggravate eczema. Finding ways to reduce stress may lessen the frequency and, hopefully, the intensity of the flare-ups. Whilst stress is associated with flares of atopic eczema, it is not yet fully understood.

Infection
Atopic skin is more vulnerable to infection and infection is often associated with a worsening of eczema. Seek urgent medical advice if skin becomes:
• Wet or weepy, with yellow/brownish crusts
• Very sore, with clusters of painful itchy blisters, particularly if there has been contact with someone who has a cold sore

Managing Eczema

The main aim is to improve symptoms and achieve long-term control. In atopic eczema, the skin’s protective barrier is weakened which allows moisture to be lost, and irritants and allergens to pass through the skin more easily. Some common everyday substances e.g. soap, contribute to the weakening of the skin’s barrier and should be avoided.

It is important to remember that on-going (every day), frequent and generous use of emollients form the basis of eczema management, but when your eczema flares up, other treatments, such as topical steroids, are needed and are usually prescribed by your healthcare professional.

For more detailed information about prescribed medical treatments including: topical steroids and other topical treatments (creams or ointments applied directly to the skin), ultraviolet light therapy (also called phototherapy, delivered in hospital dermatology departments), and systemic medications (medicines that work inside your body), please see the What you need to know about eczema booklet.

https://irishskin.ie/eczema/#what-is-eczema [1]

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