Facts About Eczema

What is eczema?

Eczema (atopic dermatitis) is a recurring, non-infectious, inflammatory skin condition affecting one in three Australians at some stage during their life. The condition is most common in people with a family history of an atopic disorder, including asthma or hay fever.

Atopic eczema is the most common form of the disease among Australians. The skin becomes red, dry, itchy and scaly, and in severe cases, may weep, bleed and crust over, causing the sufferer much discomfort. Sometimes the skin may become infected. The condition can also flare and subside for no apparent reason.

Although eczema affects all ages, it usually appears in early childhood (in babies between two-to-six months of age) and disappears around six years of age. In fact, more than half of all eczema sufferers show signs within their first 12 months of life and 90 per cent of people develop eczema before the age of five.

Although most children grow out of the condition, a small percentage may experience severe eczema into adulthood. The condition can not only afflict the individual sufferer, but also their family, friends and health practitioners.

What are the symptoms of eczema?

Moderate-to-severely itching skin (this symptom separates eczema from other skin rashes).

Recurring rash - dry, red, patchy or cracked skin. (In infants and toddlers, the rash usually appears on the face, elbows or knees. In older children and adults, the rash appears less often on the face, and more commonly on the hands, neck, inner elbows, backs of the knees and ankles).

Skin weeping watery fluid.

Rough, "leathery," thick skin.

Lesions which may be infected by bacteria or viruses.

What causes eczema?

Although the exact cause of eczema is unknown, it appears to be linked to the following internal and external factors:

Internal factors

A family history of eczema, asthma or hay fever (the strongest predictor) - if both parents have eczema, there is an 80 per cent chance that their children will too.

Particular food and alcohol (dairy and wheat products, citrus fruits, eggs, nuts, seafood, chemical food additives, preservatives and colourings).

Stress.

External factors

Irritants - tobacco smoke, chemicals, weather (hot and humid or cold and dry conditions) and air conditioning or overheating

Allergens - house dust mites, moulds, grasses, plant pollens, foods, pets and clothing, soaps, shampoos and washing powders, cosmetics and toiletries.

How long does eczema last?

Eczema symptoms tend to become less severe over time. For many sufferers, symptoms may mostly disappear, although they will tend to suffer from dry, sensitive skin.

How do you control eczema?

Although eczema is not a life-threatening disease, it can certainly affect a sufferer's, their carer/s and family's quality of life. A child's night-time itching can cause sleepless nights for the child, his/her parents and siblings. It can place a significant strain upon family relationships. Flare-ups can often lead to absenteeism from school, work, personal activities and/or family obligations.

How do you best manage a child's eczema?

The best way to manage a child's eczema is to:

Gain their cooperation

Distract the child to prevent them from scratching

Become familiar with the child's response to different environmental conditions

Educate yourself and others about the condition and learn to be sympathetic

Reduce stress for both yourself and the child

See your doctor if the eczema continues to flare.

How do you avoid an eczema outbreak?

Many things can be done to avoid an eczema outbreak. Most importantly, the skin should be kept moist by using a daily moisturiser. Other ways to prevent an outbreak include:

Wearing 100 per cent cotton or soft fabrics - avoiding rough, scratchy fibres and tight clothing

Using rubber gloves with cotton liners

Having lukewarm baths and showers using mild soap or non-soap cleanser and avoiding extremely hot water

Gently patting, not rubbing, the skin dry with a soft towel

Applying a moisturiser within three minutes after bathing to "lock in" the moisture

When possible, avoiding rapid changes of temperature and activities that raise a sweat

Removing carpets and rugs from houses (if possible) and giving pets dander treatments

Ventilating the house as often as possible

Avoiding stuffed toys which harbour dust mites

Changing bed linen regularly, vaccuuming mattresses regulary for dust mites and avoiding feather-filled pillows

Reducing daily stress

Learning what triggers eczema and how to avoid them.

How do you diagnose eczema?

Only a doctor or specialist can formally diagnose eczema. An accurate diagnosis requires a complete skin examination, a thorough medical history and the presence of a chronically recurring rash with intense itching that is consistent with eczema.

While there is no test to determine whether a person has eczema, tests may be conducted to rule out other possibilities.

Itching is an important clue to diagnosing eczema. If an itch is not present, chances are that the problem is not eczema.

Is there a cure for eczema?

Although there is no known cure for eczema and it is a lifelong disease, treatment can offer symptom control.

What are the treatment options for eczema?

The goal of treating eczema is to heal the skin and to both prevent and minimise flare-ups. This can be done by using a moisturiser to prevent the skin from cracking or itching and to offer relief. Well-moisturised skin also helps block out germs that cause infections.

Treatment may also include:

Topical corticoteroids that help reduce inflammation and itchiness. This is the most common form of eczema treatment. Most topical corticosteroids are available on prescription. However some milder strengths are available in pharmacy.

Sedating antihistamines that induce sleep and reduce itchiness

Wet bandaging that soothes the skin, reduces itchiness and helps heal lesions

Antibiotics that treat secondary infections

Allergy testing (prick or blood tests) that may help establish trigger factors

Dietician for diet assistance.

More severe cases of eczema may be treated by oral corticosteroids, systemic immunosuppressants and phototherapy.

It is important to seek professional medical advice before using any medication - whether over-the-counter or prescription - to determine its side-effects.

What are the complications associated with eczema?

Because eczema skin is often broken, it places the sufferer at risk of contracting skin infections. Professional medical advice should be sought at the first sign of any infection.

An eczema sufferer is also at risk of developing herpes simplex type 1 (cold sores) which can spread over a large area of the skin and occasionally prove dangerous. Sufferers are also at risk of contracting a widespread skin infection known as impetigo (school sores). In order to avoid any complications associated with vaccination, the disease should be discussed with a medical professional. However, normal childhood immunisations generally pose no risk to the eczema sufferer.