The term ‘eczema’ is used interchangeably with ‘dermatitis’ and refers to inflammation of the skin. It is a highly individual condition that varies from person to person and comes in many different forms. In mild cases, the skin is dry, red and itchy; while in more severe cases, the skin may ooze, crust or bleed. The skin may also become infected following breaks in the skin caused by scratching.
Eczema affects 1 out of 10 people (10%) at some time in their life. Although most often seen in children, it can affect all age groups.
Atopic eczema is the most common type of eczema. However, there are many other types of eczema as well. Atopy is characterised by a tendency to develop a group of hypersensitivity disorders; namely eczema, asthma or hay fever, due to a genetic predisposition.
Atopic eczema is a genetic disorder associated with a sensitive skin. The condition is often associated with a family history of eczema, asthma or hay fever. There are many external factors which may aggravate the eczema.
Aggravating factors include:
- Sudden changes of room temperature, strenuous exercise and hot, humid weather.
- Synthetic or woollen clothings. Children should be dressed in cotton.
- Emotional upsets
- Frequent use of soaps, bubble bath, hot water. Use mild soaps or soap substitutes like emulsifying ointment. The temperature of the bath water should be cool.
- Cigarette smoke. In an enclosed room, smokes and fumes will irritate the skin. It is best to ban smoking within the house.
- Dogs and cats danders. All furry pets will aggravate eczema. Avoid keeping cats and dogs in the house.
- Irritant foods and saliva. Acidic juice in citrus fruits eg. oranges and vegetables eg. tomatoes can cause eczema around the mouth. This is often made worse by lip licking and dribbling.
Most patients present with eczema (redness, scaling and swelling) on the face, limbs and trunk. The flexures may be more severely affected. The condition is very itchy.
There is no single medication which will cure eczema. It is possible to control eczema effectively by using a simple treatment plan.
Emollients
These are products which moisturize and soften the skin. They help to reduce the itching and scratching, are safe and should be used frequently.
Topical steroid cream
The use of an appropriate topical steroid is safe and an essential part of treatment. Your doctor will advise you on the appropriate cream to use.
Anti-itch (antihistamine) medication
Given an hour before bed, this will help the child settle and have a comfortable night's sleep.
Antibiotics
Skin with eczema seems to attract certain bacteria to the skin. Antibiotics remove these bacteria and may improve the eczema. Your doctor will advise you on whether antibiotics are needed.
