Understanding eczema: what it is, how it is treated, and managing flare-ups

Also known as atopic dermatitis, eczema is a chronic inflammatory condition in which the skin is affected. Eczema often develops in a child’s first year of life, appearing as dry, scaly patches typically (but not always) on the face, forehead or scalp. The American Academy of Dermatology estimates that around 90% of people who experience eczema do so before the age of five. Many children do outgrow it, but around 50% carry it through to adulthood.

eczema

What causes eczema?

  • Eczema is common among those who also experience hayfever or asthma.
  • Statistically, females suffer from eczema more frequently than males.
  • At this stage, we are not certain what causes eczema, but there are a few theories around it. We do know it is not contagious.
  • It is genetic, meaning more than one person in a family may suffer from eczema (and hayfever or asthma). If one or more parents have asthma, hayfever, or eczema, the child is more likely to have it too.
  • Food doesn’t cause eczema, but children with a sensitivity to certain food types may find it triggers a flare-up. Having eczema doesn’t automatically mean you have to stop eating certain foods. It is best to have a consultation and go about the proper testing methods to determine if there is a sensitivity to certain foods. In this case, trigger foods may be limited or we can find replacements. Have a consultation before resorting to knee-jerk reactions.

What are the symptoms of eczema?

Eczema’s symptoms can differ according to age groups.

Infants (0-24 months)

Children as young as two or three months of age can develop eczema. In these cases, infants often try to rub themselves against their beds or other surfaces close at hand, in order to try to ease the itch. Visible symptoms include:

  • Dry, itchy, scaly skin on the face
  • Sometimes the area may bubble and leak fluid

Children (2-12 years)

The same dry rash will occur, but the location may be different. The rash will affect the folds on the elbows or knees, wrists, neck, and just below the buttocks. Typically in the creases of the skin. Other visual symptoms include:

  • Thickened skin that hardens as the result of a prolonged rash
  • Red, inflamed, dry, scaly rash on the skin
  • Knots within the rashed area
  • Permanent bumps that look like goosebumps
  • Intense itch (the thickened areas may itch whether or not you are experiencing a flare-up)

Adults

Adults rarely get eczema without having first had it in childhood. The symptoms include:

  • A rash from the nape of the neck, elbow and knee creases, around the eyes, and widespread across the body
  • The rash tends to cover a greater area of the body
  • A prolonged rash can lead to hardened areas of skin that get a leathery texture
  • Dry skin
  • The rash tends to be scalier in adults than in infants
  • The rash can lead to skin infections
  • The rash is incredibly itchy

How is eczema diagnosed?

Dr Khoza will examine the skin, especially if there is a rash. She will ask you if there are any cases of hayfever or asthma in the family. Along with that, she may perform a patch test; this helps to identify possible food triggers. As mentioned, foods don’t cause eczema, but sensitivities to certain foods may cause the flare-ups to be more severe. Dr Khoza will place tiny amounts of potential allergens on the skin. After 24/48/72 hours she will check the result to see if there is any reaction.

How is eczema treated?

As a chronic condition, eczema can’t be cured. We can monitor and control the severity of the symptoms. Treatment aims to calm the inflammation, ease the itch, stop the spread of the rash, prevent infections and hardening of the skin.

Dr Khoza will draw up an individualised treatment based on the condition and the circumstances surrounding it. It typically contains lifestyle changes, a skincare routine, and medications (Anti-inflammatories, antihistamines and emollients.

The treatments will:

  • Reduce inflammation (redness and swelling)
  • Reduce itching
  • Calm infection
  • Help scales to come away
  • Prevent new lesions

Lifestyle adjustments to soothe eczema during flare-ups

Living with eczema can sometimes feel like a riddle, especially if you are trying to pinpoint your triggers and minimise the environmental stresses on your skin. You may encounter many strange tips from well-meaning people. As a dermatologist with personal experience in dealing with eczema and the implications of this condition, Dr Khoza has compiled a few tips that are backed by research. You can implement these alongside your treatment plan.

  • Avoid extreme temperatures

If your bathroom steams up when you shower, it is better to reduce the temperature. Extreme hot or cold will stress your skin further.

  • Choose your skin products, including soap, with care

Harsh additives will dry out the skin, it is crucial for eczema-prone skin to retain moisture. Avoid soaps that contain fragrances, dyes, preservatives and any antibacterial compounds. The same goes for your moisturiser – which is an absolute must-have. You must moisturise as often as possible.

  • Stress is a trigger for many people

Try to reduce your stress, we understand, in this day and age that is easier said than done. It may help to find refuge in an activity that brings you a sense of calm, something you can do as soon as you feel an eczema flare-up start.

Sun protection, along with moisturising, is a cornerstone to effective eczema management. Make sure you are using a sunblock that gives you full protection, every single day.

In times of intense flare-ups, discomfort can be reduced by using treatment protocols like wet wrap therapy, taking an oats bath, and ensuring the humidity levels in the air are adequate.
If you are finding your eczema difficult to manage, book an appointment with Dr Khoza. Sometimes, a new perspective and a change in your treatment protocol can make a major difference. Contact us here.