Eczema (dermatitis)

Atopic Dermatitis

The rash tends to occur on the face and on the backs of the arms and legs in babies.

Children and adults generally experience the symptoms in the folds of the elbows, knees and ankles, and sometimes on the face, neck and head.

A skin dysfunction in which the skin barrier is unable to be repaired properly is the cause of Atopic Eczema.

Genetic in nature, eczema-susceptible patients have a less than optimal content of water and oil in their skin which can consequently become dry, scaly and easily irritated.

With the skin's barrier is not operating effectively, allergens are able to penetrate the surface and trigger the immune system, causing the affected skin to become red and itchy.

Scratching can exacerbate the situation by increasing inflammation and may introduce an infectious organism (usually Staphylococcus aureus) that can cause the affected area to become infected.

Contributing factors may include:

• Dry skin

• Environmental allergens, such as dust mites, grass pollens and pet hair can contribute to eczema flare-ups when inhaled. Eczema sufferers commonly also have a dust mite allergy and even if they don't experience the condition initially, many sufferers become allergic to them later

• Some substances including perfume and synthetic or woollen fibres can irritate the skin of those prone to eczema

• Food allergies aren't a cause of eczema, but may trigger or aggravate the condition, especially in children. Dairy products, soy protein, seafood, nuts and seeds, eggs, and wheat are the foods most associated with the condition. These allergies, in most cases, are resolved in later childhood

• Over-heating of the body can be a factor as can abrupt changes in temperature or humidity

• Stress can also cause or aggravate an eczema outbreak

• Because of eczema sufferers' susceptibility to other allergic conditions (such as hay fever and asthma) professional treatment to support the integrity of the skin’s barrier and minimise the introduction of potential allergens through the skin is recommended. This may also help to reduce the risk of further allergic health problems

• Consult your doctor to find out if ultraviolet light therapy, corticosteroids and antibiotics may be needed to help manage eczema

• Consult with your healthcare professional to identify any environmental, dietary or other allergens that may be contributing to your skin problem. Skin prick and blood tests, or the use of an exclusion diet followed by food challenges are all methods used to identify the allergens. Please note that allowing children to undergo an exclusion and challenge diet without medical supervision is not appropriate and should be avoided

• When considering dietary restrictions due to allergens, make sure all nutritional requirements are met. It is best to consult a healthcare professional to assist you with making these decisions

• Avoid animal fats and increase your consumption of fish and other omega-3 rich foods like flaxseeds and walnuts. This may help your body maintain an optimal balance of essential fatty acids

• Bathe in lukewarm water using hypoallergenic soap-free cleansers as regular soap and hot water may aggravate your eczema. When towelling off after your bath, pat your skin dry; try not to rub it

• Apply thick, hypoallergenic moisturising cream or lotion immediately after bathing to keep your skin moist and supple. You should also use the same moisturisers after swimming

• Swimming in chlorinated pools may exacerbate eczema but swimming in the sea may improve your symptoms. In both instances it is important to avoid getting sunburnt or over-heated as this may aggravate the condition

• Getting over-heated in other circumstances can be detrimental too as can abrupt changes in body-temperature. Wear several layers of light clothing so you can remain comfortable as the temperature changes throughout the day and use several light cotton blankets for similar temperature control at night. It's also best not to keep your home too warm in winter.

• Exercising in hot conditions, with accompanying temperature change and perspiration, may trigger your eczema or cause itchiness

• Exposing the skin to chemicals of any kind should be avoided. It is best to choose hypoallergenic laundry detergents and wear gloves when using chemicals or detergent (wear cotton gloves inside the rubber ones). Make-up and cosmetics should be specially formulated to be hypoallergenic, but even then, keep the face make-up free as often as possible. It is recommended to perform a patch test on an inconspicuous area of your skin before using new products

• Keep the home well-ventilated and clean to help reduce the likelihood of mould developing. Vacuum frequently and change bedding regularly, this will help keep the home free of irritants such as dust mites and animal hair

• Good personal hygiene will help lessen the risk of infection and the likelihood of scratching skin affected by eczema. Wearing gloves or mittens (especially at night time) may help to prevent children from scratching and damaging the skin. Keep fingernails closely clipped so that any scratching is less likely to damage the skin

• Stress related flare-ups can be avoided by taking active steps to help you cope better. It is worth considering strategies including meditation, yoga, regular (but not excessive) exercise, and cognitive behaviour therapy

• If your or your child's eczema becomes infected, consult your doctor, as antibiotics may be required. Rashes that are weeping or crusted, or that don't respond to normal treatment are symptoms to watch out for. It is also not uncommon for fatigue, a fever and a general sense of feeling unwell to occur.