What is Eczema?
Eczema is a very common skin condition affecting 15-20% of children. It often commences in childhood – even in the first months of life and although in many cases it improves before teenage years for others it can continue into adulthood.
It is part of a family conditions known as ‘atopy’ which include hay fever and asthma. There is a strong genetic component and so it tends to run in families.
Eczema rash comes in many forms and it can sometimes look unusual or be confused with other conditions and so a visit to your GP is always useful in receiving a correct early diagnosis.
In its most classic form it is a DRY SKIN condition which typically affects the flexures (bending points) in the body e.g. the inside of the elbows, backs of knees and buttocks, under the chin/neck. Although uncommon before 4 months of age in babies it may more widespread in patches the body and can often first appear on the cheeks.
What is Happening in the Skin in Eczema?
The cells of the skin can be imagined like a brick in a wall, with cement in between. In eczema the ‘cement’ or skin’s natural barrier is defective – this allows moisture to seep out and irritants to get in. Irritants include soaps, detergents, dust and bacteria. Broken irritated skin for eczema can be prone to infection and this can be the cause of a sudden worsening of the condition.
While some children may require special steroid or other medicated creams to help settle the irritation of eczema the most important element is to replace this defective ‘cement’ with moisturisers (called emollients). These can be put into bath water, used as soap substitutes and most importantly be rubbed into the skin as frequently as possible. With emollient application ‘more is more’! There are many different emollients available and the most important thing is to choose one that you like and find easy to apply so that it will be done consistently. They should be free of fragrances etc. which may worsen irritation.
Some people may find they have certain triggers like dust, climate, foods or viral infections. Anything which places a ‘stress’ on the body can temporarily cause a flare in eczema. It is strongly linked to other ‘atopy’ conditions such as hay fever and asthma and they can coexist.
Eczema & Other Conditions
Up to one third of eczema sufferers may have a true food allergy (e.g. nut, fish, egg). Or more commonly a food intolerance that may exacerbate symptoms but it is felt that these conditions are most likely to exist side by side rather than the allergy be causative of the eczema. If there is any uncertainty a visit to your GP can best advise how to have a trial removal and reintroduction of the suspected food intolerance in order to access for any link, under medical supervision.
Current guidelines by the WHO recommend exclusive breastfeeding for up to 6 months to help reduce the risk of eczema. As with food allergy, there is a lot of interest at present in researching the role and timing of infant weaning onto solids and the effect this may have on reducing the incidence of eczema in children. Early indications are that introducing some solids between 4 and 6 months and offering a wide variety of foods at weaning is important. The guidelines have yet to be changed however while this new information is assessed.
Eczema is a common skin condition, often easing as childhood progresses but which can be greatly helped with early, accurate diagnosis and simple measures such as the generous use of emollient creams to repair the defective natural skin barrier that drives it.