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Eczema

Eczema

What is eczema?

Atopic eczema, also referred to as atopic dermatitis, is a skin condition most commonly found in children, but can also affect adults. Eczema causes the skin to become itchy, dry, red and cracked. While the condition can improve over time, unfortunately it is a long-term condition in most people.

This skin condition is thought to be caused by a weakness in the skin barrier, making it more susceptible to inflammation, and allowing allergens and bacteria to have contact with the immune system.

Atopic eczema can affect any part of the body; however, it is most commonly found on the knees, elbows, neck, scalp, hands and face. ‘Atopic’ means the body has a tendency to make increased levels of antibodies in reaction to certain allergens. An atopic individual usually suffers more than one allergic condition, and throughout their life they may experience other conditions such as eczema, asthma, hay fever or food allergy.

The majority of eczema sufferers have atopic dermatitis, which is the most severe type of eczema and usually starts in childhood. They include dry, itchy, and scaly skin, especially on the insides of the elbows and backs of the knees. It also causes rashes on the cheeks.

While there are periods when eczema can clear up or disappear, flare ups can also occur when symptoms are a lot more intense. Eczema usually becomes evident before the age of five years old, and appears in the form of red, crusted, scaly areas on cheeks and scalp, or it may appear on the arms.

Another form of eczema is dyshidrotic eczema, (also known as pompholyx eczema) the symptoms of this type of eczema are itchy watery blisters on the hands and feet. Sufferers also experience a burning and prickling sensation on the palms of their hands and soles of their feet.

This type of eczema is more common in adults over the age of 40 years old, especially those with other allergies. It’s also more common among people who tend to have their hands and feet emerged in water a lot, or those who come in contact with chromium, cobalt, or nickel. Stress is also a trigger of this type of eczema.

Nummular eczema refers to the coin-shaped spots on the skin, this is also called discoid eczema because the scaly patches look like discs. The cause of this type of eczema is still unknown.

Each different type of eczema can range in severity, and can clear up only to reappear again in the future. Doctors often consider eczema as less severe than patients rate their condition. One study found that 40% of patients rated their eczema as severe while just 18% of doctors gave it the same rating.1

Eczema can affect one’s quality of life to a significant level, and it also has an effect on sleep patterns. This can make sufferers irritable and frustrated, but with good management of symptoms this problem can be alleviated.

It is worth spending some time trying to find the most suitable therapy, as what works for one person may not provide relief for another. The symptoms can cause embarrassment and frustration for sufferers, and many people do not understand that eczema is neither infectious nor contagious.

It is estimated that 10% of the world suffer atopic dermatitis at some point in their life. Urban areas and developed countries seem to have a higher population of sufferers, but men and women and all races are affected to an equal degree.2

[1] http://www.webmd.com/skin-problems-and-treatments/eczema/eczema-different-types#1

[2] https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/

Causes and Triggers

The exact cause of atopic eczema is still unknown but it is thought to be related to a combination of factors, as opposed to a single reason. Researchers have concluded that both genetics and the environment are involved.

It can also run in families, and often develops alongside other conditions, such as asthma, dust mite allergy and hay fever. It is unknown how it is passed between generations, but if one parent has AD, asthma, or hay fever, there’s about a 50% chance that their child will have at least one of these diseases. If both parents have one or more of these conditions, the chances are much greater that their child will too.3

The symptoms of atopic eczema are often triggered by factors, such as soaps, detergents, stress and the weather. Sometimes food allergies can play a role, especially in young children with severe eczema.

Certain foods can be triggers for eczema, but the food is never the main cause of the eczema. For example, if a food seems to be making eczema worse, excluding that food might improve the severity of symptoms but it will not cure the condition completely.

Other triggers can include allowing the skin to become too dry – as when it is rough or tight, this can cause an eczema flare up. There are products and natural substances that we come into contact with every day which can irritate your skin, such as laundry detergent, shampoo, surface cleaners and soap. Even natural juices from fresh fruit, vegetables, or meats can cause irritation to sensitive skin.

