Eczema

What is eczema?

The word 'eczema' comes from Greek and literally means 'boiling over'. Normal skin acts as a barrier to prevent water loss and stop skin irritants from penetrating. If you have eczema your skin doesn't do this as effectively as it should, leading to dryness, itching and cracked, scaly skin which lets in bacteria and allergens that can cause an allergic reaction. It is not a contagious condition.

The different types of eczema

There are many types of eczema, varying in intensity from mild to severe, but the most common are atopic eczema and contact dermatitis.

In this section

Atopic eczema is the body's over-reaction to foreign substances, causing the skin to become red, inflamed and very itchy. It tends to occur in people who have a natural tendency to develop allergies such as asthma, hayfever and food allergies. This tendency can be inherited. The condition is very itchy and mainly affects the inside of the elbows and knees, and the wrists and ankles. It is most frequently seen in children, although adults can experience it.

Contact dermatitis is caused when your skin comes into contact with something that it is allergic or sensitive to. You will find more information in the contact dermatitis section.

Eczema symptoms are very variable.

Mild Dry Eczema

The mildest form of eczema involves chronic dry skin and itching. (You will find more information in the Dry Skin section.) Some people never develop the inflammatory symptoms associated with acute eczema, but the condition is still unpleasant and requires treatment with emollient therapy.

Acute Eczema

At its worst, acute eczema can involve a whole range of severe symptoms including dry skin, inflammation, itching, blistering, redness, scaling and weeping.

Chronic Eczema

Once someone has been suffering from acute eczema, their symptoms may enter a long term stage, as the skin function deteriorates. This is known as chronic eczema. The following features may occur:

Initial inflammation subsides and is replaced by a thickening of the epidermis.
Scales appear as cell turnover increases.
Itching and scratching leads to fissuring of the epidermis when the skin becomes broken and cracked.
Incessant scratching may produce secondary thickening (lichenification).
The skin is still very dry.

Eczema in children

Atopic eczema affects around 1 in 8 children and almost 30% of all new-born babies carry the risk of developing the condition. It usually starts in young babies who have dry, itchy, sore cheeks, which they may try to relieve by rubbing on the pillow. The condition progresses down the body, affecting the creases of the knees and elbows if it's a mild case, or the whole body if severe. It also often occurs on the scalp. Children with widespread eczema tend to be very itchy and miserable, particularly if they're too warm at night.

The good news is that about 75% of children grow out of eczema before they reach their mid-teens. However, their skin will always remain dry and prone to hand eczema so a good skin care routine is necessary. A regime such as complete emollient therapy can help.

Eczema in adults

If you continue to experience eczema as you get older, you will probably find that it affects the face, neck, upper chest, front of the shoulders, areas where the skin creases and the backs of the hands. Again the main symptom is severe itching and the condition can be exacerbated by stress.

The itch scratch cycle

Eczema is often accompanied by a severe itching. Scratching can cause damage to the skin. This allows bacteria to penetrate the skin and the body's immune system reacts causing inflammation which in turn leads to further itching. Inflammation can result in infection which once more can lead to itching. This itch-scratch-inflammation cycle can be hard to break. Emollients with anti-itch ingredients can help.

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