Eczema

What is it?
Eczema is a skin condition resulting in dry, red, itchy areas of skin. There are several different causes but generally speaking you can have either contact eczema, that is when a substance you come into contact with causes the eczema or atopic eczema when the eczema comes from inside, that is you are born with a tendency to eczema.

Contact eczema affects the body areas that come into contact with the relevant substance, ie usually the hands and face. Patch testing can be necessary to establish what the substance is that is causing the reaction.

Atopic eczema is the most common form of eczema and often starts in babyhood or childhood. It generally improves as the child grows up but adults can be affected. The insides of the elbows, backs of knees, wrists, feet, ankles and face are the usual sites.

What treatments are there?
Moisturisers (Emollients)

These are the most important part of treatment for any type of eczema. Emollients should be used morning and night even when the eczema is well controlled. There are 3 main types which should be used:-

Skin ointments and creams.
There are several different varieties so everyone can find one they like Soap substitutes. Soap is very drying so aqueous cream should be used to wash with instead. Bath/shower emollients. These can be added to the bath or used in the shower. They stop the skin drying out and are also available with antibacterial agents to help prevent eczema getting infected.

Topical Steroids
These help calm the inflammation seen in eczema. There are different strengths available for different body areas and your Doctor will advise you how to use these as skin thinning can result if too strong a steroid is used for too long. Hydrocortisone is the mildest and is very safe.

Light Treatment
Some people find that sunlight helps their eczema and for widespread eczema special UVB or PUVA treatments are available.

Ichthammol
This is a form of a very mild tar which soothes and treats eczema. It is available in creams or paste bandages, eg Ichthopaste. Sometimes a 'suit' made from a light bandage (Tubifast) is used on top to help the ointment or paste bandage to stay on.

Wet Wraps
These are useful for children particularly for night time itching. A wet material bandage is wrapped around the limbs with a dry bandage over the top. As the wet bandage dries, it cools the skin and helps relieve itching. Steroid creams can be used underneath.

Tablet Treatment
There are various tablet treatments available for severe eczema. Your Dermatologist will discuss these with you if you need them.

Other forms of Eczema

Varicose Eczema
This is usually seen on the lower legs and is caused by poor circulation/varicose veins. Treatment is with moisturisers, steroid creams and support stockings.

Seborrhoeic eczema
A form of dandruff often affecting the face and chest as well as the scalp.

Photosensitive eczema
An unusual form which is made worse by sunlight. A sunblock is important.