Eczema is an extremely common inflammatory condition of the skin. It may start at any age but is most common in children, affecting 1 in every 5 children at some stage.
‘Eczema’ is a term which comes from the Greek word ‘to boil’ and is used to describe red, dry, itchy skin which can sometimes become weeping, blistered, crusted, scaling and thickened. The words eczema and dermatitis mean the same thing, and thus atopic eczema is the same as atopic dermatitis.
Symptoms of Eczema
Eczema can affect any part of the skin, including the face, but the area’s that are most commonly affected are the joints at the elbows and knees, as well as the wrists and neck. Other common appearances of atopic eczema include coin-sized areas of inflammation on the limbs and numerous small bumps that coincide with the hair follicles.
Affected skin is usually red and dry, and scratch marks (accompanied by bleeding) are common. When the eczema is very active, it may become moist and weepy (during a ‘flare-up’) and small water blisters may develop especially on the hands and feet. In areas that are repeatedly scratched, the skin may thicken (a process known as lichenification), and this may cause the skin to itch more. Sometimes affected areas of the skin may become darker or lighter in colour.
Causes of Eczema
The exact causes of atopic eczema are unknown, but it seems to be a combination of genetic and environmental factors.
a) Genetic Factors
Research suggests that atopic eczema is largely an inherited condition. If one parent has eczema there’s a 60% chance that the child will develop the condition. If both parents have eczema the chances of inheriting the condition leap to 80%.
b) Environmental Factors
If a person is genetically susceptible to developing eczema then they are likely to develop the condition when exposed to certain allergens in the environment. These can include:
- house dust mites
- pet fur
- Dust or sand
- Cigarette smoke
- High pollution levels
Food allergens such as eggs, milk, nuts, soya, fish and wheat may also trigger the development of eczema.
These should be applied several times every day to help the outer layer of skin function better as a barrier to the environment. The drier skin, the more frequently one should apply a moisturizer.
- Antibiotics and antiseptics
If eczema becomes wet, weepy and crusted, it may be infected and a course of antibiotics may be needed. Antiseptics, when applied to the skin alone or as part of a moisturizing preparation, can be helpful in stopping the growth of bugs.
Doctors may recommend antihistamine tablets, which in some patients can be helpful. Those antihistamines that make people sleepy (such as chlorphenamine and hydroxyzine) are most useful and are generally given at night. They have no effect on the inflammation of eczema and are helpful largely as a result of their sedating effects, reducing sleep disruption.
- Ultraviolet light
Some people with chronic eczema benefit from ultraviolet light treatment, which is usually given in a specialist hospital department and supervised by a dermatologist. This is rarely used for children.
People with eczema will benefit from a psychological approach to their condition in addition to use of creams, ointments etc. With constant care, Eczema does not have to be an impediment to living a happy, normal life.
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