From one sufferer to another, consider this your need-to-know on the irritating skin condition, from what causes a flare-up to how it can be managed
I’ve suffered with eczema for as long as I can remember. It’s a year-round thing; in the summer the heat and my hayfever make it worse, while in the winter the harsh cold causes the sore and dry skin to split, weep and itch.
When it’s at its worse it does my head in, and I’m not alone in being driven mad by it. According to Allergy UK as many as 15 million people are living with the infuriating skin condition in the UK alone, but a lot of us still aren’t really sure what causes it or how we can keep the symptoms at bay.
Eczema varies from person to person – your eczema may be completely from mine – but to explain it thoroughly, we asked consultant dermatologist Dr Walayat Hussain of Bupa Health Clinics to shed some light on the skin condition.
What is eczema?
First thing’s first, let’s break down exactly what eczema is.
‘Also referred to as “dermatitis”, eczema is a chronic inflammatory skin condition that can make your skin red, dry and itchy,’ says Dr Hussain. ‘There are a number of different types, and the type you have determines which treatment options are best for you.’
If you’re experiencing uncomfortable dry, rashy skin there’s a good chance that it’s eczema, and your GP will be able to confirm a diagnosis. It can appear pretty much anywhere on the body; it’s possible to get eczema on hands, feet, legs, arms, torso and eczema on the face.
Although eczema in babies is very common, many people will experience symptoms throughout adulthood too.
Are there different types and causes of eczema?
Despite usually being referred to as simply ‘eczema’ there are quite a few different types, each with its own specific set of causes and treatment options. Read on for a breakdown of each below.
Also known as pompholyx, dishydrotic eczema appears as tiny, fluid-filled blisters usually on your hands and feet. They look like raised pinpricks covering the top of hands or feet or in patches between the fingers and toes, and are incredibly itchy, becoming even more sore if they burst as your skin tries to heal.
While the exact causes are unknown, it’s thought dishydrotic eczema is triggered by stress or upon contact with allergens.
Also known as atopic dermatitis, this is the most common type of eczema, often found in people who also have asthma, hayfever and allergies. ‘This can be genetic and you may notice your skin gets irritated on the face, in front of the elbows and behind the knees,’ says Dr Hussain. ‘It usually flares up if you have allergies and come into contact with soaps, detergents or other types of chemicals.
‘Although there is no cure for atopic eczema, your GP or dermatologist may prescribe you with a specific type of moisturiser known as an emollient. These work by restoring water and oils to your skin to soothe and hydrate it, as well as helping to repair the damaged skin.’
This type appears when your skin becomes sensitised to something in the environment. ‘Unlike a peanut allergy, which occurs immediately upon exposure, contact dermatitis develops over a period of time as your body becomes sensitised to something you may have been using or wearing for years, such as nickel in jewellery,’ says Dr Hussain.
‘Contact dermatitis often affects your hands, so avoid this, consider what products you’re using that maybe irritating your skin and try shielding your hands from them. Your GP may refer you to a specialist Dermatologist who performs patch testing, which can help identify what you’re allergic to.’
This type appears as very itchy, flat red patches of inflamed skin, usually on the arms and or legs, and is most commonly found in middle aged or elderly people. ‘We don’t know what exactly causes discoid eczema, but in keeping with other types, your skin loses moisture and therefore struggles to provide an effective barrier against substances,’ says Dr Hussain. ‘This means usually harmless substances, like soap, can irritate your skin.
‘Although there’s no simple cure for this type of eczema, your dermatologist or pharmacist can recommend some medications to help ease the symptoms, along with daily moisturising.’ Read our guide to the best moisturiser for dry skin and choose a gentle formula for eczema-prone skin.
In seborrhoic eczema, inflammation usually occurs in areas of your skin that are hairier or more oily, i.e. where there are more sebaceous glands, such as your eyebrows, chest or scalp.
‘It’s believed that seborrhoeic dermatitis is caused by having too much yeast in your system or your immune system’s over-reaction to yeast,’ adds Dr Hussain. ‘Your Dermatologist can recommend some creams and shampoos to help reduce the level of yeast you have which should help ease the symptoms.
Varicose eczema mainly affects people who have varicose veins, causing the skin around them to become itchy and inflamed, and can be managed by working on improving your circulation.
‘This can be done by keeping active and wearing compression socks every day, apply moisturiser to help with the dryness and talk to your pharmacist about which ointments would be best for you,’ advises Dr Hussain. ‘If this doesn’t work, your GP may refer you to a dermatologist or vascular specialist to explore other treatment options.
Treatment of eczema
There are many different options to manage eczema, and no ‘one-size-fits-all treatment plans. Your GP may prescribe topical steroid creams, such as hydrocortisone, eumovate and betnovate, to help with the itching. These work by stopping the skin cells from producing chemicals which cause inflammation in response to the allergens.
While there’s an element of trial and error in terms of which over-the-counter products keep symptoms at bay, Dermol 500 Lotion is a very gentle, daily moisturiser and also works as a soap substitute, used by eczema sufferers all over – because it really works.
For periods of unbearable itching, I personally keep La Roche Posay Lipikar Stick AP+, £13 at Boots, in my bag. It looks like a roll on deodorant that you apply onto itchy eczema for almost instant relief – and, more importantly, not itching your sore skin to the point of bleeding and potential scarring. The Lipikar Syndet Shower Body Gel, £10 at Boots, is a good replacement for your usual shower gel during bad flare-ups.
Is eczema contagious?
The biggest misconception about eczema is that it’s contagious, but it absolutely isn’t. Let me say that again just in case anyone without eczema didn’t hear me: eczema is not contagious.
It’s only if eczema becomes infected and is open and weeping that the infection itself may be contagious, Dr Hussain tells us.
Are eczema and diet linked?
Many sufferers of medical conditions see a reduction in symptoms by carefully monitoring their diet, with dairy and acne being a prime example. So what’s the deal with diet and ezcema? ‘Although changes in your diet can’t cure your eczema, in some cases it may help alleviate the symptoms and minimise flare ups,’ says Dr Hussain.
‘Some cases of eczema are caused by an allergic reaction; the most common sources of allergic reactions from food are from milk, eggs, peanuts, fish, soy, wheat, gluten and citrus, so you may find it helpful to try cutting back on some of those foods to see if it helps with your symptoms.
‘Otherwise, a simple prick test can help identify exactly what you’re allergic to, so you can avoid those foods. It is however important that you discuss potential food allergies with your GP, dermatologist or allergy specialist to ensure you get the best advice which is relevant to you and best for your skin.’
Note that the purpose of this feature is to inform, not replace one-to-one medical consultations. For advice tailored specifically to you, always discuss your health with a doctor.