Information on Eczema
What is eczema?
Eczema is derived from the Greek word to 'boil' or 'ooze'. There are many forms of eczema but the most common is atopic eczema, also known as atopic dermatitis.
In the developed world eczema accounts for a large proportion of skin disease, both in hospitals and in the community. It is estimated that 10% of people have some form of eczema at any one time, and up to 40% of the population will have an episode of eczema during their lifetime." Atopic eczema is common occurring in up to 5% of the population, (up to 10% of all children).
The skin
The function of normal healthy skin is to create a barrier between the inside of the body and the outside environment. This function is important for various reasons.
It prevents the body fluids from leaking out, and prevents the body from absorbing fluids (ie from the bath!). It allows us to be aware of heat and cold, and of anything that might be of danger to the skin. It helps to regulate the body's temperature through sweating or shivering and at the same time is one of the organs involved with detoxification. When the skin is affected by eczema the barrier between outside and inside is broken. This means that substances that might not otherwise have affected the skin may now affect it.
The itch cycle
The characteristic feature of eczema is a dry, inflamed skin. The sequence of events is easy to understand: dry, inflamed skin is itchy, itchy skin is scratched, scratched skin breaks down and weeps, and broken skin may become infected. As broken skin heals, it goes through an itchy phase, and this sparks off more scratching. Chronic scratching and rubbing ultimately lead to thickening of the skin. Thickened skin assumes a red or silvery sheen which we call lichenification. Other colour changes may also occur involving the accumulation or loss of pigment. This will show up as patches or tanned skin on a pale background (hyperpigmentation), or as pale patches on a dark background (hypopigmentation).
Atopy and the difference between atopic and non-atopic eczema
Eczema is usually divided into atopic and non-atopic. Atopic is a Greek word meaning alien and is used to describe a group of diseases that includes asthma, hay fever, urticaria and a particular type of eczema. In an atopic person the control system for producing the anti-body immunolglobulin E (IgE) appears to be faulty and a larger than normal amount is produced. Antibodies defend and protect the body against foreign substances and in an atopic person a particular allergen is reacted to as a foreign substance and causes an allergic reaction. In the case of eczema this results in inflammation of the skin and itching. "Our experience is that virtually all cases of eczema have an environmental component but the condition is complex and severe eczema is complicated by marked hypersensitivity of the skin and increased need for a number of nutrients. Management usually requires attention to local contact triggering, exposures to inhaled chemicals and aeroallergens, reactions to foods, and nutrition. Other types of eczema included discoid or nummular, hand, seborrhoeic, venous or varicose, asteatotic or winter, and photosensitive eczema. The most common type of eczema, however, is atopic and since it refers to an allergic reaction is the type of eczema that we are concerned with.
Causes of atopic eczema
There have been many books and articles written on eczema. Dr David J Atherton is an expert in children's skin disorders and is based at Great Ormond Street Hospital. The following advice is taken from his book:
Exacerbating factors:
Foods - reaction in young children possibly due to intestines being excessively permeable to intact and undigested food proteins. Or, there may be an abnormal response to normal amounts of intact proteins in the bloodstream. Any food can cause a problem but milk, wheat, eggs and food colourings are some of the most likely offenders.
Antigenic proteins in the form of airborne particles. These include
- house dust mites
- pollens
- moulds
- furry animals
The antigenic proteins in these substances appear to be harmful to eczematous skin through contact - the reaction being similar to contact dermatitis.
Microorganisms and other irritants - Damaged skin provides a perfect environment for micro-organisms, bacteria, yeasts and viruses. Cutaneous viral infections such as warts and molluscum can be spread by scratching. Tobacco smoke is also thought to be a factor.
What should I do if I or my children have eczema?
Treatments - Treatments should be tailored to fit the individual sufferer. This will normally include:
- removing any known irritants or allergens both internally and externally
- regular bathing, bath oils and emulsifiers
- application of topical therapies
- bandaging or wet wraps
- wearing cotton clothes preferably organic or untreated without extra treatments
- making sure that the sufferer does not get too hot
1. Removing any known irritants or allergens both internally and externally.
Swimming in a swimming pool is usually anathema to anyone with eczema. This is because the chlorine in the pool is basically toxic and abrasive and irritates the already sore and sensitive skin. Though this is a situation where the exposure to chlorine is excessive, few people realise that sitting in a bath or showering in chlorinated water may also have a detrimental effect on the body. A water filter can make a huge difference to reducing external sources of aggravation. Other external aggravations may include harsh detergents, toiletries, fabric conditioners, clothing etc. Dust mites have also shown to be a problem for some people with eczema. This is because the allergen from the dust mite faeces gets into the broken skin causing an increased reaction in anyone allergic to the house dust mite. Dust mite proof bedding creates a barrier between the person and the dust mites in the bedding. There are also other very useful dust mite products to help combat dust mites. Our non toxic allergy sprays are a great way top reduce your exposure to allergens in the air, on furnishings and in your washing. By considering and eliminating any of the substances that may aggravate broken skin, this may help reduce inflammation. It is important to realise that these substances may or may not be the cause of eczema but may help to alleviate at least some of the symptoms.
