The word eczema comes from a Greek word that means to effervesce or bubble or boil over. Eczema is the most common inflammatory disease of the skin and affects many millions of adults and children worldwide.
Eczema can’t be cured, but it can be managed.
Currently we do not have statistics for Ireland, but it is estimated that possibly one in five children under the age of 6 and one in twelve adults have eczema.
Eczema affects people of all ages but is primarily seen in children. Those who “grow out” of their eczema during early childhood may see it recure again in later life.
Other names for eczema
- atopic dermatitis
- atopic eczema.
The term ‘atopic’ pertains to a hereditary tendency to experience immediate allergic reactions such as eczema, asthma or allergic rhinitis because of the presence of an antibody in the skin and sometimes the bloodstream.
The words eczema and dermatitis mean the same thing, and thus atopic eczema is the same as atopic dermatitis.
Is atopic eczema hereditary?
It is now widely accepted that hereditary factors play a role in the onset of childhood atopic eczema. There is often a family history of “atopic” conditions such as asthma, eczema and hay fever.
If both parents have eczema, there is an 80% chance that their children will too. In addition, there is a tendency for these conditions to run true to type within each family; in other words, in some families most of the affected members will have eczema, and, in others, asthma or hay fever.
In some families, though, only one person has eczema. Approximately one third of children with eczema will also develop asthma and/or hay fever.
What are the symptoms of atopic eczema?
Atopic eczema usually starts in the first months of life but it may also develop for the first time in adulthood. The main symptom is itch. Scratching in response to itch may cause many of the changes seen on the skin.
The itch can be severe enough to interfere with sleep, causing tiredness and irritability. This can have an enormous impact on the whole family. Typically it goes through phases of being severe, then less severe, and then worse again.
What does atopic eczema look like?
Atopic eczema can affect any part of the skin, including the face, but the area’s that are most commonly affected are the joints at the elbows and knees, as well as the wrists and neck. Affected skin is usually red and dry, and scratch marks (often bleeding) are common.
When a flare up is severe, the skin may be moist and blistery.
Different types of eczema
- Atopic eczema, currently the most common form of eczema.
- Allergic contact eczema, for example, due to nickel allergy.
- Irritant contact eczema, contact eczema that is not allergic, for example, caused by long-term exposure to detergents.
- Seborrhoeic dermatitis, often caused by a fungal infection in the skin.
- Stasis dermatitis, caused by swelling in the lower legs.
- Photosensitive eczema, caused by the sun’s rays.
- Nappy rash, occurs when skin/nappy is in contact with skin, known as intertriginous eczema.
- Neurodermatitis, slight wound or mosquito bite that you scratch, causing an eczema patch.
Treatment of eczema
The treatment of eczema is both simple and complicated. Simple, since there are almost always only two types of treatment. Complicated as it is often a time-consuming process to apply cream to yourself or your child. The treatment consists of:
- Softening cream for areas with dry eczema.
- Cortisone cream for areas with eczema.
If the treatment does not work, local immune-dampening preparations known as calcineurin inhibitors can be used instead. The treatment is often used restrictively as the long-term side effects are not sufficiently known.
In the case of allergic eczema, it is obviously important to eliminate the cause of the allergy. Eczema can sometimes be subjected to bacterial infections, in which case it is treated with antibiotics.
Seborrhoeic dermatitis is treated with antifungal shampoos. Intertriginous eczema can be subjected to fungal infections and is treated with cortisone cream with antifungal agents.
More severe cases of atopic eczema can also be treated with UV radiation.