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    You are in >  Eczema
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    Our sponsor TAS is offering free samples of a new organic skin care range.
    If you live in the UK, and suffer from sensitive skin, pay them a visit.

    A personal note
    My second eldest of four sons suffers from eczema, enough for it to make his life uncomfortable. He is eight and otherwise healthy with one exception. He also suffers from a peanut allergy. His brothers seemed to have escaped untouched, and often, of late, he asks; Why me dad?

    I cant give him an answer, and neither can his doctor. More and more children in the United Kingdom are suffering from Eczema, and we seem to be no closer to resolving or finding a cure for their condition. Steroid creams, wraps and a host of other medications are used to control an affliction that seems to reflect in our children, the sad condition of our world.
    (if you want to read the rest of the rant, please click here..)


    Check the Product Directory for Eczema Products

    What is Eczema?
    There are many different forms of eczema (also referred to as dermatitis). The skin is very dry, caused either by external or internal factors. The severity of the condition can range from a few dry, red, itchy patches to huge areas of the body which can be covered in sore, inflamed, weeping and bleeding skin which can invariably become infected.
    Eczema cannot be cured, but it can be controlled. It is especially distressing in children, but a large proportion do grow out of it.

    It is advisable to visit your GP and/or dermatologist regularly for more detailed information.

    We have updated the info on the Eczema pages. Thanks to New Zealand DermNet. This is a wonderful site for those looking for more info on Eczema. Pay them a visit.

    Atopic Eczema

    Atopic eczema is thought to be hereditary. If one or more parents suffers with eczema, asthma or hay fever and therefore atopic themselves, then their offspring has an increased chance of becoming atopic. Atopic eczema can affect both children and adults and it tends to be the most itchy form of dermatitis. It tends to be most common in children and often begins in early life - often when the child is under the age of one. It can flare up and down from one week to the next.

    Contact Dermatitis
    There are two types of contact dermatitis - irritant contact dermatitis and allergic contact dermatitis. For a more detailed explanation than the one offered below, click here.

    Allergic Contact Dermatitis

    generally develops over a long period of time as a result of regular contact with a substance. It is the body's immune system reacting against the substance that causes the eczema. Typical substances a person can become allergic to are perfume, make up, costume jewellery.

    Irritant Contact Dermatitis
    usually affects adults and is due to contact with irritants to the skin, commonly on the hands. Household detergents and chemical used around the home or the workplace are the main culprits. New mothers often develop this type of eczema; the arrival of a new baby inevitably leads to more frequent hand washing.

    Seborrhoeic Eczema

    This can affect adults or babies. In babies it is more commonly referred to as cradle cap and can be found in the scalp and nappy areas and can quickly spread to the face, neck and armpits. Unlike atopic eczema, although it looks bad, it is not sore or itchy and generally clears up from the age of one onwards.

    In adults, men are more susceptible; it usually affects the 20-40 year old age group. It looks very much like dandruff and can spread from the scalp to the face where flakes of skin can originate from the eyebrows. This type of eczema is usually associated with yeast growth.

    Varicose Eczema
    This is more common in women than men and tends to develop in later life due to poor circulation. Therefore is affects the lower legs and ankles.

    Discoid Eczema
    Discoid eczema, also known as nummular dermatitis, is a skin condition which can occur at any age.

    The cause of discoid eczema is unknown.

    • Minor skin injury such as an insect bite or a burn may start it off.
    • It may be termed "varicose eczema" when it runs along the leg veins and result in gravitational eczema.
    • Hypersensitivity to bacteria on the skin results in crusted patches.
    • Dry skin in the winter months can cause dry non-itchy round patches.

