Eczema

Eczema is a group of skin conditions that affect the skin. The most common type, atopic eczema, affects 20% of children and 10% of adults across the globe

There are 7 types of eczema. While each type is slightly different, they all cause itching, redness and irritation. It can occur across the body. However, it is particularly common on the hands and the face.

Are eczema and dermatitis the same?

The term ‘dermatitis’ is often used interchangeably with eczema. However, dermatitis refers specifically to inflammation of the skin. It is a term that covers other conditions as well as eczema.

Each type of eczema causes slightly different symptoms. However, most types of eczema have some core symptoms in common.

Common symptoms of eczema include:

• itching
• dryness
• sensitive skin
• cracked skin
• rough, leathery or scaly skin
• oozing or crusting
• swelling and inflammation

Sometimes people itch so much that the skin breaks and bleeds. It can also lead to skin infections.

Eczema occurs across the body. However, it is particularly common on the hands, and feet, inside the elbows and the back of the knees.

Eczema vs. psoriasis

Eczema is commonly mistaken for another skin condition called psoriasis. Psoriasis causes patches of scaly skin that are pink, red, dark brown or grey.

However, the main difference is that psoriasis causes distinct raised patches of skin. It also more commonly occurs on the elbows and knees and is less likely to cause itching.

Eczema	Psoriasis

If you’re not sure which skin condition you have, consult your doctor or a dermatologist.

There are seven types of eczema that all look slightly different. Below is a summary of the most common types.

1. Atopic dermatitis - The most common type of eczema. It causes dry, itchy and cracked skin across the body.
2. Contact dermatitis - Another common type of eczema is specifically caused by certain irritants (irritant contact dermatitis) or allergens (allergic contact dermatitis).
3. Pompholyx (dyshidrotic) eczema- Itchy watery blisters that occur on the hands and feet. It is particularly common in women under the age of 40.
4. Neurodermatitis - A rarer type of eczema that causes smaller patches of thickened skin. Experts believe it’s caused by nerve damage from frequent itching.
5. Discoid eczema (nummular eczema) - A distinctive type of eczema which causes itchy and dry oval-shaped lesions. It is often confused with ringworm or psoriasis.
6. Stasis dermatitis (venous eczema) - A type of eczema that affects the calves and feet. It is caused by poor blood flow to the legs and predominantly affects older people.
7. Seborrheic dermatitis - A common scaly rash that affects the scalp, face and chest. It also affects babies as a condition called ‘cradle cap’.

Asteatotic eczema, while not officially recognised as one of the 7 types, is a type of eczema that causes dry, rough and scaly skin. It commonly affects older people on the legs but can also occur on the arms, stomach and back.

What causes eczema will depend on the type you have. Some types of eczema like varicose eczema have a clear underlying cause.

However, in a lot of cases, a cause isn’t clear. Dermatologists believe it is caused by genetics and things in your environment. They also believe people with eczema have more reactive immune systems.

Some risk factors for eczema include:

• a family history of eczema or other allergies
• having asthma or hay fever (allergic rhinitis)
• living or growing up in certain climates (e.g. cold and damp)
• jobs that work with chemicals or certain irritants

Eczema triggers

Certain irritants and allergens may cause your eczema, especially contact dermatitis, to flare up. Below are some common eczema triggers.

Eczema can also be caused by other triggers, including:

• stress and other mental health problems
• dry skin
• cold & flu
• harsh weather
• food allergies

Everyone’s triggers are different. Learning what triggers your symptoms can help with your treatment.

Because of the range of eczema types, there are a wide variety of treatments available.

Over-the-counter treatments

For the mildest and occasional eczema bouts, symptoms can be controlled by over-the-counter treatments.

• emollients (moisturisers) - used every day to prevent the skin from becoming dry
• antihistamines (e.g. fexofenadine) - used to prevent itching
• low-potency steroids (e.g. hydrocortisone) - used for short bouts to reduce inflammation
• medicated shampoos (e.g. ketoconazole or coal tar) - used to combat fungus responsible for seborrheic dermatitis

While they are mild treatments, you should still consult your doctor or dermatologist before using these treatments.

Prescription treatments

Most people with moderate symptoms will require some ongoing prescription symptoms.

The most commonly prescribed treatment for eczema is topical corticosteroids. They work by targeting inflammation to reduce eczema symptoms. Common topical steroids include:

• Betnovate (betamethasone)
• Dermovate (clobetasone)
• Diprosalic (betamethasone and salicylic acid)
• Elocon (mometasone)
• Locoid (hydrocortisone butyrate)

They are as available as creams, ointments and scalp applications. However, these steroids should not be used long-term. Overuse can cause skin side effects or serious complications such as topical steroid withdrawal (TSW).

Other treatments

For severe or widespread eczema symptoms that haven’t responded to traditional treatments, you may be offered alternative types of treatments.

One newer treatment for atopic eczema is called biologic therapy. It is most commonly used for conditions like Crohn’s disease or rheumatoid arthritis.

It is available as an injection, infusion or tablet. The treatment works by altering the chemicals responsible for the immune system.

A dermatologist or specialist may also recommend phototherapy, a type of light therapy. It uses specific wavelengths of ultraviolet (UV) light. It works to reduce an overactive immune system. You may need multiple sessions to see progress.

For many, eczema is a lifelong condition. It will require careful management to keep symptoms at bay. Here are some tips to help manage your eczema.

Avoid itching

Itching can make eczema patches worse and cause your skin to break and bleed. Make sure to keep your nails short and clean and keep your skin covered with light clothing. Also, try gently rubbing your skin with your fingers instead. Some people wear gloves to help stop itching.

Avoid triggers

Keep a diary of your symptoms and you can work out what may be causing your symptoms. It can be stress, weather-related or something in your diet. Then, you can avoid them as much as possible.

Use an emollient

It’s important to keep your skin moisturised. During a flare-up, you should try to use an emollient twice a day.

Ointments are greasy and the most moisturising. Creams are somewhere in the middle while lotions are the least greasy. Your doctor may recommend the following:

• an ointment for very dry skin
• a cream or lotion for red and inflamed skin
• an emollient to wash with instead of soap

Some people find that emollients become less effective or more irritating the more you use them over time. You may need to change products to find what is best for you.

If you struggle with eczema, you can order your treatment online at euroClinix.

Simply select the treatment you need. You will then complete an online medical questionnaire that will be reviewed by one of our registered doctors.

If approved for treatment, our doctors will issue a prescription and it will be delivered to your address for free.