Eczema is frequently thought of as a childhood disease, something that many of us suffered from as babies and then grew out of, but in fact 1 in 12 adults will be affected by eczema at some time in their lives. The incessant irritation that eczema causes is often painful and frustrating, and can be debilitating.

Eczema, also known as dermatitis, occurs in two forms. It can either be atopic, when an allergen enters the body and produces a generalised skin reaction, or it can be due to direct contact of the skin with an external allergen. 

Atopic eczema

Atopic eczema, also known as atopic dermatitis, is often found to run in families, particularly where there is a history of hay fever and asthma. It is excessive inflammation of the skin in response to particular allergens, causing red or brownish itchy patches. This type of eczema is most commonly seen in small children, but it can occur at any age. Dust mite excrement and animal dander are the main culprits with adults, though it can sometimes be the result of a food allergy.

Contact dermatitis

This is the type of eczema that usually affects adults. It can be caused either by the skin becoming sensitive to a substance over time, causing allergic contact dermatitis, or it can be a result of skin coming into contact with chemicals such as detergents and disinfectants that strip it of its natural oils, causing it to become red and dry, cracked and itchy. This is called irritant contact dermatitis.

Allergic contact dermatitis is most commonly caused when the skin is overexposed to a substance and develops allergic-type sensitivity to it, such as nickel found in jewellery, solvents, rubber, cosmetics, perfumes and dyes.

Symptoms

The common symptoms of both types of allergic eczema are inflamed, itchy, scaly skin. In children it can become weepy; in adults it tends to be extremely dry. Mild cases can be little more than a small irritation, but in severe cases the itching can be unbearable and can lead to disruption at home and at work, sleep disturbance, and even low self-esteem and depression.

Eczema can also affect the eyes. Eyelid eczema and related infections such as atopic keratoconjunctivitis are most common in adult males, and can be quite severe, sometimes leading to lens cataracts.

Prevention

As with all allergies, the most effective way to prevent allergic eczema is to avoid the cause.

For contact dermatitis, allergen avoidance could mean anything from wearing only gold jewellery to swapping to hypoallergenic cosmetic ranges, or simply avoiding such products altogether.

In the case of atopic dermatitis, allergen avoidance is more difficult that for contact dermatitis sufferers, as many of the allergens that cause this type of eczema are airborne. If your eczema is triggered by allergens around the home, you can invest in allergen-tight bedding, air filters, and anti-allergen cleaning products to reduce their presence.

Treatment

If your trigger is unavoidable in everyday life you can treat the symptoms with low-dose steroid ointments or emollients that will help to soften and rehydrate the skin and relieve the itching.

Emollients in the form of creams, lotions, ointments and bath oils may help with mild cases, but more severe outbreaks are usually treated with steroid creams or a short course of oral steroid tablets. These help to reduce the inflammation that causes the symptoms and are often highly effective at treating the skin.

Anti-histamine tablets can be taken on a regular basis to reduce inflammation and itching, which may provide relief at night when the irritation can be at its most relentless.

Swapping shower and bath creams and shampoos that contain detergents for soap-free, pH-balanced alternatives may help to improve the condition of the skin and will cause less additional irritation. A lukewarm bath containing an emollient can be beneficial, and patting skin dry as opposed to rubbing with a towel will also help. Cotton is better to wear than synthetic fabrics as it will be less likely to irritate and will help to minimise perspiration, which can exacerbate eczema.

One thing that many people forget is that stress makes eczema worse. Remember to take time out for yourself, and try to build time into your week for activities that promote relaxation such as yoga, meditation, or a creative pastime or hobby.

19/05/2009