Eczema, also known as dermatitis, is a group of conditions that cause inflammation, redness, and itching of the skin. It is a chronic condition that can affect people of all ages but is most common in children. Eczema often flares intermittently and can significantly impact quality of life due to discomfort and visible symptoms. While the condition is not contagious, it requires ongoing management to control symptoms and prevent complications like infections.
Eczema can present in different forms, including:
- Atopic Dermatitis: The most common type, often associated with other allergic conditions like asthma and hay fever.
- Contact Dermatitis:
- Irritant Contact Dermatitis: Caused by exposure to irritating substances such as soaps, detergents, or chemicals.
- Allergic Contact Dermatitis: Triggered by allergens such as nickel, fragrances, or certain plants.
- Dyshidrotic Eczema: Characteried by small, itchy blisters on the hands and feet.
- Nummular Eczema: Appears as circular, coin-shaped spots on the skin.
- Seborrheic Dermatitis: Affects oily areas like the scalp, face, and chest, often resulting in dandruff or scaly patches.
- Stasis Dermatitis: Develops in the lower legs due to poor circulation and fluid buildup.
- Peri-Oral Dermatitis: Presents as a rash around the mouth, often triggered by overuse of topical steroids, heavy skincare products, or certain irritants.
The exact cause of eczema is not fully understood, but it is believed to result from a combination of genetic, environmental, and immune system factors. Key contributors include:
- Genetic Predisposition: A family history of eczema, asthma, or allergies increases the risk.
- Skin Barrier Dysfunction: Abnormalities in the skin barrier make it more prone to irritation and dehydration.
- Immune System Overreaction: An overactive immune system can trigger inflammation in response to irritants or allergens.
- Environmental Triggers: Factors such as allergens, irritants (e.g., soaps, detergents), temperature extremes, and stress can exacerbate symptoms.
Options include:
Eczema treatment focuses on managing symptoms, reducing inflammation, and preventing flare-ups. A tailored treatment plan can significantly improve quality of life.
Topical Treatments
- Corticosteroids to reduce inflammation and itching.
- Calcineurin inhibitors (e.g., tacrolimus, pimecrolimus) for sensitive areas like the face and neck.
- Gentle soap-free cleansers and gentle fragrance/colour free moisturisers and emollients to restore the skin barrier and prevent dryness.
Phototherapy
Narrow Band UVB (NB-UVB) therapy can help reduce inflammation and itching in moderate to severe cases.
Systemic Medications (for severe or treatment-resistant eczema)
- Biologic therapy blocking specific immune pathways IL-4/IL-12 (i.e., dupilumab).
- Janus kinase (JAK) inhibition (i.e., upadacitinib) – a targeted therapy modulating specific immune pathways.
- Oral corticosteroids or immunosuppressants (e.g., cyclosporine, methotrexate) may be used for short-term control of severe flare-ups.
Lifestyle Modifications
- Identifying and avoiding known triggers such as allergens, irritants, and stress.
- Establishing a consistent skincare routine with gentle, fragrance-free products.
- Wearing soft, breathable fabrics and avoiding wool or synthetic materials that can irritate the skin.
By working closely with a dermatologist, patients can develop an individualised treatment plan to effectively manage eczema and improve their skin health. Organise a referral from your GP to streamline a consult with our dermatologist today.
