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Eczema

EczemaCauses, symptoms and practical tips

It can be difficult to know where to start with eczema. There are many things that can trigger it, or aggravate the condition once you have it.

Often, people with eczema think they just have to live with it, not realising that there are underlying causes that can be dealt with. Some people do grow out of it as they get older but may be left with very dry and sensitive skin. In cases of mild eczema you may find it just an inconvenience and be frustrated that other people do not show concern. You may have been prescribed steroid creams which may cause problems with long term use.

As a parent it is very hard to see your child suffering with eczema and it may make you feel guilty, confused and helpless. Over the years we have found that a few lifestyle changes can make a big difference to eczema.

Read information about the symptoms, causes and treatment of eczema below....

You can also sign up to our Newsletter to download a free Eczema Explained E-booklet.

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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. It is sometimes confused with psoriasis. We will refer to atopic eczema as simply ‘eczema’.

Around one in five UK children has eczema. In 80% of cases, the condition develops before the age of five[1].

It can improve dramatically or even disappear in some children as they grow older, with two-thirds of cases improving before the age of 16.

It can, however, continue well into adulthood and even appear for the first time in adults.

 

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:

1. It prevents the body fluids from leaking out, and prevents the body from absorbing fluids (i.e. from the bath!)

2. It allows us to be aware of heat and cold, and of anything that might be of danger to the skin.

3. 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 triggers more scratching.

Chronic scratching and rubbing ultimately lead to thickening of the skin. Thickened skin assumes a red or silvery sheen, which is known as 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).

 

What causes eczema?

The exact cause of eczema is still not known. However, scientists have noticed that the immune systems of people with eczema behave in a slightly unusual way.

Antibodies defend and protect the body against foreign substances. If you have eczema, your body produces larger than normal levels of the antibody IgE (immunoglobulin), due to increased sensitivity to certain substances.

These substances can be anything from animal dander and dust mites to food, bacteria and normally harmless yeasts[2]. The reactions vary between individuals.

It is therefore thought that exposure to certain substances can exacerbate eczema in allergy-prone individuals.

Dryness of skin is also a key factor in eczema. Skin that is unable to retain enough moisture can become thin and/or cracked. This makes skin more likely to react to certain triggers, leaving it itchy and irritated[3].

Another factor may be genetics. Studies have shown that children with one or both parents, or siblings, with eczema are more likely to suffer from it[4].

It is important to remember that eczema is not contagious.

 

Exacerbating factors

Little girl with eczema cream

Certain factors have been linked to flare-ups of eczema.

These include:

  • Airborne allergens like pet dander, moulds, pollens and dust mite faeces.
  • Hard water and chlorine can be abrasive on delicate, eczema-prone skin. The irritating effects may be felt both in the swimming pool and in the bath and shower at home
  • Foods with cow’s milk, eggs, wheat, soya, artificial flavours and colours among the most likely offenders, although any food can potentially cause a problem.
  • Chemicals including perfumes, irritating soaps and detergents.
  • Rough fabrics, such as itchy clothing and wool.
  • Weather extremes can aggravate eczema-prone skin, generally through increased sweating in the summer or drier air dehydrating skin in the winter.
  • Hormonal changes can trigger a flare-up, particularly for women, who may find that their symptoms worsen during pregnancy or before their period.
  • Stress is thought to play a role, with some people reporting outbreaks of eczema during stressful times. Eczema symptoms themselves can also cause stress.

 

Treatment

Treatments for eczema are very individual, and what causes one person’s symptoms to flare up may not affect another.

  1. Removing irritants

The first step we recommend is to remove any potential irritants from your environment and diet.

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.

  • Airborne allergens from moulds, pollens, dust mites and pets can be tackled in a number of ways.

If you feel that dust mites could be a trigger, you could try dust mite proof bedding. The bed is where dust mites are most active and by encasing bedding in specialist cases many people report an improvement in their symptoms.

Our non toxic allergy sprays are a great way top reduce your exposure to pollen, dust mite, mould and pet allergens in the air, on furnishings and in your washing. If your symptoms are severe and you think it is highly likely that airborne allergens play a big part in your condition, an air purifier is a worthwhile investment.

