What is eczema?

Eczema is a chronic skin disorder. It is also known as dermatitis. Mild eczema causes the skin to become dry and irritated. It may also become scaly and red, like a rash. In more severe types of eczema, the skin may exhibit crusting, weeping, or bleeding. The condition affects one out of every five children. In adults, the illness is significantly less frequent, affecting one out of every twelve people. 

Skin is meant to act as a barrier against irritants and pathogens. It is made up of three layers: a thin outer layer called the epidermis, an elastic middle layer called the dermis, and a fatty interior layer (hypodermis). All three layers include skin cells, water, and lipids, which contribute to maintaining and protecting the skin’s state. However, if you’re suffering from eczema, you may not produce enough lipids and oils to appropriately maintain these skin layers. This reduces the skin’s capacity to retain water, causing skin cells to dry up and break. This dryness can cause microscopic crevices in the skin, making it easier for irritants and germs to infiltrate. These irritants are responsible for the skin being injured, red, and irritated.

What types of eczema are there?

There are several forms of eczema, which include:

Common types

Atopic eczema

Presents itself as an itch that chiefly affects the creases and folds of the body, such as the inside of the elbows, backs of knees, and hands. It is also known to affect the armpits, breasts, nipples, wrists, mouth, lips, neck, fingers, and eyelids. Flare-ups can occur in small patches or all over the body. Spontaneous flare-ups are usually the result of an external trigger, the most common being: soaps, pollens, animal dander, overheating, house-dust mites, stress, and rough clothing.

Contact dermatitis

This is also known as contact eczema. Contact dermatitis affects around 10% of the UK population, making it the most frequent kind of skin ailment. This type of eczema causes red, itchy, scaly skin that can sting and burn. It can cause the skin to become dry, cracked, and blistered. Contact dermatitis can affect any region of the body, although the hands and knuckles are the most usually afflicted.

Seborrhoeic eczema

This type of eczema affects parts of the body with a high concentration of sebaceous glands, such as the scalp and sides of the nose. It is distinguished by a red rash or, in the case of the scalp, dandruff. It most usually affects the scalp and face, although it can also extend to the chest and back. Armpits, underarms, groin, genitals, and between the buttocks can all be affected. The exact cause of seborrheic eczema is unknown. It is thought to be caused by the yeast pityrosporum ovale. This yeast is detected on the skin of those who have seborrheic eczema, however, it is uncertain if it is the primary cause.

Less common types

Discoid eczema

Also known as nummular dermatitis, is commonly observed in adults with dry skin. This kind of eczema manifests as coin-shaped discs of afflicted skin the size of a two-pound coin. Before they leak and crust over, these discs have a somewhat rough feel. The skin might then become dry and flaky as the surface of the discs becomes scaly before the centre of the discs clears. Discoid eczema most commonly affects the lower legs, forearms, and trunk. The specific causes of nummular dermatitis are unknown, as they are for other types of eczema. However, the majority of patients who present with the illness have dry skin.

Gravitational eczema

This is also known as varicose or stasis dermatitis. This kind of eczema affects the lower legs and is more frequent in older people. Poor circulation, blood clots, and varicose veins all increase a person’s chances of getting this illness. Gravitation eczema manifests as dark red or brown areas beneath the skin’s surface layer. As the disease worsens, the skin thins and becomes more delicate, potentially resulting in an ulcer. In more severe situations, the skin may begin to leak, causing bigger portions to crust over and eventually result in a varicose leg ulcer. This type of eczema is caused by impaired circulation, which produces increased pressure in the lower legs, resulting in blood clots.

Asteatotic eczema

Also known as eczema craquelé, this type of dermatitis exclusively affects people over the age of sixty. Asteatotic eczema manifests as little islands of dry, rough skin crowded together. Sufferers will feel pain and irritation in the afflicted regions. This form of eczema appears first on the shins but can also be detected on the upper arms, lower back, and thighs. The cause of asteatotic eczema is assumed to be a considerable reduction in the oils on the skin’s surface. This might be the effect of excessive cleaning or scrubbing. Low humidity might also have a role.

Pompholyx eczema

This condition is also known as dyshidrotic eczema. The primary symptom of this kind of eczema is blistering on the hands and feet. Blisters are most commonly observed on the sides of the fingers and the palms of the hands. They are typically found on the soles of the feet. The skin will become irritated and itching. The blisters are prone to bursting and leaking, and the skin begins to peel as it dries out.

How is eczema diagnosed?

Eczema is usually identified via a visual inspection of the skin in conjunction with questioning about your symptoms. Medical professionals will mostly want to know when the symptoms initially emerged and what substances you may have been exposed to. They will most likely ask you questions about your job and lifestyle to determine what’s triggering your symptoms. The majority of eczema cases are not significant, and symptoms may be managed.

Seeing a dermatologist may also be necessary if your eczema has been successfully diagnosed but you are not responding to conventional treatment.

How is eczema controlled and treated?

