How to Stop Eczema From Ruining Your Life!

Is eczema/dermatitis (used interchangeably throughout this article) stopping you or your family from doing things that you love? Having itchy red skin is the first sign of eczema, and the more you itch the worse it gets! Thus, it is important to know how to recognize it, treat it and prevent it.

What is Eczema?

First and foremost, eczema or dermatitis is a superficial inflammation of the skin which can cause redness, itchiness, swelling, crusting and scaling. The word dermatitis refers to inflammation of the skin. There are a few types of eczema of which atopic and contact dermatitis are more common.

Our skin is primarily made up of three layers:

1. The epidermis - the outer layer which provides a waterproof barrier and carries our skin tone.

2. The dermis - the second layer which contains hair follicles, tough connective tissue and sweat glands.

3. The hypodermis - the third, deeper layer which is made up of fat and soft connective tissue.

The epidermis is the first line of defence between the body and the environment. This skin barrier keeps irritants and allergens away and prevents excessive water loss. Therefore when this defence skin layer is under threat due to various factors, it causes eczema.

Atopic Eczema

Atopic eczema is the most common type of dermatitis. It involves an overactive immune system and is characterised by chronic itching, redness, blisters, and inflammation of the epidermal layer of the skin. It is usually linked to a family history of related conditions like hayfever and asthma. Inflammation damages the skin barrier which leads to excessive moisture loss therefore causing very dry and infection prone skin. Characteristics usually overlap with other types of eczema especially contact dermatitis.

Symptoms, Signs and Causes

Atopic eczema can start in babies with red, weeping, crusty lesions on the face,

babycenter.com.au

In older children eczema is more localized. It typically presents itself on the crease of the elbow or behind the knees, but may also be present on eyelids, neck, wrists or ankles. It often improves by the ages of 3-4, but exacerbations can occur through to adulthood in some people. Skin on the hands can be very dry and flaky. They can also be thicker due to lichenifcation.

Aggravating trigger factors of dermatitis can be categorized in 2 groups; avoidable and unavoidable.

Avoidable factors can be attributed to irritants such as:

• bubble baths

• liquid soaps

• hand sanitizers

• fragrances

• saliva

• wool

• sand

• grass

• pollen

• public pools

• smoke

• tomato based sauces

• citrus

• nuts

• dairy

• emotional stress in adults

Unavoidable factors may be caused by weather such as cold or winter weather, or changes in temperature and humidity.

Itching is a constant symptom, and scratching and rubbing leads to an itch-scratch-rash-itch cycle, so it Is important to know what trigger factors are in order to control the symptoms better as life progresses into adulthood.

Prevention, Maintenance and Treatment

New research is emerging which shows that maternal diet may contribute to allergic eczema in babies. For instance, if a mother consumes wheat , nuts or dairy throughout her pregnancy (if she is not allergic herself), the risk of babies born with allergic conditions is reduced. Research also shows that probiotics play an important role in reducing eczema flareups in babies and children especially if babies have not been exclusively breast fed.

The most important thing to remember is to improve the skin barrier by avoiding irritants which trigger eczema flareups. Keeping fingernails short minimizes the effects of scratching, like broken skin, which would lead to infections.

For babies, a non irritant bath oil (for example 'Ego QV' bath oil which is available here if you interested : https://amzn.to/3W84LL3 ) should be used in the bath and moisturizer (for example Ego QV baby moisturiser) should be applied within 3 minutes of a luke warm bath or wash to ensure moisture is locked in to keep skin hydrated longer. Another great moisturiser to use on sensitive, reactive or allergy prone skin is made by La Roche-Posay which is called Cicaplast Baume B5 balm which you can buy here. I have had great success with this baume in keeping flareups at bay according to feedback from parents. Lipkar syndet AP+ wash also made by La Roche-Posay can be safely used in babies and children as a cream wash and you can purchase it using this link: https://amzn.to/4bs0tCM

If eczema is recurrent, bleach baths are recommended to prevent flares. Bleach baths can be made with of 1/4 cup white king (household bleach, not concentrated) in a bath tub of water. Please check with your childs pediatrician before using bleach baths.

For moderate eczema in children and adults, 10% glycerin in sorbolene, QV cream or Dermaveen cream( available here: https://amzn.to/4bpYLBT ) can be applied to eczema regions three times daily. I highly recommend QV cream which can be purchsed from this link: https://amzn.to/4cLsjuY

For very dry skin and severe eczema, Dermeze ointment, QV balm or intensive ointments should be used (3 times a day) as they are greasy and highly moisturising.

Dermeze is available here : https://amzn.to/3xKA85d

medicalnewstoday.com

Lotions and pump packs should be avoided as they tend to have more preservatives, are runny, less moisturising and may sting more.

After bathing, gently pat your skin dry with a soft towel and apply moisturiser while the skin is still damp.

If wool is an irritant- wear 100% cotton clothing

Antihistamines are generally not recommended but are used for sleeping if itchiness is worse at bedtime.

Topical corticosteroid creams and ointments are still the mainstay of treating eczema. Ointments are best for very dry areas. Contrary to 'applying sparingly', dermatologists recommend these should be applied liberally and aggressively to affected areas until they are cleared in short bursts. 0.5% and 1% hydrocortisone creams and ointments are available from your pharmacist and should be applied three times daily. This cream is available for you here: https://amzn.to/4crxHn2

If these recommendations do not work, please see your doctor for a more potent solution.

Finally, I want to reiterate the importance of using soap free wash, avoiding known irritants and regular and frequent application of emmolient creams.This is the key to keeping eczema from flaring up as it keeps the skin moisturised and hydrated which in turn breaks the itch-scratch-itch-rash cycle.

Contact Dermatitis

There are 2 types : irritant contact dermatitis and allergic contact dermatitis.

Irritant Contact Dermatitis

This is more common of the two but doesn't involve the immune system. Instead damage to the skin cells are caused by direct exposure to irritating substances: solvents, detergents, soaps, bleach and many more. These are also trigger factors for some people with atopic eczema mentioned earlier.

Allergic Contact Dermatitis

mayoclinic.org

Dermatitis or eczema caused by a delayed hypersensitve reaction which may take between 6-10 days (for example, poison ivy) to years for weaker sensitisers (for example cosmetics, moisturisers, deodorants) when they come in contact with the skin. These are harder to detect because you know these products so well and would not think of them as a cause of irritation. Another cause of major allergic contact dermatitis are medications such as penicillins and sulphonamides. Chemicals used in the manufacturing of shoes and clothing also contribute to skin allergies. These are tanning agents in shoes, dyes, rubber accelerators and antioxidants in gloves, undergarments and other apparel, metal compounds such as nickel, chrome and mercury in jewellery and other accessories.

Symptoms

Contact dermatitis also causes redness and itchiness but may have severe swelling of the skin. It can also have a burning sensation in case of irritant dermatitis. Usually it is limited to the site of contact but may slowly spread in case of allergic dermatitis.

Treatment

It is important to remove the agent causing the skin reaction which usually reduces redness and blisters dry up within a few days unless severe. As with atopic eczema treatment is with topical corticosteroid cream/ointment for mild cases. In case of allergic dermatitis, since it has an allergic component, antihistamines can be taken to combat histamine release. A cold compress can also be used to cool and soothe the site of reaction.

Prevention is the cure but its not usually easy to avoid irritants and allergens 100% of the time. Therefore, knowing what to do when it happens is of utmost importance!