Atopic dermatitis or eczema, is an inflammatory skin condition and often
causing a lot of discomfort. It usually occurs in families, or where family members
have related allergic conditions such as asthma and hay fever. Eczema is known
to flare up and disappear for no apparent reason. It is not contagious. It affects
all ages, but it usually appears in babies aged from two to six months.
In general:
* Most people with eczema develop it before the age of five.
* Most grow out of it, but a small number have severe eczema into adulthood.
* It tends to improve in middle age and is not as common in older people.

Symptoms include: itching (this distinguishes eczema from other rashes) and a
recurring rash of dry, red, patchy or cracked skin. In the very young, it usually
appears on the face, knees and elbows. In older children, it’s less common on
the face than on the neck, inner elbows, backs of the knees and ankles. In adults,
it tends to affect the face and hands. Skin may become weeping and watery or rough
and leathery.

The exact cause of eczema is a mystery, but it seems to be linked to a family history
of the condition (or of hay fever or asthma), particular foods, including dairy and wheat
products, citrus fruits, eggs, nuts, seafood and chemical food additives, preservatives
and colourings, and alcohol.

Other causes include stress, irritants such as tobacco smoke, chemicals, hot and humid
or cold and dry weather conditions, and airconditioning or overheating. Eczema can be
caused by allergens, including household dust mites and their droppings, moulds, grasses,
plant pollens, foods, pets, and irritants including woollen clothing, soaps, shampoos and
washing powders, cosmetics and toiletries. (Household dust mites which feed on the skin
that humans shed are particularly numerous in the homes of people with eczema because
of the number of skin scales they shed. Strict anti-dust measures may be required.)

Symptoms tend to become less severe over time, but the skin is likely to remain dry and

Many things can be done to avoid outbreak. Most importantly, keep skin moist by using
a daily moisturiser such as sorbolene. Some people recommend applying it at least four
times a day. Wear pure cotton or soft fabrics, avoiding rough, scratchy fibres and tight
clothing. If you use rubber gloves, wear cotton liners. Bathing too often, especially with
harsh soap, can make eczema worse.

Remember the following:
* Use warm water, not hot
* Use as little soap as possible, limiting it to face, armpits and genitals if possible, or use
  non-soap cleanser and/or bath oil.
* Dry yourself thoroughly yet gently – pat, don’t rub.
* Bathe or shower less often.
* Apply cold compresses to itchy areas, but don’t let them dry out.
* Over-the-counter hydrocortisone creams or lotions can be applied several times daily to
  inflamed skin.

See your doctor if such home-care methods do not help, if you feel itchy but have no rash,
if dry and itchy skin is preventing you from sleeping, if you have open cuts from scratching
yourself, or if you have developed infected areas (crusting, pustules, spreading redness).

Other Tips:
If possible, remove carpets and rugs from your house to avoid dust mites, and keep pets
outside. Air your home as often as you can. Avoid soft toys (these are popular with dust
mites). Change your bed linen regularly, vacuum the mattress regularly for dust mites, and
avoid feather pillows.
Try to reduce stress. Learn what triggers your eczema and how to avoid those triggers.
Try not to scratch! If it’s driving you mad, get into a cool bath with soothing bath oil or
oatmeal. Skin infections can make eczema worse – avoid people with cold sores, shingles
or chicken pox.

There is no known cure for eczema, but treatment can control symptoms. The aim is to
heal the skin and prevent flare-ups. Moisturising is important.

Treatment may include corticosteroids, in cream form to reduce inflammation and itchiness.
Most require a prescription, but hydrocortisone is available at pharmacies. Another treatment
is sedating antihistamines to help you sleep and reduce itchiness. Wet bandages can soothe
the skin, reduce itchiness and help heal broken skin. More severe symptoms may call for oral
corticosteroids, immunosuppressants or phototherapy.

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