    It can affect any part of the body particularly the lower leg. One or many patches appear, and may persist for weeks or months. The majority of patches are round or oval, hence the name "discoid" or "nummular" dermatitis, which means coin or disc-shaped dermatitis. They can be several centimetres across, or as small as two millimetres. The skin between the patches is usually normal, but may be dry and irritable. Discoid eczema may be extremely itchy, or scarcely noticeable. When the patches clear, they may leave marks for some weeks of months which are darker or sometimes paler than the normal skin tone. Sometimes patch testing is arranged to see whether there could be a contact allergy responsible for the dermatitis. In most cases no specific allergy can be found. Discoid eczema does not run in families, and unlike atopic dermatitis, it is not associated with asthma. It does not result from food allergy. It is not infectious to other people, although it sometimes becomes secondarily infected by bacteria.


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    Symptoms of Eczema
    Whatever causes your eczema, it leads to itching and redness, and may make the skin dry and flaky. Sometimes, itchy blisters form. When these burst, or when scratching damages the skin, the surface may be left moist and crusty.

    Often, in the commonest form of eczema (Atopic eczema), the problem is worst in the folds of the skin where your limbs bend.

    The itch is intense, and makes you want to scratch. You should avoid this if you possibly can, as scratching only makes the symptoms worse. People say that if you have to do anything, gentle rubbing, with the flat of your hands, is better than scratching.

    Whatever the cause of your eczema, the skin becomes more sensitive, and you may well notice that you are more easily upset by cosmetics, soaps, detergents, etc.

    In adults the main symptom is dry, scaly, inflamed and itchy skin. Children may have wet or weepy and infected lesions with impetigo.

    In mild cases, eczema is nothing more than a slightly irritating patch of sore skin, but in severe cases extensive areas of skin may become inflamed with unbearably itchy. It is hardly surprising that some people with these symptoms develop problems such as depression with low self-esteem, and have difficulty coping at school or work. Eczema sufferers are more prone to Herpes and wart infections of the skin.

    Unfortunately, up to half of all babies with widespread Atopic eczema will later develop asthma as the eczema improves. This phenomenon is referred to as the Allergic March.

    How to diagnose the cause?
    • If you have contact dermatitis, you must try to identify the cause and avoid the substance that causes it. Patch Tests are used to identify the cause.
    • If you have atopic eczema, you may be able to find out what you are allergic to by having special tests for respiratory and food allergen. Once an allergen is identified, practical steps can then be taken to avoid it.

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    Risk Indicator

    Eczema is not normally a dangerous condition. It can however vary in severity from one individual to another, in certain instances, requiring hospitalisation. Always consult your Doctor if you are in doubt as to symptoms or severity.

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    Triggers
    Possible causes of Atopic Dermatitis:
    • Food allergy plays an important role in small children.
    • The house dust mite is the more common allergen in older children and adults while allergy to cats and dogs may also be responsible.
    • Ensure your living space, especially the bedroom is kept dust and dust mite free.

    The most common causes of Allergic contact dermatitis are:

    • Nickel in jewellery and on clothing fasteners and studs.
    • Rubber and building materials such as cement, solvents and glues.
    • Some of the ingredients found in cosmetics, hair dyes and perfumes.

    The most common causes of Irritant contact dermatitis include:

    • Soaps, detergents and fabric conditioners (SLS)
    • Shampoos (SLS).
    • Disinfectants and bleaches.

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    What helps?
    If you have Atopic eczema you may find the following useful:
    • Take lukewarm baths with emollients and don't stay in too long. Pat the skin dry with a towel, never rub eczematous skin dry.
    • Avoid soap, detergents and shampoo - use aqueous cream instead of soap.
    • Wear cotton fabrics next to your skin. Avoid wool and polyester.
    • Don't wear tight-fitting clothes.
    • Clip your fingernails and don't scratch or rub the skin
    • Avoid sports that make you sweat a lot.
    • Try to stay calm and relaxed - stress can make eczema worse.
    It may shock you to discover that one of the major irritants (SLS) found in most commercial soaps, shampoos and shower gels is also in your toothpaste.

