Eczema is super-common – around 15% of children get it and unfortunately a third of us then carry this through to adulthood. Eczema is characterised by red, inflamed and itchy skin that can look different from person to person. Inflammation damages skin cells and stops them retaining moisture, so skin becomes dry and sometimes even cracked. Let’s get to grips with this common problem!

Depending on triggers and appearance, this pesky skin condition can be categorised into 5 subtypes, let’s have a look …

Eczema Types
Atopic Dermatitis
‘Atopic’ means sensitive to allergens (molecules that cause allergic-like reactions) so no surprise there! Stay away from anything you know that you are allergic too. There is a strong correlation between allergy and eczema sufferers. A whopping 75% of those with eczema also have hayfever (which is allergy-based) and a large percentage of asthma sufferers also have atopic dermatitis (AD). Just like hayfever and asthma there is not yet a cure but eczema is manageable with moisturisers and topical corticosteroids, which work to dampen down inflammation.

Unfortunately this is one to blame on the parents. Genes have a big part to play in the makeup of our skin and our susceptibility to certain allergies. If your parents have eczema, the chances are you will too, but genes are not the only contributor. A lot of media attention has been on modern clean lifestyle and the uprising of allergies. The theory is that if our immune systems are not exposed to many allergens at a young age, when we are exposed to things later in life our immune systems overreact, resulting in allergies to everyday things (like pollen). Releasing molecules like histamine (the target of anti-histamines) leads to inflammation, like that as in eczema, asthma and hayfever. Children exposed to dogs at a young age have a 30% decreased chance of developing AD.

Contact Dermatitis
This is the most common work-related skin problem. Contact dermatitis presents itself more like an allergy with localised breakouts (as the name suggests) at the point of contact with an irritant. For frequent hand washers like nurses, cleaners, beauticians or us scientists in the lab, soaps and other chemicals dry the skin out and damage the cells ability to retain moisture.

Allergic contact dermatitis is similar to atopic in that it is triggered almost immediately after coming into contact with something you are allergic to. Metal allergies are a relatively common cause a contact dermatitis outbreak. Metal door knobs, metal belts, metal nightmare! If you’re allergic to those not-so-expensive earring your ex bought you (other than for reasons of good taste!), then contact dermatitis is to blame. Unfortunately in this instance it is just best to avoid any known triggers, rubber, cosmetics, it could even be the dye in your favourite outfit. Wear gloves where possible, check all clothing and be aware of what your skin is coming into contact with. It’s such a fragile thing!

Discoid Dermatitis
Unlike the previous forms of eczema, discoid (also known as nummular dermatitis) is more common in adults than children. It is characterised by very dry, scaly disc shaped spots of eczema which can ooze and become very itchy, usually on lower legs or forearms. It is important to keep an eye on the outbreak to make sure it does not become infected. When cleaning ensure not to dry skin out any further using harsh soaps. Moisturise after washing.

Seborrhoeic Dermatitis
If you are no stranger to Beauty by the Geeks, you will have read lots about sebum. This oily substance secreted from our skin has a tendency to cause mischief when it goes array and here is another one of its mishaps. Seborrhoeic dermatitis is common in babies and goes by the more commonly known cradle cap (you’ve probably heard of that one). Cradle cap looks like baby dandruff with dry skin across the head.

Seborrhoeic dermatitis in adults can be more extreme, red, itchy and inflamed scalp that can spread to eyebrows, sides of the nose and neck. People who suffer from seborrheic dermatitis have been found to have a yeast called Pityrosporum ovale on their skin but it is not certain that this yeast is to blame. Without much concrete research we are willing to give anything proven safe a go! Products which contain antimicrobials such as zinc oxide should be something to consider but if things get worse and it is getting you down, call the GP.

Pompholyx Dermatitis
Similar to contact dermatitis, pomphoylx dermatitis usually occurs when the palm of the hands are in direct contact with an allergen or irritant. The difference is how the skin reacts. Pompholyx dermatitis presents itself as lots of small blisters across the hands and/or feet accompanied by a burning sensation, not nice at all! Again the exact cause is not known but it is important to identify and avoid any triggers, soaps, metals, even stress! Try to keep it clean and see a doctor if it persists or becomes infected.

Doctor’s Orders on Eczema
As ever, there is no quick fix and no complete cure to stop eczema ever coming back. There is hope! Topical Corticosteroids creams can be prescribed by doctors to use in short treatment bursts. No they are not the same kind of steroids used in body building. Corticosteroid creams reduce inflammation to stop cells getting damaged and help them to keep hydrated. It is always advised to use a good moisturiser or emollient which you know does not cause a skin reaction alongside corticosteroids to prevent more dry skin so that you can heal faster.

Never fear, the geeks are here to debunk yet another myth. Topical application of corticosteroids do not cause weight gain and do not stunt growth. Although they are more readily absorbed into broken and dry skin, it is not in high enough quantities to affect your whole body. Saying this, you do not need to apply more than a thin layer to affected area to clear up the rash.

Warning! Topical corticosteroids thin the skin so it is important to take extra care looking after damaged areas, even after eczema appears to have healed, the area will be more susceptible to future damage from chemicals and the sun. A good SPF is always a must, especially after using corticosteroids.

Infection
On its own, eczema can be embarrassing and hit your confidence, but generally does not have massive health implications. It is important to remember that when the skin cracks, it removes the barrier that usually stops bugs and nasties from causing infection and this can become a lot more serious. Any suspected infection, discolouring from the normal red, extra redness, oozing or blisters should be reported to your GP to keep on the safe side.

At home and alternative therapies
Step 1 – stop scratching!! Scratching can damage the skin even further, leading to further loss of barrier function and even more inflammation! After that, the best way to manage eczema at home is to use a good moisturiser which does not irritate your skin (we can’t stress avoiding potential irritants enough!). Look for products that are specific for sensitive skin and that contain ingredients like coconut oil, sunflower seed oil, hyaluronic acid and the like!.

Antioxidants are another thing to keep an eye out for. Damaged skin is more prone to further damage from reactive oxygen species (ROS). Antioxidants remove these ROS particles to allow your skin to heal properly. Resveratrol, retinol (aka vitamin A) and vitamin C are potent antioxidants, amongst others, found in some moisturisers that may help look after your skin. Many eczema sufferers favour simple fuss-free fragrance-free products that minimise the risk of irritating the skin.

Evening primrose and borage oil are often shouted about when eczema is mentioned but many studies have proven them to be ineffective in treating this condition.

Rounding up on Eczema
Outbreaks always seem to come at the worst times, like just before exam time, or an important deadline at work. It is not a secret that there is a link between stress and eczema. Although difficult to find evidence for, it is an idea to try yoga or meditation alongside any medication prescribed by your doctor to reduce stress levels and reduce the red itchiness. