Exactly What Is Eczema?
Eczema (sometimes referred to as atopic dermatitis) is a common condition where patches of skin become inflamed, itchy, red, cracked, and rough. The severity can vary greatly.
Eczema is most common in children and will typically clear as they age. However, they will often continue to have sensitive skin AND eczema will often return again in later life.
As I’ve explained in previous articles, our skin should act as a protective barrier against external irritants and bacteria. However when the skin is affected by eczema (and the lipid barrier is compromised), external irritants and bacteria are able to penetrate into the skin and moisture is lost . This causes further irritation, inflammation and dryness, which can lead to cracks in the skin, itching, infection etc.
While the exact cause of eczema is not fully understood, we do know that;-
Skin hypersensitivity and reactions are often the by-product of hypervigilant immune system skin cells (called Langerhans cells), thrown into overdrive by triggers such as environmental allergens, stress etc.
To put it simply, eczema is caused by inflammation of the skin.
TRIGGERS, which activate and exacerbate episodes of eczema include diet, hormonal, environmental, stress and lifestyle-related factors.
Common triggers include soap, perfume, detergents, stress and change in temperature or weather. Food allergies can also play a part, especially in young children. Individuals will react differently to different triggers.
- Hormones: Women can experience increased eczema symptoms at times when their hormone levels are changing, for example during pregnancy and at certain points in the menstrual cycle.
- Stress: This is not a direct cause of eczema but can make symptoms worse. See mind-skin connection.
Mild cases of eczema can leave the skin irritated, dry, red, scaly and itchy, while the more severe cases can lead to weeping, bleeding and crusting of the skin.
For many people, the severity of flare-ups will lessen with maturity, and ‘some’ may completely outgrow it. However, as eczema can come and go throughout life, learning how to manage flare-ups and identifying triggers is the best course of action.
There are a number of things people with eczema can do to support skin health and alleviate symptoms, such as:
Avoiding external irritants and allergens
Common environmental irritants include:
- Harsh soaps, bubble baths, some shampoos
- Wool, nylon
- Grass and sometimes sand
Common allergens (substances that can aggravate eczema if you are allergic to them) include:
- house dust mites;
- animal dander (small scales from the skin and hair of animals).
- certain foods.
Note: an allergy assessment by an allergist will properly identify the allergic triggers.
- As Overheating can make eczema worse, therefor try not to have heating too high in winter, bathe in lukewarm water (not too hot), don’t use an electric blanket.
- Prevent your skin becoming dehydrated and dry (which are two different conditions).
- Wear cotton and soft fabrics, and avoid rough, scratchy fibers and tight-fitting clothing.
- Use a mild soap when washing and a non-soap cleanser (such as Soothe gentle cream wash).
- Gently pat (with a towel) or air dry rather than rubbing the skin dry after bathing.
- Avoiding rapid changes of temperature and activities (like heated yoga) that make you sweat excessively.
- learn and avoiding individual eczema triggers
- Use a humidifier in dry or cold weather.
- keep childrens fingernails short to prevent breaking the skin when itching.
- Use an emollient daily to keep the skin moisturised.
- Wear cool breathable natural fibres.
- Eczema can get worse when stressed or anxious, so consider relaxation techniques such as meditation. See Mind-Skin-Axis.
- Check ingredients of skincare products before use.
- See common skin conditions
Nutrition and skin health
As certain food allergy’s intolerance’s can aggravating eczema, keeping a food diary can help pin point the particular foods that may be causing flare-ups. Speaking to a nutritional professional will point you in the right direction here.
It is important to remember that eczema is an inflammatory skin disorder. Therefore avoiding inflammatory foods can greatly help manage eczema. See gut-skin connection article.
When it comes to healthy eating, certain Vitamins and Nutrients can have a very positive effect on skin health. Some of the key nutrients believed to be essential in maintaining good skin health include; essential fatty acids (EFAs such as salmon, wallnuts or Sea Buckthorn), Zinc, Probiotics, Selenium, Vitamin E (avocados), Vitamin D, Beta-carotene etc. See here for more info.
Everyone is individual and what your body needs, may be different to someone else’s. A nutrition professional can help you understand what foods may be causing your skin issues and guide you in the right direction.
Moisterisers / Emollients
Moisturising is one of the easiest (and most important) measures in protecting the skin barrier. It can also prevent itching and scratching, as well as reduce eczema flare-ups.
As eczema is a chronic condition, it is important to incorporate regular moisturising into your daily skincare routine. – normally a cream or ointment that softens and soothes the skin. For very dry skin, this should be done twice per day.
- Avoid moisturisers that contain perfumes which can irritate the skin.
- Moisturisers should also be applied within 3 minutes of bathing to ‘lock in the moisture’
Rodan + Fields offers dermatologically tested and proven products that are gentle and safe enough to use on childrens delicate skin. Steps 2 & 3 from the Soothe Regimen are two of the products that I recommend. If you are looking for relief and just don’t know where to turn, please feel free to contact me to see if these products are right for you and your family.
Note: emollient is just another word for a moisturiser
Steroid creams and ointments?
Creams or ointments containing corticosteroid are commonly used for flare-ups of eczema. Steroid preparations can relieve itching by reducing inflammation. However it is important to discuss this with a dermatologist as using high-strength steroid ointments or creams over long periods can be associated with side effects. Short term use intermitted (when required) is a better option.
Anti-itch preparations for eczema
Cold compresses, oatmeal baths, coal tar and pine tar preparations may help to relieve itchy skin.
Antihistamines are occasionally recommended to relieve itching that is disrupting sleep. Their benefit is partially due to the sedating effect – they do not completely suppress the itch. Sedating antihistamines (such as Phenergan) are therefore best taken at night.
The mind-skin connection
Some skin conditions, including eczema, have a psychological component. This is a dynamic is referred to as psychodermatology. See more information here…
Victoria Isherwood (Registered Nurse)