Eczema is a non-contagious condition in which the skin is irritated, causing dryness, itching, and red rashes often coupled with a scaly surface. While it is more common in infants and young children, eczema can affect any age group and must be diagnosed by a dermatologist. The condition may be temporary or chronic, mild or, in rare instances, very serious.
Atopic dermatitis is the prevalent form of chronic eczema. It is a genetically inherited condition that tends to run in families who also suffer from hay fever and asthma. Atopic dermatitis will affect about 10 to 20 per cent of people at some point in their lives.
Dyshidrotic eczema occurs on the palms of the hands, sides of the fingers, and the soles of the feet, and it is associated with itching and blisters.
Nummular dermatitis is a type of eczema that normally affects older adults. Round patches of scaly, inflamed skin may appear anywhere on the body, most commonly on the legs. Winter is the peak period for this condition. It tends to strike dry skin.
Stasis dermatitis (or gravitational eczema) affects the lower legs of older adults. It is basically a poor circulation problem, usually due to blood not being able to get out of the legs well. It is caused by varicose veins.
Symptoms and complications of eczema
Atopic dermatitis appears as red, itchy, dry skin. It tends to first appear in childhood, and may disappear completely before adulthood. It most often affects the area behind the knees and around the elbows, as well as the face.
Dyshidrotic eczema can cause blisters on the palms of the hands, sides of the fingers, and soles of the feet. The skin will feel itchy or you may feel a burning sensation, and it can crack or peel.
Nummular eczema appears as itchy, red, coin-shaped areas with discharge on the limbs and torso.
Stasis dermatitis appears as inflamed, scaly skin around the lower legs and ankles. Over time, it may turn dark brown.
If you get inflamed skin, it’s important to tell your doctor about any allergies you have and any unfamiliar substances you have recently come in contact with.
Treating and preventing eczema
Your doctor will recommend a treatment plan for your eczema that will take into consideration the type of eczema you have, the severity of the eczema, as well as other factors. For most people, a combination of therapies is needed to manage eczema.
Treatment options for most types of eczema can include moisturisers and topical corticosteroids. The most important step in both treating and preventing eczema flare-ups is frequent moisturising.
For some people with more severe eczema, oral corticosteroids may rarely be needed to control symptoms. For older adults, ultraviolet (UV) radiation is sometimes used, but the skin cancer risk makes this unsuitable for younger people. Antihistamines that cause drowsiness may be recommended for some types of eczema to help with itching and sleep. When skin infections occur, topical or oral antibiotics may be prescribed.
Stasis dermatitis can be helped by keeping in good physical shape so that blood flows freely through the legs. Support stockings can also assist in pumping the blood up out of the leg. And elevating your leg also increases circulation.
Susceptibility to most forms of eczema is genetic and unavoidable. Knowing what allergens and irritants to avoid can help you get through life without being inconvenienced by eczema.
Tips to help you deal with eczema:
• Bathe in cool or tepid water with gentle soap. Minimise the use of soap when possible.
• Use moisturisers immediately after you bathe to keep the moisture locked in. Avoid moisturisers with perfumes, as they may worsen the condition.
• Avoid scratching affected areas. Some people wear cotton gloves at night to prevent scratching in their sleep.
• Keep your fingernails short.
• Don’t let sweat stay on your skin.
• Avoid clothes that don’t let the skin breathe.
When selecting a skin care regimen, it is important to avoid ingredients that may irritate the skin. Products containing alpha-hydroxyl acids, glycolic acid and alcohol should be avoided.
Using mild, non-drying, detergent-free soaps and cleansers, followed by soothing and nourishing moisturizers are key steps in any skincare routine for those with sensitive, dry skin regardless of the products you choose to use. Applying calming creams and masks every so often or as your skin tolerance allows will also help in relieving eczema symptoms.
Nutrition and dietary supplements
Many people who have eczema have food allergies, so eating a healthy diet may help reduce inflammation and allergic reactions. Check with your doctor before giving a supplement to a child.
• Avoid exposure to environmental or food allergens. Common foods that cause allergic reactions are dairy, soy, citrus, peanuts, wheat (sometimes all gluten containing grains), fish, eggs, corn, and tomatoes.
• Eat fewer refined foods, and sugar. These foods contribute to inflammation in the body.
• Eat more fresh vegetables, whole grains, and essential fatty acids (cold water fish, nuts, and seeds).
• Fish oil: In one study, people taking fish oil equal to 1.8 g of EPA (one of the omega-3 fatty acids found in fish oil) experienced significant reduction in symptoms of eczema after 12 weeks. Researchers think that may be because fish oil helps reduce leukotriene B4, an inflammatory substance that plays a role in eczema. Talk to your doctor before taking fish oil if you are taking any blood-thinning medications, and before taking a high dose. If you’re taking high dose fish oil, make sure you use a brand that removes most of the vitamin A. Too much vitamin A over time can be toxic.
• Probiotics (bifidobacteria and lactobacillus, 3-5 billion live organisms per day) may boost the immune system and control allergies, especially in children. However, scientific studies are mixed; more research is needed to know for sure if probiotics will help reduce eczema symptoms.
• Evening primrose oil: In some studies, evening primrose oil helps reduce the itching of eczema. However, other studies have found no benefit. People who take anticoagulants (blood thinners) should talk to their doctor before taking evening primrose oil, and you should always ask your doctor before taking a high dose of evening primrose oil.
• Borage oil, like evening primrose oil, contains the essential fatty acid GLA (500-900 mg per day, in divided doses – amount of GLA varies by supplement), which acts as an anti-inflammatory. Evidence is mixed, with some studies showing that GLA helps reduce eczema symptoms and others showing no effect. Borage, like Evening Primrose Oil can interact with blood thinners and other medications. Speak with your doctor.
• Vitamin C (1,000mg two to four times per day) can act as an antihistamine. In one study, it helped reduce symptoms of eczema, but more studies are needed. Rose hips or palmitate are citrus-free and hypoallergenic.
• Bromelain (100-250mg two to four times per day), an enzyme derived from pineapple, helps reduce inflammation.
• Flavonoids, antioxidants found in dark berries and some plants, have anti-inflammatory properties, strengthen connective tissue, and may help reduce allergic reactions.
Herbs
Topical creams and salves containing one or more of the following herbs may help relieve itching and burning, and promote healing. The best evidence is for chamomile (Matricaria recutita) creams. Chickweed (Stellaria media), marigold (Calendula officinalis), and licorice (Glycyrrhia glabra) may also help, although there is little scientific evidence to back that up. One study did find a licorice cream was more effective than placebo.
• Witch hazel (Hamamelis virginiana) cream can relieve itching. Liquid witch hazel can help with “weeping” or oozing eczema.
• St. John’s wort (Hypericum perforatum), used as a topical cream, has shown promise in one double blind study. People with eczema who used St. John’s wort on one arm and a placebo cream on the other saw more improvement on the arm treated with St. John’s wort.
• Other herbs that have traditionally been applied to the skin to treat eczema include sarsaparilla (Smilax sp.) and marshmallow (Althea officinalis).
Nuala Woulfe is the owner of Nuala Woulfe Beauty Salon and Serenity Day Spa, both in Sandycove, Dun Laoghaire. Nuala Woulfe Beauty Salon has been a top beauty salon and skincare clinic for over 20 years. Serenity Spa is of the top day spas and wellness centres in Dublin, and offers massages, ayurveda and naturopathic treatments, all tailored to your needs, in a tranquil haven.
For more, log on to www.nualawoulfe.ie and www.serenityspa.ie or see their Facebook page facebook.com/nualawoulfesalonandserenityspa