ECZEMA –  A Skin problem that effects millions.

Eczema, or dermatitis as it is sometimes called, is a group of skin conditions which can affect all age groups, although the condition is most common in infants.  It is non-infectious and will permanently resolve by age 3 in about half of effected infants. 

Eczema is not contagious, but nevertheless it is very common—estimates are that more than 15 million people in the United States have eczema.

Eczema most commonly causes dry, reddened skin that itches or burns and in severe cases may weep, bleed or form crusts so that over time a rough appearance results.

However the appearance of eczema varies from person to person and varies according to the specific type of eczema. 

Eczema can sometimes occur as a brief reaction that only leads to symptoms for a few hours or days, but in other cases, the symptoms persist over a longer time and are referred to as chronic dermatitis. 

Eczema can occur on just about any part of the body; however, in infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.

In adults eczema often affects the skin in areas around joints such as the elbow, behind the knees and in front of the ankles.      

Eczematous skin is particularly vulnerable to bacterial infection, which can aggravate the eczema or cause serious illness. 

Atopic eczema is thought to be a hereditary condition, being genetically linked.

Eczema does run in certain families and can be associated with other 'allergic'-type disorders, like allergic rhinitis and asthma.

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. 

Eczema may be set off by extreme temperatures, stress, sweating, medication, clothing (especially wool or silk), grease, oils, soap and detergents, and environmental allergens. 

Other factors include; some dairy and wheat products, citrus fruits, eggs, seafood, chemical additives and food colourings.

External factors include; Moulds, grasses, pet dander, house dust mites, shampoos, detergents, soaps and washing powders.

Contact eczema is curable provided the offending substance can be avoided, and its traces removed from one’s environment.  About three quarters of cases of contact eczema are of the irritant type, which is the most common occupational skin disease.

To determine whether an eczema flare is the result of an allergen, a doctor may test the blood for the levels of antibodies and the numbers of certain types of cells.

Dietary elements that have been reported to trigger eczema include dairy products and coffee (both caffeinated and decaffeinated), soybean products, eggs, nuts, wheat and maize (sweet corn), though food allergies may vary from person to person.   

Treatment

The first and primary recommendation is that people suffering from eczema shouldn't use detergents of any kind on their skin unless absolutely necessary. 

Anti-itch drugs, often antihistamine, may reduce the itch during a flare up of eczema, and the reduced scratching in turn reduces damage and irritation to the skin (the Itch cycle).  Moisturizing is one of the most important self-care treatments for sufferers of eczema.  Some common emollients for the relief of eczema include Oilatum, Balneum, Medi Oil, Diprobase, bath oils and aqueous cream. 

For mild-moderate eczema a weak steroid may be used  but because of the risks associated with this type of drug, a steroid of an appropriate strength should be sparingly applied only to control an episode of eczema. 

Corticosteroids are generally considered safe to use in the short- to medium-term for controlling eczema, with no significant side effects differing from treatment with non-steroidal ointment.  While these usually bring about rapid improvements, they should not be taken for any length of time and the eczema often returns to its previous level of severity once the medication is stopped. 

When eczema is severe and does not respond to other forms of treatment, immunosuppressant drugs are sometimes prescribed.  These dampen the immune system and can result in dramatic improvements to the patient's eczema. 

The most commonly used immunosuppressants for eczema are ciclosporin, azathioprine and methotrexate.   

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