Emotional stress is thought to be linked to worsening of eczema symptoms, but doctors have yet to fully understand why.

Excessive heat can also aggravate the symptoms of eczema. Most sufferers will experience an uncomfortable prickly heat type sensation when they are hot or sweat. This is common during exercise or when bedding or nightwear is too heavy for the climate. During the winter months, the skin also gets very dry which can trigger flare-ups.

Everyday environmental materials such as pollen, dust mites, pet dander, mould and dandruff can also trigger eczema, and women are especially prone to experiencing flare ups caused by fluctuating hormone levels in the body.

So, there really is no single cause of this condition. However, extensive studies have been carried out and doctors have provided useful guidelines for managing symptoms.

[3] https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/

Signs and symptoms

Eczema is usually first noticed in babies, but children and adults can also develop the condition. The symptoms vary from person to person, but generally eczema appears as very itchy, dry, swollen or sore patches of skin.

The rash tends to come and go and at times can be crusty and scaly. Sufferers also develop blisters or may leak fluid, and experience cracking or peeling. Scratching can worsen symptoms and cause infection. The skin also becomes thick and leathery from scratching.

Eczema can appear anywhere on the body, but the most common areas are inside the elbows, backs of the knees, face, behind the ears, buttocks and on the hands and feet.

Sometimes there may be other changes in the skin, such as raised bumps, hives or an extra fold of skin under your eyes.

Scratching can break the skin, allowing bacteria or viruses to enter and cause an infection.

Although symptoms tend to lessen over the years, sufferers of eczema are at greater risk of other skin problems throughout life.

Since there are varying degrees of eczema, it can be difficult to know if your skin is just excessively dry or you are suffering eczema. The difference is dry skin is generally a temporary problem, and isn’t usually very itchy or inflamed, whereas if you are suffering an itchy rash frequently, it is likely to be eczema. It is recommended to visit your GP for proper diagnosis and advice.

Treating eczema (including tips for self-care)

A visit to your GP will usually determine whether you are suffering eczema, as your GP will be able to diagnose the condition through looking at your skin and asking you some questions such as about your symptoms, family history and any other allergies, asthma or hay fever you may have.

You should inform your GP if your quality of life is affected, for example, if you are experiencing difficulty sleeping because of the itching, or your everyday activities are limited.

Emollients

Emollients are non-cosmetic moisturisers which help keep the skin moist and flexible, to prevent cracking. Emollients come in the form of creams, lotions, gels and ointments which help keep the skin feeling more comfortable and less itchy.

Emollients are the most effective way to manage all types of eczema, as they keep the skin soft and supple.

The creams feel light and cool on the skin and are popular for day time use. Ointments can be very greasy, although because they hold water in the skin, they are effective at hydrating very dry and thickened skin. Lotionsare the least effective; however, they are useful for areas of the body covered in hair. Emollients are ideal for managing moderate eczema.

Topical corticosteroids

Topical corticosteroids, or topical steroids for short, are creams, ointments and lotions which reduce the inflammation of the skin and are usually applied once or twice a day. It is important to use the right amount of steroid creams as directed by your GP, as opposed to emollients - which can be applied liberally.

Steroids are grouped into different categories depending on their strength - mild, moderately potent, potent and very potent. In general, a topical steroid should only be used when there is more than one patch of eczema.

Topical’ describes something that is applied to the skin, while ‘steroids’ are natural hormones, produced by different glands in the body. Topical steroids reduce redness and soreness (inflammation) and are very effective in treating flare-ups, as they reduce the itch and soreness, giving the skin a chance to heal.

