Eczema: A Doctor's Guide to Dealing With This Skin Condition
One of the most common skin conditions I see in GP practice is eczema. I am passionate about everything skin-related, from skin health problems to skincare. As this week is National Eczema Week I wanted to take the opportunity to raise awareness about eczema, as sadly I find it is often undertreated in many patients, which can profoundly affect both patient health and self-confidence.
From what eczema is to its symptoms and treatments, I'm here to answer all the questions that are commonly asked. Keep scrolling for my comprehensive guide to this frustrating and confidence-denting skin condition.
What Is Eczema?
Eczema, or dermatitis as it is otherwise known, simply means inflammation of the skin.
Eczema can affect people at any age—it typically develops in childhood and continues into adult life.
The most common type of eczema is atopic eczema. Atopy describes people that have allergic tendencies. Eczema itself is not an allergic condition, however, there are certain triggers that people are sensitive to that cause eczema symptoms, such as soaps, shower gels, washing powders and animal hair. People with atopic eczema are also more likely to develop other atopic conditions, such as asthma and hay fever.
What are the symptoms of eczema?
- Dry skin
- Inflamed red areas
- Itchy skin
- Areas of thickened skin
What causes eczema?
The skin is the largest organ in the body. The primary function of the skin is to provide a protective barrier to protect our internal organs from damage caused by harmful substances, infection and extremes of temperature.
Skin is made up of a thin outer layer, a fairly elastic one in the middle, and a fatty layer at the deepest level. Each layer contains skin cells, water and fats, all of which help maintain and protect the condition of the skin. In eczema, the skin lacks fats and oils, which make the skin drier and less able to retain moisture. As a result, the skin is more prone drying and cracking which leads to the characteristic symptoms of eczema: dry, red, inflamed skin.
There is not one specific cause of eczema, but there is a strong genetic factor related to atopic eczema. Eight in 10 children with eczema will find that their parents also have the condition. The underlying genetic cause is not fully understood, but some recent research suggests that people with atopic eczema may also have deficiencies in the production of a chemical called filaggrin, which is important in maintaining the defence barrier of the skin.
In addition to genetic causes, eczema can also be caused by environmental factors such as:
- Climate change
- Dust mites
Occasionally, areas of skin affected by atopic eczema can become infected. Signs of an infection can include:
- Flare-up in your eczema symptoms increasing dryness and redness
- Skin is sore and swollen
- Increased itching
- Areas of oozing fluid
- Areas of pus on the skin
- Generally feeling unwell
- High temperature
- Blisters on the skin
All of the above symptoms suggest your eczema has got worst and is infected. If you have any of these symptoms, it is really important to you seek help from your doctor.
Unfortunately there is no cure for eczema. Treatment is based around maintenance, preventing infection and flare-ups in symptoms.
There are two medications used predominantly to treat eczema:
- Emollients (moisturisers) used every day to stop the skin becoming dry
- Topical corticosteroids creams and ointments used to reduce swelling and redness during flare-ups
Anti-histamines can also be used to help control excessive itch.
There are more specialist medications, such as topical pimecrolimus or tacrolimus, which may be prescribed to treat eczema in sensitive sites that are not responding to simpler treatment. These medications are usually prescribed by a dermatologist.
Your GP should be on hand for treatment and advice. In some cases that are not responding to treatment, your GP may refer you to a dermatologist for expert help.
Like all chronic conditions, self-care and self-surveillance is key. This basically means the patient becomes an expert in managing their own condition.
Eczema is a unique condition, meaning the triggers for one person’s type of eczema may completely vary compared to another person. Once you “get under the skin” of your eczema, and understand the triggering and relieving factors, you will be able to manage it most effectively in the long term.