What is Eczema?
Eczema is a condition which is caused by a variety of factors, including genetic changes, environmental triggers and immunological factors. Individuals have an abnormally leaky skin barrier, meaning that it cannot waterproof itself.
The skin dries out and leaves an appearance of dry, flaky skin which is incredibly itchy for the individual.
Patients with eczema have a mutation of the filaggrin gene which is the component in part responsible for the structure of the skin. Eczema treatment is key, and we can help.
Worried about Eczema?
If you are worried about your eczema or wondering if you have eczema, the best thing would be to make an appointment with Dr Helen Allergy or Odette Rodda, our resident dermatology expert.
Book an Eczema Consultation
Eczema is often poorly managed
Families often feel like they can control the eczema and cure it by making a change somewhere in their environment or diet. This can leave families in a vicious pattern of making more and more changes without any improvement. Families and patients blame themselves for flare ups of the skin and look to find what they have done differently to trigger the skin.
Sadly, no matter how hard families try, the cure for eczema is not something any of us can provide. Eczema is a condition which many will outgrow with age, but some patients have lifelong disease. Effective eczema treatment management of the condition is crucial for a good quality of life and symptom control.
Are allergies responsible for Eczema?
Despite what the majority of the population believe, large clinical studies have clearly shown that no external source such as food, pets or house dust mite are solely responsible for eczema.
Many families fall into the trap of highly restrictive diets in the hope that this will cure eczema. In fact, implementing a restrictive diet for a child with eczema can allow allergies to form as the child may lose tolerance to foods they are not eating.
Additionally, many children end up with nutritional and growth deficiencies due to these restrictions. It is vital to obtain the correct advice from a specialist to understand whether or not a food should be removed from the diet of a child with eczema.
Many individuals with eczema will have environmental allergies and it is sensible to assess this and minimise these factors in order to help improve the appearance of the skin and the control of the eczema.
How is Eczema diagnosed?
The diagnosis of eczema can be made by asking a few questions and by examining the skin. No specific tests are needed.
Eczema can present at any age. It commonly affects up to 20% of children and 8% of adults.
In infants, eczema commonly starts on the face and trunk. Older children tend to have eczema in the more ‘classical’ places such as creases of the arms and backs of the knees.
More significant disease will affect a wider area of the body.
Are children with Eczema at risk of food allergies?
Whist we know it is not caused by a food allergy, we have clear evidence showing us that infants with eczema are at high risk of food allergies developing, especially egg and peanut allergy.
In order to prevent this, these children should be weaned early between 4 to 6 months and foods like egg and peanut, should be given into the diet early and regularly.
The British Society of Allergy and Clinical Immunology have produced clear, useful guidance about this which you can read here.
How do I get Eczema Treatment?
The mainstay of eczema treatment will always be moisturisation using an appropriate emollient. This helps waterproof the skin and will reduce the number of flareups an individual has.
In addition to moisturisation, many individuals with eczema can be well managed with the addition of the right strength of steroid, used for an adequate length of time.
For those where this is not effective or appropriate, the next stage of treatment would be the addition of a calcineurin inhibitor. This is a very safe and effective cream that often brings major improvement to those in whom traditional treatments have not worked.
A holistic approach to Eczema management
Alongside these eczema help treatments, Dr Helen and Odette will discuss a more holistic approach to eczema management.
For the small minority of patients where these treatments have made little difference, a referral to a dermatologist will be appropriate to discuss the use of oral or injectable immunosuppressants. These medications of course carry greater risk and will need regular blood tests to monitor the body’s response to the medication, but they are highly useful for the right patient group.