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Eczema

Eczema is the most common skin condition: it affects all ages and both sexes. The words eczema and dermatitis can mean the same thing and are used to describe a condition in which the skin becomes inflamed, itchy, dry and scaly. The appearance of eczema can vary from person to person, and can affect different parts of the body. It can be a long term condition or a sudden outbreak.

What causes eczema?

In normal skin the skin acts as a barrier, preventing loss of water. It also stops things that irritate the skin from penetrating it. In people with eczema the skin does not perform this role effectively. Moisture is lost, resulting in a dry, cracked, scaly appearance. These cracks then allow irritants, allergens and bacteria to penetrate, causing an allergic reaction.

In normal skin the skin acts as a barrier, preventing loss of water. It also stops things that irritate the skin from penetrating it. In people with eczema the skin does not perform this role effectively. Moisture is lost, resulting in a dry, cracked, scaly appearance. These cracks then allow irritants, allergens and bacteria to penetrate, causing an allergic reaction.

Are there different types of eczema?

There are many different types of eczema affecting different parts of the body. The two most common types are:

Atopic eczema: This type is commonly seen in children, less so in adults. It occurs in individuals with a natural tendency to develop allergies such as asthma, hay fever and food allergies. Atopic eczema can be inherited and is often seen in several members of the same family. It mainly affects the inside of the elbows and knees and also the wrists and ankles and can be worsened by the use of soaps and perfumes. Atopic eczema is very itchy.

Contact dermatitis: This is caused by contact with something that the skin is allergic or sensitive to. Different people can be allergic to different things but some of the most common allergies are to nickel,(found in many items of jewellery), washing powder, sticking plasters, condoms, cosmetics and certain plants. The best way to prevent this type of dermatitis is to simply avoid the irritant. If you are unsure as to what is causing the reaction, the hospital doctor can carry out a '‘patch" test. This means that small amounts of various chemicals are applied to your skin at the site of a small pinprick; the strength of the subsequent reaction should give a clue to the most likely allergen.

The itch and eczema

Itching is a major symptom of atopic eczema and causes an ‘itch-scratch’ cycle. When the sufferer scratches the infected area, a chemical is released within the skin that causes more irritation. This makes the skin even itchier, causing further scratching and so the cycle goes on.

What treatment is available?

Emollients: These are moisturisers that replace the lost water from the skin. In doing so they soften the skin and make it more resistant to irritants. Emollients are best applied when the skin is moist, although they should generally be applied as often as possible. Ideally you should use 250 grams/week on a child with eczema and as much as 500 grams/week on an adult. The important thing with emollients is that they are applied as liberally and as frequently as you need them.

It is important to try to follow a daily emollient therapy routine using a combination of cream, ointment, bath oil and emollient soap substitutes. There are a number of very effective treatments available and your doctor or pharmacists will advise you. Often the emollient that suits you best is the one that you prefer to apply and therefore you will feel happy using it more regularly.

Steroid creams: These are ‘anti-inflammatory’ products that may sometimes be prescribed to treat the underlying inflammation and so reduce the itch-scratch cycle. They may be offered to help treat forms of eczema that have not been improved by emollients. Steroids are used to treat the ‘flare-up’ of eczema and should not be used as a long term therapy. Always use emollients in conjunction with your steroids.

What can be done to help yourself?

• Avoid triggers that you know will make your eczema worse.
• Use an emollient regularly even when your skin feels better
• Consult your doctor or pharmacist as soon as possible, especially if the condition seems to be getting worse.

A complete emollient therapy routine

Morning
Wash with an emollient soap substitute. After washing gently pat the skin dry. Gently apply emollient cream or lotion with clean hands in the direction of hair growth. Do not rub vigorously as this could trigger itching.

Throughout the day
Use emollient soap-substitute to wash hands. Apply emollient cream or lotion whenever the skin feels dry or itchy. Do not allow the skin to dry out.

Evening
Have a warm 10 minute bath with an emollient bath oil. Do not use soap- the bath oil will clean the skin. After bathing gently pat the skin dry and, while the skin is damp, apply your chosen emollient liberally.

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Your Neighbourhood Professionals. Just a Click Away! Private physiotherapist in Lancaster
Your Neighbourhood Professionals. Just a Click Away! Private physiotherapist in Lancaster