First Published: Investigator - February 2008
Do you have dry, intensely itchy skin? It’s possible you may have eczema – a common inflammatory skin condition that affects up to one-in-five people.
Nurse practitioner Marianne Grillo from Flinders Medical Centre’s Dermatology Unit offers some tips for managing the condition.
TEczema is an inflammatory skin condition that affects between 4 and 20 percent of the population. The condition is characterised by itchy, dry and reddened skin. Atopic eczema or atopic dermatitis is the most common type of eczema. The vast majority of those affected (85-90 percent) are under fi ve years old. In Australia there has been a 2-3 fold increase in atopic eczema over the last 30 years.
Eczema may occur at any age, however most often the condition begins in infancy and childhood.
There is no cure for atopic eczema but the condition can be managed. Most children’s atopic eczema greatly improves during later childhood.
What causes eczema?
The exact cause of atopic eczema is unknown; however it does appear to have a genetic and environmental component.
For example, two thirds of people with eczema tend to have a family history of ‘atopic’ conditions, ie a parent with asthma, hay fever or eczema.
Environmental factors that can trigger eczema may include excess heat, a dry environment, excessive bathing or hand washing, sweating, swimming or exposure to some solvents, chemicals or cosmetics.
In some people eczema can also be triggered by allergens such as house dust mites, food allergies or contact with animals.
The main symptom of eczema is itchy skin. Sometimes the itching is so intense that the sufferer will scratch their skin until it bleeds. Once the skin breaks it is easy for infection to set in, causing further skin irritation.
Common treatments for eczema may include emollients to soften the skin, creams to add moisture to the skin, topical steroids (antiinflammatory creams, ointments or lotions) and oral antihistamine medication.
Topical steroids, also called topical corticosteroids, are a group of medications similar to cortisone that are applied to the skin. They are used to relieve redness, swelling, itching and other discomforts of the skin. Your doctor will prescribe the most appropriate dose and type of topical steroid.
Antihistamines block the action of ‘histamines,’ a chemical produced by the body that is associated with many symptoms of inflammation, particularly itching. Antihistamines may be helpful in stabilising atopic dermatitis and reducing the itch.
Tips for living with eczema
- Bath or shower in lukewarm water. Water that is too hot causes blood vessels to dilate and increases evaporation of water from the skin and so causes dryness.
- Have brief showers or baths. Staying in the water for longer than 10 minutes can cause the skin to dehydrate and thus become scaly.
- Use bath oils or soap substitutes to help prevent the loss of the skin’s natural oils and help to rebuild the barrier.
- Pat the skin dry gently; vigorous rubbing will irritate the skin.
- Apply an emollient moisturiser to the skin after you bath or shower. Moisturisers should be applied at least 2-3 times a day to replace the liquid barrier and prevent water loss through evaporation.
- Keep fingernails short and filed to avoid scratching or irritating the skin
- Avoid overheating. Keep cool.
- Avoid wool and certain synthetic fabrics. Cotton clothing is best.
- Wear loose fitting clothing to avoid aggravation from friction caused by seams and fabric.
This article was compiled with the resources of the Flinders Medical Centre Dermatology Unit and the Better Health Channel (www.betterhealth.vic.gov.au)