Self-care tips

  • Keep fingernails cut short and consider light gloves if scratching is a problem during the night
  • Moisturizers and emollients are most effective when they are applied to skin that is wet or damp. After bathing, lightly pat the skin dry and then apply the moisturizer right away to seal in the moisture
  • Use gentle skin care cleansers rather than traditional soaps, and limit use to only on your underarms, genital areas, hands, feet and face
  • Keep your home cool, especially the bedroom, as a hot environment causes itching
  • Use your emollient even when you are not experiencing symptoms. Keep a supply of emollients at work or school, and a tub in the bathroom and one in a living area so you can constantly top up. Don’t be shy to ask for a large quantity on your prescription
  • Ask your GP about special medicated bandages, clothing or wet wraps. These are used over emollients or with topical steroids to prevent scratching, promote healing, and stop the skin from drying out
  • Reduce stress by listening to relaxation tapes, trying out meditation or practicing mindfulness, as eczema can be aggravated by anxiety
  • Invest in specialist clothing and bedding available for eczema sufferers. Cool cotton or silk fibre clothes and bedding are ideal for eczema sufferers, as these allow the skin to remain cool and less irritated.
  • Avoid sweating by not over-dressing during warmer weather and using suitable bedding for the climate

Avoiding triggers

  • Steer clear of chemicals such as washing detergents, perfume, soap and air freshener
  • Avoid hot baths and showers, instead keep water lukewarm and gently pat dry before applying emollient
  • Dust and vacuum regularly and try to keep allergens such as dust, pet dander, mould and pollen to a minimum
  • Avoid any foods that may be triggers - peanuts, milk, soy, wheat, fish, and eggs are common

Dietary Changes

There is no solid evidence that certain foods cause eczema or trigger a flare-up; however, some people notice symptoms do develop after they eat a specific food.

It is not an easy task identifying what is the cause, as there can be many triggers at work - such as environment and stress, as well as diet.

Elimination diets may help you work out if a specific food is contributing to your condition. This involves cutting out a certain food, such as eggs or cow’s milk, to check if there is any improvement in your skin.

Unless you have been tested and confirmed to have a particular food allergy, be sure to discuss your diet with your doctor before cutting out a whole food group.

Food allergies can sometimes be the cause of eczema in young children. After the age of three or four, this is rare and an allergic reaction to dairy products, eggs, nuts or wheat may cause skin reactions such as hives, but this is different from eczema. If you think a food allergy is contributing to your child’s skin disease, it is advised to talk to your doctor.

On the other hand, unfortunately there is little evidence that any particular food or supplement can help eczema, but research is still going on.

For example, scientists are studying tea - a few studies suggest that drinking black or green tea may help provide relief. Also the omega-3 fatty acids found in fish and fish oil, may also help fight inflammation, and therefore ease the symptoms of eczema.

Despite the uncertain links between eczema and food, a well-balanced eating plan including lots of fruits, vegetables, grains and low fat dairy products is the best diet for overall good health.

Eczema and the work place

Many people who suffer from eczema find work uncomfortable, challenging and even impossible. Contact dermatitis is the most common form of eczema among workers and is caused by contact with chemicals, both natural and synthetic. Approximately nine per cent of the UK population suffer contact dermatitis, the Health and Safety Executive estimates that around 84,000 employees in the UK have dermatitis which was caused by or made worse by their work, with ten percent of these cases working in the food or catering industry.4

There are two types of contact dermatitis, one is caused by irritants in the environment and the other is caused by allergens.

Regular contact with everyday substances such as water, detergents, soap or even cold air can cause irritant contact dermatitis. Also perfumes, oil, acids and alkalis and even plants can cause this type of eczema, and as a result, hairdressers, nurses and carers, chefs, cleaners, mechanics and all types of construction workers often suffer from workplace contact dermatitis. Symptoms vary from very mild dryness, to cracked and flaking skin or even bleeding. In very severe cases skin may have blisters and weeping sores.

Allergic contact dermatitis is less common but just as debilitating. This condition is caused by an allergic reaction to a substance after exposure. While the symptoms are similar to those of irritant contact dermatitis, the reaction happens much faster.

