Is your skin itchy, red or dry? Does it leak fluid that crusts over when scratched? If so, there’s a chance it’s Atopic dermatitis, more commonly known as Eczema.
Eczema is the most common skin condition, especially in children. It affects one in five infants but only around one in fifty adults. It arises from a “leakiness” of the skin barrier, which causes it to dry out and become prone to irritation and inflammation by many environmental factors.
In about half of patients with severe atopic dermatitis, the disease is due to inheritance of a faulty gene in their skin called filaggrin. Patients with the faulty filaggrin gene often have hand eczema with excessive little lines on their palms.
Unlike hives, the itch of eczema is not only caused by histamine so anti-histamines may not control the symptoms. Eczema is often an allergic skin reaction linked with asthma, allergic rhinitis (hay fever) or food allergy. This order of progression is called the atopic march.
The location of the rash depends on the age individual. In infants, eczema is often seen on the face. Children are prone to have the rash on the elbow, wrists, behind the knees and behind the ears. Adolescents and young adults typically have the rash in the same locations as children, but also have it on the hands and feet.
In many children, the exact cause of the eczema is not clear and treatment depends on regular use of moisturizer and topical medicines to dampen down the inflammation. One such treatment is topical steroids. In children where the skin is oozing, crusting and painful, an infection that needs treatment with antibiotics may be the primary trigger.
Some people with eczema have a food sensitivity which can make eczema symptoms worse. Infants and young children with more severe eczema should be evaluated for food allergy. If this is the case for your child, come in and see us for diagnosis and management. We also have our dietician in-house, who can be a great help in this.
Food allergies causing eczema are much less common in older children and adults. If you think your eczema is an allergic skin reaction caused by a food allergy, diagnosis begins with testing and a discussion with an allergist before starting any elimination diets.
Eczema is sometimes described as an “itch which rashes.” The rash is caused by scratching, so the more the patient scratches the more severe the rash will be. This is why it’s important to avoid scratching.
The best way to treat eczema is to use moisturizers and topical ointments that reduce the inflammation e.g. topical steroids or calcineurin inhibitors. The itch is not relieved by antihistamines although these are sometimes used at night to help people with eczema sleep.
Antibiotics may be prescribed if a skin bacterial infection is suspected as a trigger for your eczema flare-up. Symptoms of infection include crusting, oozing and pain. Oral steroids should be avoided, as although they are effective the eczema usually returns when the medicine is stopped. Oral steroids can also cause serious side-effects if taken for long periods of time.
Sometimes, wearing cotton undergarments and body suits can help protect the skin from irritants and scratching. We recommend you avoid using soap products that contain sodium laurel sulfate and any triggers that cause a reaction. If you come in and see us, will be able to help determine whether there is a trigger that can be avoided.
These skin allergy treatment and management strategies can relieve social challenges as well. People with eczema, especially children, are sometimes ignored or singled out by others who believe the rash is contagious.
Come in today to find out if you have eczema and to get the treatment you need. We can’t wait to meet you!
