Eczema (Atopic Dermatitis)

Eczema, also known as atopic dermatitis, is a skin inflammation that usually causes redness, swelling and itching. It usually begins in childhood, appearing within the first months and often disappears towards the age of 4 or 5 years or in early adolescence. Although eczema can develop into a chronic condition, this does not mean that its symptoms will be constant throughout your life. Chronic eczema is characterized by flare-ups (appearance or aggravation of symptoms) and symptom-free periods.

Causes

Persons who suffer from eczema have overly sensitive immune systems. This means that they are more likely to react to certain allergens (mites, foods, dander, pollen, dust, etc.). They are also more prone to suffering from asthma, hay fever or other infections. This predisposition is hereditary. A child is therefore more likely to suffer from eczema if one of his parents has eczema or allergies.

We also know that certain risk factors can trigger eczema flare-ups. These factors vary from person to person but the most common are:

• allergens
• hot baths
• dry climate
• emotional factors (anxiety, anger, stress)
• skin irritants (detergents, perfumes, soaps)
• dry skin
• sweat
• rough or scratchy fabrics (wool, synthetic fibres)

Symptoms

Itchy skin is sign of an impending flare-up. Sores will most likely develop as a result and remain until the skin heals. Flare-ups begin with patches of skin that become irritated and red and small blisters (vesicles) appear, giving the skin a sandpaper-like appearance. After some time, the blisters burst and release a clear fluid that dries and forms a crust. That crust will fall off leaving behind a raw patch of skin that will slowly heal. Areas on the body most often affected by eczema include neck, arm, leg and knee creases as well as the face, wrists and hands.

Resist the Urge to Scratch

It is very important that you resist the urge to scratch in spite of the overwhelming urge because the more you itch, the more the lesions will weep. This in turn will worsen the irritation, increase the healing time and increase the risk of infection. Here are a few tips:

• Stay in a cool environment.
• Refrigerate moisturizer and apply on areas that are itchy.
• Moisturize every time you feel like scratching.
• Rather than scratching, pinch or rub the skin.
• Keep nails short to minimize the risk of infection.
• At night when you sleep, wear cotton gloves to avoid scratching yourself.

Prevention

To better the odds and prevent flare-ups as much as possible:

• Moisturize your skin, especially when you step out of the bath or shower (idealy, several times a day).
• Wash clothes and sheets with detergent for sensitive skin (perfume-free).
• Avoid wearing clothes that are too hot or that do not breathe.
• Wear cotton clothes and use cotton bedding rather than other fabrics.
• In the winter, use a humidifier in your home.
• Use gentle non-irritating soap (ex. Cetaphil™).

Treatment

The first step involves identifying the source of the flare ups. With regards to allergens, you may benefit from consulting an allergist who will conduct skin tests to confirm the substance responsible for the eruption.

The next step is finding the treatment that best suits your needs. That may include damp bandages, moisturizers and cortisone based, lotions, creams or ointments. Antihistamines, in their pill form, may also prove helpful if the cause is allergy-based and cannot be avoided. In more serious cases, the physician may prescribe an oral or injectable corticoid.

For more information or for support :

The EASE Program (Eczema Awareness, Support and Education)

www.eczemacanada.ca