This information helps you to know what’s ‘normal’ and what you can expect to happen if you or your child suffer from atopic eczema or dermatitis . It tells you when you should become concerned and when it’s best to seek medical advice from a health professional.
NB: Atopic means that someone is sensitive to allergens which include a wide range of substances such as foods, animals, pollutants or dust, which cause them to have an allergic reaction. Dermatitis means inflammation of the skin.
How common is eczema? Eczema is a dry skin condition that can persist or seem to go away and then come back again. It affects about two out of ten children and two to ten out of every 100 adults in the UK.
What skin changes does eczema cause? Skin colour can change in areas of your skin where you have eczema, with either red or darker patches developing depending on whether you have lighter or darker skin.
Areas of skin can become swollen and crusty and can develop cracks. Itching is common and often caused by skin dryness, infection, allergens or scratching. Most common affected areas include the creases of the joints at the elbows and knees, as well as wrists and neck (called a flexural pattern)
What causes it? Eczema tends to start in childhood (though it can develop first in adulthood). There is no specific cause and it is probably due to a number of things. It is affected by your genes and by things you come into contact with.
People with eczema often suffer other allergic conditions as well, such as asthma or hay fever, or both. Food allergy may sometimes be responsible in children who present with more severe eczema early in life.
What can I expect to happen?
How bad can eczema get? The severity of eczema can range from mild to quite severe. Around eight out of 10 children have mild eczema, with episodic flare-ups.
Will I get cured? Many children with eczema ‘grow out’ of it by the time they reach adolescence. But in some people, eczema may persist throughout their life. While there is no known cure there are many effective treatments which can alleviate your symptoms and reduce inflammation.
Speak to a member of your pharmacy team for more information about treatment and symptoms.
What can I do myself to get better - now and in the future?
Avoid trigger factors Environmental allergens (such as dust-mite antigens or pollen), irritants (such as detergents or dirt), certain foods, pet dander, smoke, certain weather conditions and stress may all impact on eczema. Try to find out whether any of these impact on your eczema and minimise them.
Avoid general use of soap Soap, bubble bath, shower gels, etc can dry out the skin. Use emollients as soap substitutes, or in the case of hand hygiene use emollients and moisturisers after using soap and water
Avoid scratching too hard Scratching is a natural reflex, but scratching too hard can make the itch even worse (the ‘itch-scratch cycle’). So whenever possible, avoid scratching your skin too hard with your fingernails – even if it’s tempting. Instead, rub itchy patches gently with the flat of your hand or gently with your fingertips.
Moisturisers Eczema causes the skin to become dry, the dryer the skin becomes the higher the chances that your symptoms will get worse. So try to keep your skin as hydrated and smooth as possible by using your moisturising creams or ointments regularly and liberally, even when your skin appears ‘clear’.
Inflammation and flare-ups Speak to a member of your pharmacy team about how you can step up/down treatments. Antihistamines can help with itching.
Avoid temperature extremes: Hot and cold temperatures may also make your eczema worse. Avoid hot baths, dress appropriately for hot and cold environments and try to avoid temperature extremes altogether.
Detergents: Avoid using fabric conditioners and consider adding an extra rinse cycle.
Use non-irritant garments: Synthetic garments and wool can trigger eczema, so you may prefer wearing clothes made out of cotton or other non-irritant materials.
Paraffin-Based Emollients: People who need to use large quantities (more than 100g) of any paraffin-based product should regularly change clothing, bedding, or dressings which become impregnated with the product and keep away from naked flames, as there is a risk of fire.
When should I seek medical attention?
Contact your surgery if you feel you need help – rarely, eczema needs more urgent assessment and treatment, so seek medical advice if you notice any of the following:
- Reduced quality of life: Your skin problems severely affect your sleep or impair social activities such as swimming.
- Infection: Crusting, cracking, weeping and painful skin may suggest infection.
- Blistery rash: You develop a painful blistery rash, which may be due to an infection with the herpes simplex virus.
- Spread: Over larger areas of your body, such as most of your chest, back, or limbs become dry and/or red.
Where can I find out more?
There’s a lot you can do to prevent problems and relieve symptoms if your eczema gets worse.
Here are reputable websites for more information:
- The National Eczema Society
- NHS England
- NHS NI Direct, Northern Ireland
- NHS Inform, Scotland
- NHS111, Wales
Remember that a member of your pharmacy team can also help you with assessing and treating your symptoms.