Dr Caitlin: Eczema And How To Treat It

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Dr Caitlin O’Connor of Tralee Medical Centre in St Brendan’s Park, on the Eczema skin condition…

rsz_dr_caitlin_oconnorEczema (also called dermatitis) is a group of skin complaints that can affect all age groups and can occur anywhere on the body.

It is estimated that about one in 10 people are affected by eczema at some point in their lives.

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What are the symptoms of eczema?

The appearance of eczema varies according to the specific type of eczema involved; however, intense itching is often the first symptom for all types of eczema. Other symptoms may include:

• Redness of the skin

• Weeping skin

• Scaling, crusting or dry skin

• Fissures (broken skin)

• Vesicles (small blisters)

• Pain or tenderness

• Thickening and scaling of the skin.

What are the different types of eczema?

Atopic eczema is the most common form of eczema and is frequently associated with asthma and allergic rhinitis.

In this condition, the body produces too much of a type of antibody, which reacts to various allergens such as dust or pollen, causing inflammation and itchiness.

It is particularly common in young children and infants, many of whom outgrow the condition. There is a strong genetic component to this condition.

Contact dermatitis causes redness and itching on skin that has come into direct contact with an irritant or allergen. This type of eczema gets more common with age and is also associated with certain occupations that involve close proximity with chemicals – such as hairdressing or nursing.

Seborrhoeic dermatitis mainly affects the scalp, where it appears as dandruff in adults – however, it may also spread to the face, ears and chest. It can also occur in babies, where it appears as greasy, yellow scales; however these are not uncomfortable or itchy and the problem normally resolves within months.

Varicose eczema is caused by poor circulation and is more common in middle-to later years of life. It affects the ankles and lower legs, which become speckled, itchy and inflamed.

Discoid eczema most commonly occurs in adults, appearing as coin-shaped areas of red, irritated skin on the trunk or lower legs. It can be considered as an adult form of atopic eczema.

Pompholyx (also known as dishydrotic eczema) is characterised by intensely itchy vesicles on the hands, fingers and soles of the feet.
Juvenile plantar dermatosis is caused by friction of the sole of the foot with an ill-fitting synthetic shoe or trainer. It has become more common in recent years with modern footwear.

Light-sensitive eczema – this is a rare form of eczema caused by sunlight. It can also be caused by taking certain medication or using certain cosmetics.

How is eczema treated?

Certain types of eczema may clear up on their own or can be resolved by avoiding particular triggers. For many sufferers however, eczema is a lifetime condition that has to be carefully managed and monitored. While eczema cannot be cured, it can be controlled.

A good knowledge of the condition combined with a willingness to develop daily skincare routines or take prevention measures is the key to controlling eczema.

Moisturising the skin is the mainstay of treatment, and this can be achieved with the use of emollients. They are available as moisturisers, soap alternatives, bath additives, emulsifying ointments and shower gels. It may take time to establish which type of product suits you.

Other treatments that your doctor may prescribe include:

• Topical steroid creams or ointments – these reduce inflammation and may be used to treat flare-ups

• Antibiotics may be used to treat eczema that has become infected

• Antihistamine tablets can sometimes be used to relieve itching at night-time

• In severe cases, oral steroids and other immunosuppressant may be used.

How can I prevent flare-ups?

• If the eczema is due to an allergic reaction, avoid triggers – such as pets, pollen or certain foods.

• Include emollients in your daily routine to keep the skin moisturised: take a daily emollient bath to moisturise skin and relieve itch and apply moisturiser creams several times a day – it may be useful to carry a small tub of emollient with you in your schoolbag, handbag or car, to apply throughout the day.

• Avoid soap and commercially-prepared shower or bath products, which may dry the skin.

• Wear rubber gloves to protect your hands if you will be coming into contact with irritants.

• Try to avoid stress as this can often cause flare-ups.

• Avoid scratching and keep nails clean and short to avoid eczema becoming infected.

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