Hair dye used by hairdressers, metals used in jewellery making, latex used in rubber gloves, and plants like chrysanthemums used in floristry are common allergens.

Products that can help:

Hope's Relief Dry Skin Rescue Cream

Hope's Relief Premium Eczema Cream is an all-natural cream specifically developed to assist in relief of the irritating symptoms of eczema, psoriasis, dermatitis and dry itchy skin.

Hopes Relief Moisturising Lotion

This nourishing formula with mango butter which gives intense all over moisturising for dry, flaky sensitive skins to help repair the skins natural barrier. Ideal to use alongside Hope's Relief original Dry Skin Rescue cream, to give all over body hydration for eczema prone and dry skin.

Derma Silk Adult Gloves

If itching is causing you sleepless nights and making your eczema worse, then these silk-like gloves will help you get the rest you deserve. The special Derma Silk fabric is breathable and controls temperature, reducing sweating, itching and reducing flares.

DermaTherapy® Fitted Sheet

DermaTherapy® bedding keeps friction to the absolute minimum, which reduces the risk of irritation, ideal for sufferers of Eczema. These bed linens are free of the short fibres, so it doesn’t pull on irritated eczema skin, and it’s also temperature regulating. DermaTherapy® sheets successfully wick moisture away from the skin, which helps avoid irritation from sweating. The combined effect of moisture wicking and friction free fibres makes it easier to roll over in bed as the skin glides smoothly across the surface.

Bamboo and silk bed linen also naturally has the same features and benefits. Not only does bamboo reduce irritation during the night, but also wicks away excess moisture naturally and helps regulate body temperature. Silk and bamboo are great choices as they are naturally resistant to dust mites, fungi and mould, therefore ideal for those whose conditions are triggered by these allergens.

For those eczema sufferers who have a dust mite allergy, the Allersafe Anti-Allergy bedding is ideal.

Allersafe bedding dramatically reduces the growth of dust mite allergens. Providing a healthier sleeping environment for those already sensitised to household dust mite allergens and preventing the sensitisation that leads to asthma, sinusitis and allergic rhinitis.

Allersafe bedding is blended with Amicor Pure fibre, an intelligent fibre with anti-bacterial and anti-fungal additives inside. It creates an environment that is not suitable for dust mites to survive. Its effects last for at least 200 washes.

For eczema sufferers who find that chlorine in water irritates their skin, the Aquatiere range is ideal.

Allersafe have sourced a superior range of water filters from Aquatiere. The Aquatiere filters are designed to improve the quality of your household water.

They combine a unique mixture of granular ceramics and traditional water treatment media. They incorporate Ceramet, their unique patented media which is said to eliminate scale whilst providing you with naturally healthy, chlorine free water.

[4] http://fitforwork.org/blog/eczema-in-the-workplace-contact-dermatitis/

Have eczema? Could you also have allergies?

If you suffer from eczema, you may have allergies also as they are thought to be connected. Doctors refer to eczema, allergies, and asthma as the ‘atopic triad’ because they often occur together.

In the past, scientists claimed that eczema was caused by allergies, but we now know it is not this simple. Research shows that some people with the condition have a gene flaw that causes a lack of a specific protein (filaggrin) in their skin.5 This protein’s role is in protecting the outer layer of our skin which is a barrier to bacteria and foreign bodies. Without filaggrin the skin dries out and the barrier breaks down making the skin vulnerable to substances it is exposed to, such as soaps and detergents. It is also easier for allergens to enter the body, which makes people more sensitive to particular allergens, even food.

Research also highlights an issue with a type of white blood cell that helps control allergic reactions in the body. This could explain why people with eczema suffer flare ups when they are exposed to allergens.

It has also been proven that eczema sufferers have higher than normal levels of antibodies.Researchers have yet to work out why eczema sufferers have this higher level and its role in this skin disease.

[5] http://www.webmd.com/skin-problems-and-treatments/eczema/treatment-16/eczema-allergies-link

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