  • The relationship between certain foods and eczema is an area that requires more research, but some people experience symptom relief by reducing or removing the following foods from their diet: cow’s milk, eggs, wheat, soya, artificial flavours and colours. It is important to remember that everyone’s eczema is different, so foods that cause a problem for one sufferer may have no effect in another. Keep a food diary to help you work out what your potential triggers could be.
  • 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 an irritant effect on the skin. People with asthma may also find that chlorine can irritate their airways. Water filters for eczema can make a huge difference to reducing external sources of aggravation. 
  • Harsh detergents, heavily scented fabric conditioners and perfumed products can aggravate eczematous skin. These can be replaced with more gentle, natural ingredient-based cleaning products, toiletries and laundry products.  
  • Itchy, rough fabrics and clothing can be abrasive on delicate, thin skin. Swap woollens for specialist clothing for skin conditions such as the DermaSilk range, or opt for organic cotton. School-age children can find standard uniforms to be too itchy and rough on the skin. This specialist school uniform for eczema is made with a gentle lining of bamboo and silk, designed to reduce irritation to sensitive skin.

 

2. Regular bathing, bath oils and emulsifiers

Bathing (in dechlorinated water) is important in keeping the skin clean and free from infection. It helps to remove dry skin scales and caked on blood. Gentle, natural-based bath oils and emulsifiers help to nourish and rehydrate the skin, providing a protective layer to function as normal healthy skin would function in protecting the body from irritants.

3. Topical therapies

Topical steroids are a commonly prescribed treatment for eczema symptoms. They are designed to reduce redness and itchiness in the skin, and when used correctly for short periods of time, are considered to be a safe treatment for eczema symptoms.

For some people with extremely debilitating eczema, it may be considered necessary to undertake a short course of topical steroid treatment. However, they are not 

a cure, and if used for long periods of time they can cause unpleasant side effects that can be very hard to get rid of.

These side effects include thinning of the skin, loss of elasticity, stretch marks, increased hair growth and perioral dermatitis (a persistent red, spotty rash around the mouth and nose). There is also some concern about the potential absorption of these steroids by the skin into the bloodstream. 

At The Healthy House, we always advocate the most gentle and natural approach possible when it comes to treating allergy symptoms and skin conditions. This is particularly relevant in the cases of mild to moderate eczema.

Gentle emollients protect the deeper layers of the skin when broken, fragile top layers naturally can’t. We offer a wide range of creams and oils, shampoos and skin care that contain no chemical ‘nasties’.

4. 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.

5. Making sure the sufferer does not get too hot

Overheating can cause eczema-related 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.

On holiday, a gentle protective sun lotion is a must. Many sun creams on the market contain irritants. Our gentle alternatives have been chosen because of their suitability for sensitive skin.

 

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 physical and mental health. In this instance it is important to allow complete medical treatment in order to help 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.

Sometimes antibiotics are necessary to control bacterial infections. Topical antiseptics can be given for recurrent infection or added to bath water. Cyclosporine is an immunosuppresant and is used in very severe cases of eczema when all other treatments have failed. This is a very powerful drug which is often used for patients with a transplanted organ[5]. It has potentially serious side effects, and therefore many doctors and patients prefer to avoid this treatment unless absolutely necessary. Antihistamines are occasionally used to help sleep and reduce itching.

 

Wholistic treatment of eczema – a summary

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 a link has been observed between eczema and certain nutrient deficiencies, 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 help to maintain healthy skin. Stress can also be a factor in flare ups of eczema.


References and Information Sources:

[1] http://www.nhs.uk/Conditions/Eczema-(atopic)/Pages/Introduction.aspx

[2] http://www.netdoctor.co.uk/skin_hair/atopic_eczema_003731.htm

[3] http://www.nhs.uk/Conditions/Eczema-%28atopic%29/Pages/Causes.aspx

[4] Ibid.

[5] http://nationaleczema.org/eczema/treatment/immunosuppressants/Allergy 

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