    We strongly recommend using cosmetic, facial and body products that are organic, and are certified as being organic. This will not cure your eczema, but will almost certainly prevent flare ups. Please visit TAS and look through a carefully selected, Organically certified range of Cosmetics, creams, and SLS free products.

    If you have children who suffer from Eczema, please, please do try the SLS and preservative free soaps, shampoos, creams and ointments. These are organic products and at worst will not aggravate a condition. At best they can offer huge relief to itchy little bodies and prevent future flare ups.


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    Medication
    The treatment for Contact Dermatitis is to completely avoid the substance that triggers the rash and to treat any existing rash with low-dose steroid ointments and Vaseline based emollients.

    Emollients

    Emollients keep the skin soft and smooth, and reduce itching. Emollients should be applied to dry skin even if it is not itchy or red. Apply an emollient after swimming or bathing, with extra during the winter months, and when working in an air conditioned office.

    There are many suitable emollients available from your chemist; some can be obtained with a doctor's prescription. Try out several, applied several times a day. Avoid highly perfumed products.

    • Bath oils based on mineral oil or lanolin
    • Aqueous cream & emulsifying ointment are well tolerated and mix with water
    • Urea cream & alpha hydroxy acid lotions are excellent for relieving dryness, but can sting and sometimes aggravate eczema
    • Wool fat (lanolin) or mineral oil-based lotions are easy to apply, but once again, use caution. Many people find their skin does not tolerate Lanolin

    Corticosteroids

    Topical steroids are very effective anti-inflammatory agents when applied to eczema. Use ointments for dry skin, creams for weeping skin or body folds, and lotions or scalp applications for hair-bearing areas.

    Their strength varies. The mildest topical steroid is hydrocortisone, which can be applied to facial skin or babies' bottoms. It is quite safe used even for months, but should be used only intermittently on the face. The stronger topical steroids should only be used for a few days or weeks, except when specifically advised by your medical practitioner. Potent or ultra potent topical steroid preparations should be avoided on the face, armpits, groins and bottom, because they may cause significant skin thinning and other problems.

    Topical steroids are applied to the dermatitis once or twice daily. Often several different preparations are prescribed for different parts of the body or for different occasions. Make sure you understand your doctor's instructions.

    In severe eczema it is sometimes necessary to take steroids by mouth or by intramuscular injection; this is usually only for short periods and under the close supervision of a doctor.

    Antibiotics

    Infected eczema may need specific antimicrobial treatment.

    • Antiseptics eg. potassium permanganate soaks (Condy's), chlorhexidine cleansers, povidone iodine, dibromopropamidine cream
    • Topical antibiotics for localised areas eg, mupirocin, chlortetracycline, sodium fusidate.
    • Oral antibiotics for extensive flare-ups eg, flucloxacillin, erythromycin.

    Antihistamines

    Oral antihistamines are very effective in reducing urticaria (hives). They can also reduce the itch of eczema. They can be obtained from the chemist without prescription.

    The non-sedating type are sometimes helpful and with less side effects. Eg. fexofenadine, loratidine, cetirizine.

    The conventional type of antihistamine is cheaper, but may cause drowsiness. These are often useful at night-time. Eg. trimeprazine, hydroxyzine, azatidine, chlorpheniramine.

    Coal tar or ichthammol

    Ointments or paste bandages containing coal tar or ichthammol are useful for chronic lichenified patches of eczema. Coal tar smells and stains the clothes so it is best applied at bedtime under cotton bandages or old pyjamas. It can provoke a folliculitis (inflamed hair follicles).

    Immune suppressant medications

    Severe cases of atopic dermatitis are sometimes treated with oral cyclosporin or azathioprine.

    Ultraviolet radiation

    Troublesome eczema may respond to UVA or UVB phototherapy (ultraviolet radiation treatment) or PUVA (a combination of a medicine, psoralens, with UVA). A course of treatment may require 30 or more visits to a phototherapy unit over a period of several months.


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