Understanding Atopic Eczema
Atopic eczema is a dry, itchy inflammation of the skin. It can affect any part of the skin, including the face, but the areas most commonly affected are the bends of the elbows, around the knees, and around the wrists and neck. These are known as 'flexural' areas.
It affects both sexes equally and usually starts in the first weeks or months of life. It is most common in children, affecting at least 10% of infants, although it can carry on into adult life or come back in the teenage or early adult years.
Atopic eczema tends to run in families. If one or both parents suffer from eczema, asthma, or hay fever, it is more likely that their children will suffer from them too. In addition, there is a tendency for these conditions to run true to type within each family. In other words, in some families most of the affected members will have eczema, in others, asthma or hay fever will predominate.
Causes
This is still not fully understood. Atopy runs in families and is part of one's genetic make-up. Atopic people have an overactive immune system and their skin easily becomes inflamed (red and sore). Their skin 'barrier' does not work well, so that their skin may become dry and prone to infection.
Atopic eczema is not infectious.
Reasons
• Many external factors can make eczema worse. These include heat, dust, and contact with irritants such as soap or detergents.
• Being unwell - for example having a cold can make eczema flare up.
• Infections with bacteria or viruses can make eczema worse. Bacterial infections make the skin yellow, crusty and inflamed, and may need treatment with antibiotics. A viral infection with the herpes simplex virus can cause a painful flare of eczema, and may need treatment with antiviral tablets.
• Dryness of the skin.
• Perhaps stress.
Symptoms
The main symptom is itch. Scratching in response to this may be responsible for many of the changes seen on the skin. Itching can be bad enough to interfere with sleep.
Diagnosis
It is usually easy for health care professionals, such as health visitors, practice nurses and general practitioners, to make the diagnosis when they look at the skin. However, sometimes the pattern of eczema patches in older children and adults is different, and the help of a hospital specialist may be needed.
Blood tests and skin tests are usually not necessary. Occasionally the skin may need to be swabbed (by rubbing a sterile cotton bud on it) to check for bacterial or viral infections.
Atopic eczema cannot be cured, but there are many ways of controlling it. Most children with atopic eczema improve as they get older — 75% clear by their teens. However, many of those who have had eczema continue to have dry skin and need to avoid irritants such as soaps or bubble baths.
Eczema may persist in adults it but should be controllable with the right treatment.
Treatment
You will need the advice of a health care professional on the best treatment for eczema and how long this should continue. The treatments used most often are moisturisers, and topical steroid creams or ointments.
Moisturisers (emollients) should be applied every day to stop your skin becoming dry. Many are available, and it is important that you choose one you like to use.
Topical steroid creams or ointments will settle the redness and itching of your eczema when it is active. They come in different strengths (potencies), and your doctor will advise you which type needs to be used where, and for how long.
Topical steroids should be used in combination with moisturisers in a skin care regime
Source : British Association of Dermatologists
More info on ECZEMA here.
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