What is Eczema?
Eczema is a skin condition that is becoming increasingly more common. It can affect individuals of all ages and is characterised by itchy, reddened, dry and sometimes blistering skin. Whether you are personally affected by eczema or are a caregiver, here are some valuable insights into living with and managing this often-challenging skin condition.
Eczema itself is caused by a combination of factors, both genetic and environmental. There is a familial element, which means that if you or your partner have eczema, then your children are more likely to have it too.
Eczema and Atopy
Eczema, specifically the most common form of “atopic dermatitis” therefore has a significant link to atopy. Atopy refers to the genetic tendency to develop allergic diseases, including allergic rhinitis, asthma and eczema.
It is characterized by an overactive immune system response to common environmental allergens.
Genetic Factors: The way atopy works, is that the genes inherited may predispose someone to having an overactive immune system. This reacts excessively to otherwise harmless substances like pollen, dust mites, or certain foods. In atopic dermatitis, this immune response manifests in the skin, leading to inflammation and the characteristic symptoms of eczema.
Environmental Factors: While genetic factors are a significant component, environmental factors also play a crucial role in triggering eczema in individuals with atopy. These triggers can include irritants like soap and detergent, allergens like pollen and pet dander, and even climatic factors like cold and dry weather.
Causes and Triggers
As the development and flare ups of eczema result from a combination of genetic and environmetal factors, managing eczema well can become quite complex.
Here are some common triggers of eczema. These can be especially problematic if there is an allergy to the specific element.
| Trigger Category | Common Triggers | Notes/Examples |
|---|---|---|
| Environmental | Pollen, Dust mites, Pet dander, Moulds, Hayfever | These are common allergens found in the household and outdoors that a lot of the people who suffer from atopy are also allergic to. Eczema flare ups may also be more common during high pollen season. You can use our pollen count tracker to see if this might be the case for you. |
| Irritants | Soaps, Shampoos, Detergents, Disinfectants, Fragrances | Chemicals and substances that can irritate the skin including the scalp. |
| Foods | Dairy products, Eggs, Nuts, Soy | Certain foods can cause eczema to flare up, especially in children. These can be tested for either via skin prick test or through an exclusion diet. |
| Fabrics | Wool or other synthetic materials | Certain fabrics can irritate sensitive skin and cause flare-ups. |
| Climate | Extreme temperatures, Low humidity, Sweating | Both hot and cold, dry climates can trigger eczema symptoms as these extremes tend to dry the skin. This makes it more prone to breakages and can easily become irritated. |
| Stress | Emotional stress, Anxiety | Stress can worsen or trigger eczema symptoms. |
| Hormonal | Menstrual cycle, Pregnancy | Hormonal changes can influence eczema flare-ups. In some individuals, eczema may simply flare up around the time when periods start. One solution for this is to discuss with your GP regarding contraception. |
If something triggers my eczema, does this mean I am allergic to it?
No, not necessarily. If something triggers eczema, it doesn’t automatically mean you are allergic to that substance or factor. The relationship between eczema triggers and allergies can be complex.
For example, eczema can be triggered by irritants (subjects that physically irritate the skin), without them being an allergen (if they don’t provoke an immune system response). An irritant doesn’t cause an allergic reaction but can aggravate the skin, leading to eczema flare-ups.
If you are worried about being allergic to something that also triggers your eczema, you can have an allergy test done to know for sure.
Eczema Symptoms and Diagnosis
Symptoms of eczema can range from mild to severe. These typically include:
- Persistent itching and dry skin, which can be particularly intense during the night.
- Red or brownish-gray dried skin patches. These tend to be found in the flexural areas, on the hands, feet, ankles, wrists, neck, upper chest, eyelids and inside the bend of elbows and knees. In infants and younger childre, eczema also frequently affects the face and scalp areas.
- Small, raised bumps that may leak fluid when scratched. If the eczema starts leaking fluid, this can lead to it becoming infected. This would then be called infected eczema and may need antibiotics for it to fully go away. Your GP should be able to review your skin symptoms and give you the appropriate treatment.
- Thickened, cracked, dry, or scaly skin.
- Raw, sensitive and swollen skin can develop if the symptoms and underlying cause of eczema are not addressed over a longer time period.
How is Eczema Diagnosed?
Eczema is a clinical diagnosis and no specific tests are needed.
Remember that eczema can present at any age and it can affect pretty much any part of the body. The classical places are the flexural areas. However, in infants, eczema tends to start either on the face or the scalp and trunk areas.
What is the Best Eczema Treatment?
Eczema management or treatment involves keeping the skin moisturised appropriately, to help prevent flare ups.
The second part of the treatment is identifying what your eczema triggers are and avoiding these in the future. Take a look above for the common eczema triggers.
During flare ups, you might need to use a steroid cream for a short duration (up to 2 weeks), in order to get the eczema back under control. It’s best to avoid prolonged or frequent use of steroids due to their potential for side effects.
Common steroids from least to most potent, include Hydrocortisone 0.5%, 1% or 2.5%, Eumomvate, Betnovate or Dermovate.
Worried about Eczema?
If you are worried about eczema, and wonder whether you might have it, please get in touch. We can help with the diagnosis and provide you a management and treatment plan going forward.
Eczema can affect more than just skin; it can impact sleep, daily activities, and mental health. Managing itching, particularly at night, is a common challenge. It’s important to address not only the physical symptoms but also the emotional aspects, seeking support when needed.
At Holistic Allergy, we offer a holistic approach in terms of both lifestyle adjustments, avoiding eczema triggers and also potential medication to keep eczema flare ups under control.
Should I get treatment privately or on the NHS?
The treatments for eczema are broadly the same in both the NHS and privately. The key advantage to seeing an allergist privately for eczema treatment is the quicker access, thus saving time.
