Eczema can be incredibly troublesome – we give a background on causes & treatments
What is eczema?
Eczema means the same as dermatitis, and is basically inflammation of the skin. The skin can become red, itchy, sore, and even blister or crack. There are two main types of eczema: Atopic eczema, and Contact dermatitis.
Atopic eczema is where you are born with a tendency to get skin inflammation and eczema. Different parts of the skin can flare up at any time through life.
Contact dermatitis is skin inflammation caused when the skin comes into contact with certain substances (eg metals, latex gloves etc). The inflammation usually subsides when irritant is removed
What causes eczema?
The causes for eczema flare-ups may not be obvious, although some people do learn which things to avoid in life to reduce the incidence of a flare-up of inflammation. These include:
Clothes – Rough materials such as wool can sometimes cause eczema to worsen. Smoother material such as cotton may help
Soaps – Soap removes the oils from skin and so can cause eczema to flare up. Try to avoid bubble bath and only use soap in ‘needed’ areas such as the armpits and groins. If you need to use soap, aim for non-perfumed types
Washing powder – Biological detergent can cause eczema to worsen, so if your clothes are washed in detergent, rinse them well after washing
Aftershave & Perfume – This can sometimes be an irritating cause and worsen eczema. Try stopping aftershave or perfume use for a while and see if this helps
Itching/scratching – Eczema can be itchy, but scratching it will cause it to get worse and itch more. This leads to more scratching, worse eczema, more scratching……and this is why it’s called the ‘itch-scratch cycle’. Obviously, the way to help this is by not scratching the eczema, but if you really have to itch it then use your finger pulps to gently rub rather than using your nails
Food allergy – Food can cause eczema to flare, and the common foods are cow’s milk, eggs, wheat, soya, fish and nuts. The symptoms can be within 1-2 hours, or sometimes take up to 24 hours to show, and include itching and redness around the mouth, itchy tiny bumps on the skin (called ‘urticaria’), tummy pain, sneezing, itchy eyes, vomiting and wheezing. To find the food causes of the eczema, keep a diary of all the foods and drinks you have, and when you get the eczema flare-up. Then cut all the suspects out and see if this helps your eczema. If it does, re-introduce each food one at a time, week after week – the culprit will cause an eczema flare up (remember more than one food may be causing the eczema flares!)
Pets – Sadly, pets can sometimes be the cause of eczema. The logical thing to do is to move the pet to another house etc, but emotionally this is often easier said than done
House dust mite – these are microscopic insects that live in all houses, and can cause eczema to worsen in some people. Reducing the amount of house dust mites may help, but this has not been absolutely proven yet.
How can I help my eczema?
Avoid the cause of the eczema – this may seem obvious, but the first thing to do is try and identify what causes your eczema, and avoid this. If for example a certain soap seems to flare up your eczema, try using a different soap for a while. Only change one thing at a time though, as if you stop using five things, and your eczema improves, you won’t know which of the five things you need to avoid long-term!
Avoid scratching – when eczema is scratched, it makes it more inflamed, making the eczema worse and causing it to itch more. This is a vicious cycle that you should try to avoid
Use moisturiser – moisturisers can help soothe the eczema and prevent it from itching so much. The moisturiser should be applied gently so as to not flare up the eczema too much, and regularly through the day. Aim for moisturisers that are fairly plain and fragrance-free to avoid chance of irritation
Avoid tight or rough clothing – depending on where your eczema is, it can be flared up by tight or rough clothing rubbing on it.
Steroid creams – a low strength (1% hydrocortisone) steroid cream can help calm an eczema flare, but must be used regularly. These creams can often be bought without prescription, and are made by a number of different brands. Make sure you read the label carefully, and speak to the pharmacist to check which cream is best for you
Anti-itch medication – some antihistamine medications, such as Diphenhydramine (found in eg Benadryl) can help the itching of eczema, but can also make you drowsy. They may be an option for night-time though, helping you itch less during your sleep. Always read the label carefully and speak to the pharmacist to check if this is an option for you
What prescription medication can help my eczema?
Steroid creams – if a low-dose 1% steroid cream has not helped your eczema, then a doctor may prescribe a higher dose for you, such as a 2.5% steroid cream
Antibiotics – occasionally eczema can become infected, and become very inflamed, painful, and weepy. In this instance the doctor may need to prescribe an antibiotic to help fight the bacteria and calm the flare
Other treatments – occasionally, for severe eczema that won’t respond to the above treatments, other methods can be used such as coal tar, UV light therapy and anti-inflammatory medications. These may need you to visit a hospital or even stay for a short while
This information is for general reading only, and does not replace the advice given by a healthcare specialist. If you have any concerns about any skin condition, including eczema, please see your doctor for advice and treatment options