What is eczema?

Eczema or Atopic Eczema is an itchy, scaly skin condition that comes and goes in flare-ups. The word comes from the Greek meaning “to boil over”.

The most common form of eczema is atopic dermatitis although there are many types of dermatitis, each with different causes or conditions. Atopic eczema usually appears before the age of 5 (in 90% of cases), often between the ages of 2 to 6 months. While it occurs more often in infants and children (who eventually outgrow it in 60 to 70% of cases), it can affect people of all ages.

Eczema is not contagious. Someone with the condition cannot “infect” anyone else. It is closely linked to family history where cases of eczema, asthma or hay fever appear – referred to as the ‘atopic march’.

Recent reports estimate that up to 80% of children who suffer from the chronic skin condition atopic eczema subsequently go on to develop other related diseases –namely asthma and hay fever (or rhinitis). This widely-recognised disease progression is being investigated in a clinical trial called SAM (Study of the Atopic March) involving 1,100 infiants aged 3-18 throughout the U.S.

What are the signs of eczema?

Everyone experiences eczema differently. Should you notice any of the following skin conditions, see your doctor for proper diagnosis.

• Moderate to severe itchiness in one or more areas
• Dry, patchy or scaly red areas that look like a rash
• Rough, thickened skin
• Sores that form by scratching and may ooze watery fluids

What causes eczema?

No specific causes are absolutely clear, but we do know that the tendency to get eczema is hereditary – or passed down through the family. If parents or grandparents of a child have eczema (or asthma or hay fever, other closely linked conditions), there’s an 80% chance that child will develop it.

Irritants like tobacco smoke, chemicals or solvents, even weather (hot, humid conditions or cold, dry ones) can aggravate eczema. Allergens as well - like dust mites, moulds, plant pollens, pets and any number of pollutants - can trigger an outbreak. It’s important to take notice of any allergies & sensitivities and avoid them.

Stress can also make eczema worse or trigger a flare. Unfortunately, the very fact that eczema and it’s itchiness can cause stress makes it that much more difficult to cope.

An individual’s sensitivity to certain foods can trigger eczema. Among those most suspect are dairy and wheat products, citrus fruits, eggs, nuts, chemical food additives, preservatives and colourings. Not all of the foods, irritants or allergens listed may aggravate your eczema.

Various types of eczema or dermatitis

Eczema is the most common term used to describe the group of skin conditions also known as dermatitis where rashes and painful itch are evident. A doctor will try to diagnosis your condition based on how the symptoms look (a physical exam) and your medical background (including your family’s). While there is no cure, treatment with medical aids and certain lifestyle habits can help manage any form of eczema.

Various forms of eczema or dermatitis include:

Atopic Eczema

The most common form of eczema affecting all ages (although more among infants and children) characterised by intense itchiness of dry, patchy skin welts that look like a red rash.

This eczema can be controlled with good daily cleaning and moisturising as well as non-steroid treatments. Once the condition is aggravated or flaring a topical steroid cream helps reduce inflammation and soothes and stabilises the skin. Most of these creams must be prescribed by a doctor and are usually for short-term use. A new steroid free cream is now available from your doctor, and can be used to prevent the early signs and symptoms of atopic eczema (eg itch, redness) from progressing to a flare and may reduce the need to use some steroid creams. In some cases, antihistamines and antibiotics may be prescribed, by your doctor, to help reduce the itch and infection.

As with all types of eczema and dermatitis, daily moisturising forms the basis for controlling atopic eczema.

Allergic contact dermatitis

This appears as a rash (often itchy) that comes on quickly as a result of contact with a particular substance. Many people have reactions to certain metals – such as nickel, found in earring posts or belt buckles – and must avoid contact with sensitive skin. Reactions can also occur to rubber or synthetic products, including perfumes or dyes. Moisturisers and emollient creams will help symptoms, but it’s best to avoid contact with anything causing a rash.

Irritant contact dermatitis

Certain substances like detergents or chemicals can trigger itchiness, redness and an irritating skin reaction in adults, most commonly on the hands. Any suspected or known irritants should be avoided or gloves worn when handling them.

Infantile seborrhoeic eczema

Sometimes referred to as “cradle cap,” this is a common condition in babies. Dry flaking skin on the scalp or nappy area can spread quickly yet is not sore or itchy. This type of eczema can clear within a few months with regular use of gentle cleansing moisturisers and bath oils.

Adult seborrhoeic eczema

What appears as mild dandruff starting on the scalp of adults can spread to the face, ears and chest. Specific anti-fungal treatments will help avoid infection.

Varicose eczema

Affecting the lower legs of older people, this condition occurs due to poor circulation. Dry, itchy skin around the ankles or shins needs constant care with emollients to prevent it from breaking down into ulcers.

Discoid eczema

Typically a condition found in adults that appears as a small red patch on the trunk or lower legs.

With so many types of eczema, the advice of a doctor or specialist is important. At the first signs of any skin condition – whether they are itchy or look like a skin rash – see your doctor.

FAQ's

Is it eczema? (questionnaire)