Eczema treatment is divided into two categories:

  • Emollients. These keep skin moisturised and healthy.
  • Steroid creams. These are used to control flare-ups.

Emollients are moisturisers that keep the skin moisturised, flexible, and less irritated. Keeping the skin smooth and supple is one of the most critical parts of treating all forms of eczema. This can be accomplished by using emollients regularly. Emollients come in a range of forms, including creams, ointments, and lotions. Emollients, when administered often, efficiently manage mild to moderate eczema.

Emollients with cleansing properties, such as Aqueous cream and Dermol cream, are especially effective when used as a soap or shower gel alternative. Bubble baths, like soaps, can cause skin irritation and dryness. You may still wash and moisturise without causing further irritation by using emollient bath oil, such as Balneum Medicinal Bath Oil. Emollients function best when used immediately after washing or bathing, while water is retained in the skin. It is suggested that they be used liberally and regularly (at least 3 – 4 times a day).

Emollient creams

Creams are preferred by many since they’re lighter on the skin. However, all creams include preservatives, which might cause discomfort in certain people over time. We’ve listed some different kinds of emollient creams below:

  • Aqueous Cream
  • Epaderm Cream
  • Hydromol Cream
  • E45 Cream
  • Oilatum Cream
  • Emollient ointments
  • Dermol Cream
  • Balneum & Balneum Plus Cream
  • Diprobase Cream
  • Doublebase Gel

Emollient ointments

Unlike creams, ointments do not include preservatives and are thus less likely to cause irritation. Because ointments are more greasy by nature, many people use emollient ointments at night for deep moisturization when greasiness is less of an issue. Because ointments retain moisture well, they should not be applied to weeping skin; instead, a cream or lotion is recommended. Emollient ointments are ideal for very dry or thickened skin. These include:

  • Epaderm Ointment
  • Hydromol Ointment
  • Emoll
  • Diprobase Ointment

Emollient lotions

These preparations are suitable for hairy parts of the body. They are less effective than creams because they contain more water and less fat. Emollient lotions include the following:

  • E45 Lotion
  • Aveeno Lotion
  • Dermol 500 Lotion

Specially developed shower and bath products include:

  • Dermol 200 Shower Emollient
  • Doublebase Emollient Shower Gel
  • Cetraben Emollient Bath Additive
  • Doublebase Emollient Bath Additive
  • Hydromol Bath and Shower Emollient
  • E45 Emollient Shower Cream
  • Balneum & Balneum Plus Antipruritic Medicinal Bath Oil
  • Dermol 600 Bath Emollient
  • Aveeno Body Wash

Topical corticosteroids

Topical corticosteroids are steroid-containing lotions or ointments. Corticosteroids are one of the most effective treatments for eczema and dermatitis when administered as advised by your doctor or pharmacist. If the skin has become very irritated and red, a corticosteroid is usually used. These treatments are applied directly to the skin and act to relieve inflammation quickly. Corticosteroids are administered to the afflicted region in a thin layer, generally no more than twice a day. In most circumstances, a single daily application will be enough.

There are several types and strengths of topical corticosteroids. Weaker corticosteroids are often used for mild eczema or more sensitive parts of the body. A stronger corticosteroid will most likely be prescribed for usage on the palms of the hands, knuckles, or soles of the feet, as well as locations with thicker skin. If you have severe eczema or dermatitis, a powerful corticosteroid may be administered for a limited period of time. Topical corticosteroids include the following:

Weaker corticosteroids

Hydrocortisone Cream 1%

Eumovate Cream (Clobetasone)

Eumovate Ointment (Clobetasone)

Stronger preparations:

Betnovate Cream (Betamethasone)

Betnovate Ointment (Betamethasone)

Stronger corticosteroids (for the scalp)

Betacap (Betamethasone)

Elocon Scalp Lotion (Mometasone)

Betnovate Scalp Lotion (Betamethasone)

Antibiotic preparations (for use on infected eczema)

Fucidin H Cream (Hydrocortisone & fusidic acid)

Fucibet Cream (Betamethasone & fusidic acid)

If the use of emollients and topical corticosteroids prove ineffective at controlling your eczema, it may become necessary to seek alternative treatments from a dermatologist You may also benefit from the use of cotton gloves to prevent scratching, and antihistamines to manage the itchiness. 

Can I prevent flare-ups of eczema?

There are several self-help methods for reducing or preventing eczema flare-ups. Including:

  • Use an emollient daily to maintain skin supple and moisturised
  • Avoiding high temperatures, such as extremely hot baths or showers
  • Avoid using irritant-causing soaps, bubble baths, and cosmetic items
  • Pat regions dry with a soft cotton towel after washing or showering. This method will leave some wetness on the skin. More moisture can then be sealed into the skin after applying a moisturising cream or lotion.
  • Use a humidifier during the winter months. 
  • If you have contact dermatitis, avoid contact with recognized triggers such as detergents, cleaning solutions, other chemical irritants, jewellery, plants, and any material that causes skin sensitivities.