Eczema (medical term: atopic dermatitis) is a continual itchy skin condition consisting of skin dryness and inflammation. The areas of eczema become red, scaly, and thickened. It typically starts within the first two years of life, and is characterized by periods of clear skin, and then recurrent “flares”. “Flares” are acute episodes, and are unpredictable in terms of timing and potential triggers.

Fact: Approximately 15-20% of the population suffers with eczema

Triggers

A trigger is any substance that sets off the inflammation, skin rash, and itching associated with eczema. Avoiding triggers is an important part of preventing eczema flares and keeping the skin healthy.

Fact: Stress may be an eczema trigger! When someone is under stress, they may be more likely to feel itchy and then scratch their skin, which aggravates the eczema.

What triggers your eczema?

Triggers can be different for everyone; however there are common triggers that affect most people with eczema, such as wool clothing, some fabric softeners, dust mites and perfumed lotions.

Use the chart below to try and identify your triggers, then you can start to eliminate them from your lifestyle. It is also important to avoid triggers when outside of the home. It may mean asking family members to not use perfume in your presence, or not going to visit friends with a pet, if it means you will help to keep you or your child’s skin healthy.

It is important to note that for many patients, a given flare up can have no identified trigger.

Flare Chart

Click here to download the printable flare chart.


Atopic eczema

Atopic eczema is the most common form of eczema and is closely linked with asthma and hayfever. It can affect both children and adults, usually running in families. One of the most common symptoms of atopic eczema is itching (pruritus), which can be almost unbearable. Other symptoms include dryness of the skin, redness and inflammation. Constant scratching can also cause the skin to split, leaving it prone to infection. In infected eczema the skin may crack and weep and develop pustules. Treatments include emollients to maintain skin hydration and steroids to reduce inflammation.

Allergic contact dermatitis (ACD)

ACD develops when the body’s immune system reacts against a substance after contact with the skin. The allergic reaction often develops over a period of time through repeated contact with the substance. For example, an allergic reaction may occur to nickel, which is often found in earrings, snaps on baby's undershirts, belt buckles and jeans buttons. Reactions can also occur after contact with other substances such as perfumes and rubber. In order to prevent repeated reactions it is best to prevent contact with anything that you know causes a rash.

Irritant contact dermatitis

This is a type of eczema caused by frequent contact with everyday substances, such as detergents and chemicals, which are irritating to the skin. It most commonly occurs on the hands of adults and can be prevented by avoiding the irritants and keeping the skin moisturised. It commonly occurs in patients who have atopic dermititis.

Infantile seborrheic eczema

A condition that affects babies under one year old, the exact cause of which is unknown. Also referred to as cradle cap, it usually starts on the scalp or the nappy area and quickly spreads. Although this type of eczema looks unpleasant, it is not sore or itchy and does not cause the baby to feel uncomfortable or unwell. Normally this type of eczema will clear in just a few months, though the use of moisturising creams and bath oils can help to speed this along.

Adult seborrheic eczema

Characteristically affects adults between the ages of 20 and 40. It is usually seen on the scalp as mild dandruff, but can spread to the face, ears and chest. The skin becomes red, inflamed and starts to flake. The condition is believed to be caused by a yeast growth. If the condition becomes infected, treatment with an anti-fungal cream may be necessary.

Varicose eczema

Varicose eczema affects the lower legs of those in their middle to late years, being caused by poor circulation. Commonly the skin around the ankles is affected, becoming speckled, itchy and inflamed. Treatment is with emollients and steroid creams. If left untreated, the skin can break down, resulting in an ulcer.

Discoid eczema

Is usually found in adults and appears suddenly as a few coin shaped areas of red skin, normally on the trunk or lower legs. They become itchy and can weep fluid. Usually discoid eczema is treated with emollients (and steroid creams if necessary).

The Causes of Eczema

Research into the cause of eczema is still in the beginning phases. In most cases, there is a person with eczema who has a family history of the disease. A diagnosis of eczema is more likely if other members of the family suffer with eczema, asthma, or hay fever. These diseases are known as Atopy (allergic rhinitis, asthma and eczema) and make up “The Atopic Triad”. Although genetics are important, the environment plays a role as well (such as the triggers listed above). There are many aspects of this disease that we don’t know about, and we hope continuing research will help to give us more information in the future.

Patients with eczema have skin that is very sensitive. Once skin is exposed to a trigger, it causes cells to go to the surface of the skin causing the patient to itch. Itching in turn initiates a chemical release of substances leading to inflammation.

Is there a cure for eczema?

Atopic eczema is a chronic, recurring condition with "flares" (active or new patches of eczema – which look red, scaly, and/or bumpy) and remissions (when eczema is not as active). Some people always seem to have some active areas. There are no definite cures for eczema although patients can achieve excellent control and live quite comfortably. Most children will grow out of their eczema, and flares will gradually reduce over time.

We recommend following our Triangle of Control and Regimen to ease your eczema symptoms and prevent future flares.

This is the first line of defense!

Eczema’s Impact on Quality of Life

When one member of the family suffers with eczema, the whole family suffers. Rigorous bathing and moisturizing regimens, constant monitoring of the condition, lifestyle changes in an effort to avoid triggers, and sleepless nights can greatly impact the quality of life for all members of the family.

When a child is small the constant itch can disrupt the whole family's sleep. A school-aged child who has poor skin control may feel isolated from his/her peers and can develop low self-esteem. Many people do not realize that eczema is not contagious and a child might be unnecessarily sent home from school. For adults, eczema can impact everything from personal relationships, to self-esteem, to stress levels, and can even impact career choice and the way they function at work. Your doctor can help you to keep the disease under control and also provide guidance on how to deal with day-to-day problems.