Skin Facts: Eczema

What is eczema?

Eczema is a condition that many people will encounter at some point in their lives. Most common in childhood, it affects approximately one in five children and one in 12 adults in Ireland, affecting both men and women equally. Although not contagious, it is recognisable by red, dry, itchy skin that is most often seen on inner sides of the arms around the elbow creases and wrists, behind the knees, and on the face and neck, but can affect other parts of the body.

Causes

There are multiple factors that can cause eczema, with no exact universal cause known. A flare can be triggered by environmental irritants such as soap or detergents, changes in temperature, sweat, stress, as well as genetics and a weakened skin barrier/immune system. The condition is often linked to other atopic conditions such as asthma and hay fever, where the hypersensitivity of the condition is caused by a change in environment.

Contact dermatitis

Dermatitis means an inflammation of the skin, which is when symptoms such as redness, dryness and itch worsen. The two main types of contact dermatitis are irritant and allergic. Irritant contact dermatitis can develop when the skin comes into frequent or prolonged contact with substances that cause reactions such as detergents, that damage the outer layer of the skin over time. Allergic contact dermatitis is when a more immediate reaction will appear when the skin is exposed to a substance or ingredient that is rejected by the immune system. Red and itchy skin will often appear at the point of contact of the substance, which may be the likes of fragrances, hair dyes, or glues.

Dry Skin

Many eczema sufferers experience abnormally dry or tight skin. This is due to a weakened skin barrier that is less capable of retaining water, as the lipids (fats and oils) that surround the skin cells break down more quickly, allowing gaps to open between the skin cells and moisture to be lost, subsequently irritants or allergens to pass through.

Diet

Many people who have eczema are also diagnosed with food allergies. Common food allergies associated with eczema include dairy, eggs, gluten, nuts and soy. Foods high in sugar may also cause flare-ups, as sugar causes your insulin levels to rapidly increase. Of course, not everyone will be affected by these foods, and alternatively, some foods do contain properties that may help decrease eczema flare ups. Fish oil found in salmon and herring contain high levels of Omega 3, which are anti-inflammatory. Whether its through food intake or supplements, it is recommended that you get at least 250mg of Omega 3 daily.

Similarly, Quercetin is a powerful antioxidant and antihistamine found in apples, blueberries, cherries and spinach that should be included regularly in the diet, whilst probiotic-rich foods such as sourdough bread, miso soup and pickles will help to build up the immune system.

In general, focusing on a healthy diet filled with fresh fruits and vegetables, healthy fats and lean protein should help to minimise or eliminate eczema flare ups.

Treatments

  • Emollients & Moisturisers – Used throughout the day and before going to bed, these products soothe the skin and help repair the skin’s barrier, which should increase the effectiveness of prescribed treatments. Many eczema sufferers are told to avoid using ordinary soaps as the dry out the skin by stripping away its natural oils, and instead opt for emollient wash products that leave the skin coated with a protective film.
  • Topical steroids – These are creams or ointments prescribed by your doctor to be used during times of flare ups. When using with emollients, it is best to try to leave 15-30 minutes between applying the two different types of creams to allow time for the first to sink in, and to avoid diluting the topical steroid with the emollient and spreading it to areas that don’t need it. The strength of steroid prescribed is influenced by factors such as age, severity of eczema, body site and size of affected area. Generally, apply mild steroid first to face and or/body folds, where skin is thinner and more sensitive, before applying stronger steroids to other areas.

If used over long periods of time, topical steroids can thin the skin, making it appear transparent, fragile and susceptible to bruising, losing its elasticity and developing ‘stretch marks’. Keeping up a good routine of using complete emollient therapy for washing and moisturizing to constantly repair the skin barrier has been shown to reduce the amount of topical steroids required for some people.

For most sufferers, managing the condition and symptoms comes down to knowing your triggers, maintaining an effective moisturizing routine, using prescription medication as directed, and watching out for and quickly reacting to infection. It is ultimately worth accepting that eczema is an unpredictable condition, and having a flare can occur out of the blue despite all your best efforts.

For more information on eczema, speak to your local Allcare Pharmacist.