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Sep 2014
What is Eczema?
Eczema is a common condition, 1 in 5 children and 1 in 12 adults are affected. It has many forms including, atopic, contact eczema (also called contact dermatitis) seborrheic eczema (also called seborrheic dermatitis) and gravitational eczema. It’s not contagious, so you can’t catch it from another person. Atopic eczema is more likely if there is a family history of eczema, asthma or hay fever.In its mildest form eczema produces dry, scaly, red and itchy skin. In more severe case the skin can weep, and go on to crust over or even bleed. The itch often leads to scratching and can cause breaks in the skin and even secondary infection.Most of us accept healthy skin without thinking. It is the largest organ in the body and forms a protective barrier against the environment and infection by the action of the 3 layers of the skin; it is also crucial in regulating temperature. The 3 layers areThe epidermis which is the thin outer layerThe dermis which is the middle layerSubcutaneous fat which lies underneath All 3 layers contain varying amounts of cells containing water and fats which help to hold everything together so producing this protective barrier and also help regulate temperature.If you have eczema these functions become more difficult because the skin may not produce as much fat and oils as healthy skin. When this happens, the cells in the skin do not hold onto the water and so microscopic gaps appear between the cells, this in turn allows more water to escape and the skin integrity is also lost. Once this happens, irritants in your everyday life, such as soaps and washing up liquid, which can dry out even healthy skin, cause irritation and redness and the typical red and scaly skin appears.TreatmentThe most important treatment for eczema is keeping the skin soft and supple by the frequent use of emollients. Emollients are non-cosmetic moisturisers which come in various forms of creams, ointments, lotions and gels. If you have eczema or you have a child that has, you may find that you need to use different preparations at different times. Use of emollient soap substitutes and shower gels are also recommended and it is important to remember that although these don’t foam like soap they are still cleaning the skin effectively. Emollients are applied after bathing and washing, apply gently, don’t rub. Emollients may need to be applied up to 3 times daily but your doctor, nurse or pharmacist will advise. As things improve the inclination is to stop the treatments but continuation even when there is improvement is essential to keep the skin healthy.RememberEmollients are non-cosmetic moisturisers so they do not contain any perfume or anti-ageing ingredients.Applied consistently they may be enough to control your eczema so thatYou don’t need to consider or use steroids as oftenFinding the right preparation for you may take a little time as some leave more oil on the skin than othersSo let’s have brief look at three common forms of eczema although there are other forms.Atopic EczemaThis type of eczema tends to run in families and is often associated with conditions like asthma and hay fever. The exact cause it not known but it is thought to be an interaction between genetics and environment. It can affect all ages but is commonest in children. Most children grow out of atopic eczema-in 74% of children the eczema will have disappeared by the time they are 16. However, those that have had more severe eczema are less likely to grow out of it. This type of eczema affects the creases of body joints so typically it affects the inside of the elbow and the back of the knee. When it settles down the skin can still remain a bit itchy and dry so it is important to carry on with emollients. Flare ups can be triggered by exposure to environmental factors and can include, soap, animal fur, pollens, rough clothing and house dust mites. Many people say there is often a flare up when they are stressed but it is not clear whether this is the cause or the effect. Obviously identifying and avoiding triggers can be very beneficial to controlling the condition. Simple changes like wearing gloves to wash up can have a dramatic effect.Contact DermatitisThe good thing about this condition is that it is preventable. Once the condition is bought under control by using emollients and steroids avoiding the sensitising agent will prevent reoccurrences. But remember it can take several months for the skin to fully settle. Other things will help to keep the skin in good conditionKeep using emollientsUse protective clothing if required to avoid contact with triggers.Avoid perfumes in washing liquids and cosmetics.Try organic cosmetics and cleaning products.Find the trigger and avoid it. Common triggers include perfumes, nickel in metal products like earrings(choose silver or gold instead), and white spirit, Seborrhoeic eczemaThis normally starts on the scalp as dandruff which then goes on to redness, irritation and scaling increases. The eczema may then spread onto the face especially where there is increased numbers of sebaceous glands, like the sides of the nose. Areas around the ear can also be affected as can inside the ear canal which is called ear eczema. A yeast, called pityrosporum ovale, is found on the skin of people with this type of eczema but is unclear if this is the cause or just a contributing factor. Treatment is by using specific medicated shampoos, but you should first get a proper diagnosis before treating.
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