Eczema

Eczema (also known as dermatitis) is a non-contagious, inflammatory dry skin condition that can affect people from early infancy to old age. The most common form, atopic eczema, affects 1 in 5 children and 1 in 10 adults in the UK. The skin is itchy, red, cracked, sore, raw and inflamed and it can affect all body areas including the scalp, hands and feet and genitalia. 

Secondary infection is a common complication. If not properly treated it can lead to sleeplessness, anxiety, depression, and other mental health problems. Chronic eczema can lead to hypo or hyperpigmented patches and lichenification (thickened/ leathery skin). Eczema can look very different in people with dark skin.

Eczema / Dermatitis is an umbrella term for this condition. Other forms of eczema include contact dermatitis (irritant and/or allergic), dyshidrotic eczema, nummular/ discoid eczema, seborrheic dermatitis, and stasis dermatitis. Eczema is a complex interplay of genetic, environmental, and immunological factors.

Common triggers include: 

• Soap and detergents: Harsh cleaning products can strip the skin of its natural oils and damage the skin barrier.

• Fragrances and dyes: Often found in personal care products, these can irritate sensitive skin.

• Stress: Emotional stress can worsen symptoms or provoke flare-ups.

• Weather: Cold, dry air and hot, humid conditions can both exacerbate eczema.

• Clothing: Wool or synthetic fabrics may aggravate the skin.

• Allergens: Pet dander, pollen, dust mites, and mould.

It is vital to diagnose the right type of eczema early to get the condition under control and prevent flare ups. Different skin conditions may mimic eczema so getting a diagnosis by a GP or dermatologist is an important first step.

Eczema treatment and research has advanced greatly over the past few years, although it is still important to get the basic management in place before considering other steps.

Available treatment options include:

• Emollients/Moisturisers: Keeping the skin well-hydrated is essential. Use unscented creams or ointments immediately after bathing to lock in moisture.

• Topical corticosteroids: Prescription or over-the-counter steroid creams and ointments can help reduce inflammation during flare-ups.

• Topical calcineurin inhibitors: These non-steroid creams (like tacrolimus or pimecrolimus) can be prescribed for sensitive areas or long-term use.

• Infection control: Treating bacterial, viral, or fungal infections promptly can prevent complications.

• Antihistamines: Oral antihistamines may help control itch, especially at night.

• Phototherapy: In cases where topical treatments are not sufficient, controlled exposure to ultraviolet (UV) light may be recommended.

• Systemic medications: For severe cases, you may be prescribed oral or injectable medications that suppress the immune system. These can include methotrexate, cyclosporin A, Azathioprine, Mycophenolate mofetil, biologic therapy or Jak-inhibitors.

• Psychological treatments:  mindfulness, gentle exercise, or relaxation techniques.

Eczema is common and eminently treatable, so it is important to have an experienced doctor prescribe and recommend the best treatment combination for you. If your eczema is not well controlled and affecting your quality of life, make an appointment for a consultation.