Eczema

Eczema is likely caused by both genetic and environmental factors. Common triggers include:

• Dry skin/impaired skin barrier function
• Heat
• Excessive friction on the skin
• Irritants (e.g. foaming cleansers, wet wipes, soap, toners, exfoliating cream)
• Bacterial infection or overgrowth on the skin
• Environmental allergens (e.g. pollen, dust mites, pet dander, grasses)
• Stress
• Weather (particularly cold and dry climates)
• Viral illnesses

Eczema affects everyone differently. One person’s triggers might not be the same as another person’s triggers, and it may take time to identify yours thoroughly.

• Involved skin is typically erythematous (red), xerotic (dry), and scaly.
• Acute eczema may be oozing, exudative (weepy), and crusted.
• You may also see blistering or very small intact vesicles (blisters).
• Chronic patches of eczema become raised and lichenified (thickened).
• Evidence of excoriation is common (scratching).
• The skin may become fissured (cracked).

At-home care plays a critical role in eczema maintenance.

• Avoid drying agents and fragranced products that irritate your skin, such as certain soaps, detergents and skincare products.
• Use mild temperature water for showers and baths.
• Moisturise your skin liberally and often, particularly after bathing. Moisturisers can be applied to wet skin straight after a bath or shower.
• Take emollient baths
• Use ointments and creams rather than lotions as moisturisers for better hydration.
• Avoid excessive heat when possible. Turn the heating down at home. Avoid electric blankets in winter.
• Wear soft clothing that does not cause friction against your skin.
• Wear clothing made of breathable materials.
• Take measures to reduce your exposure to household dust mites and other allergens.
• During a flare up, keep your fingernails short to reduce trauma from scratching.

Depending on the type and severity of your eczema, your doctor may recommend combining practical lifestyle changes like those above with medical treatment.

Topical corticosteroids are the mainstay of treatment of flares of atopic dermatitis. If there is redness associated with the rash, then a topical corticosteroid will help reduce the inflammation. Steroid sparing agents, e.g., tacrolimus 0.03%/0.1%, can be used as maintenance therapy but are not effective in active eczema as they can cause ‘burning’ on application. Sometimes an antibiotic or anti-fungal must be added due to superinfection.

For moderate to severe cases of eczema that do not respond to topical treatments, a referral can be made to a hospital dermatologist for consideration of oral medications and injection treatment (biologics) to suppress the immune system and reduce its ability to send an inflammatory response to the skin.

Because eczema can take many forms, we recommend consulting with a professional to receive a personalised treatment plan that encompasses both immediate care and strategies for long-term management. Schedule a dermatology appointment by calling us on 087 4223492 or booking in online.