Food allergy and food and chemical sensitivity is another area that needs thorough investigation.
Other triggers that need to be considered for eczema sufferers are pet allergy, pollens and moulds.
2. Regular bathing, bath oils and emulsifiers
Bathing (in dechlorinated water) is important in keeping the skin clean and free of infection. It helps to remove dry skin scales and caked on blood. Bath oils and emulsifiers help to nourish and rehydrate the skin and provide a protective layer to function as normal healthy skin would function protecting the body from irritants.
3. Topical therapies
Normal medical treatment includes the use of steroid creams. Though there can be problems associated with the use of steroid creams, whether you agree to use them or not must depend on the severity of the condition. Steroid creams penetrate from the surface of the skin to the deeper layers where eczema occurs. Problems can result from the hormone being absorbed into the blood stream but this will depend upon the strength of the steroid, how much is applied and the extent of the area treated. Externally, persistent use of steroid creams can damage the skin causing thin and fragile skin. The other problem with constant use of steroids is that they cease to be effective after time and the patient requires stronger and stronger doses.
We offer a wide range of creams and oils, shampoos and skin care.
4. Bandaging and wet wraps
Wet bandaging is used with steroid creams. Wet and dry bandaging prevents scratching in very severe cases. Our cotton and silk clothing is designed specifically with eczema in mind.
5. Cotton clothing and gloves
Ideally cotton clothing should be unbleached and undyed unless the dyes contain no heavy metals. Organic clothing is recommended. Our DermaSilk clothing comes in a range of products for babies, children and adults. Gloves can be used to protect children's and adults' hands. They can be used during the day for playing or working or at night after putting creams on.
6. Making sure the sufferer does not get too hot
Eczema sufferers tend to get hot especially at night. Overheating causes the itching to get worse. Ensure that the bedclothes are not too warm and make sure the room is well ventilated and not too warm. Cotton bedding is preferable to synthetics because it breathes and lets the heat out. We recommend the use of untreated cotton bedding which can be washed at 60 degrees to keep it dust mite free. Make sure bath water is not too hot as this overheats the body and always allow a cooling off period before applying creams. Once creams have been applied it is more difficult for the body to cool down.
Severe eczema
It is vitally important to remember that occasionally eczema can get out of hand and can become a major threat to the sufferer's health. In this instance it is important to allow hospital admission and complete medical treatment in order to stabilise the condition. Steroids can be administered both topically and orally. Systemic steroids are given orally in the severe cases of eczema. Though these are effective, prolonged use may result in side effects. These can include restriction in growth in children and osteoporosis in adults.
Sometimes antibiotics are necessary to control bacterial infections. Topical antiseptics can be given for recurrent infection or added to bath water. Cyclosporin suppresses the immunological system and is used in very severe cases of eczema when all other treatments have failed. This is a very powerful drug with potentially serious side effects. Antihistamines are sometimes used to help sleep and reduce itching.
Wholistic treatment of eczema
Eczema affects many thousands of people in the UK each year. When the condition is bad it can seriously affect the whole household with sleepless nights and general misery. It is always worth looking carefully at lifestyle changes, reducing harmful chemical use in the home, including those used in everyday soaps, shampoos, cleaning products, body and face creams. Diet should be carefully looked at and foods containing additives, colourings and preservatives removed as much as possible from the diet. Control of the house dust mite, air cleaning to remove chemicals, pollens and moulds may all be of benefit. Removal of chlorine from bath, shower and drinking water can make a big difference to people with eczema. Nutrition needs to be looked at carefully. A visit to a nutritionist may help in ascertaining which nutrients may help since some eczema sufferers are deficient in certain nutrients including essential fatty acids, zinc and vitamin B6. Essential fatty acids are fats that are not made by the body and have to be obtained through diet. Essential fatty acids in supplement form are usually recommended since they to maintain healthy skin. Stress can also be a factor in flare ups of eczema.
Disclaimer
Information included in this website is intended for information purposes only and is not to be used as a substitute for consultation with a medical practitioner.
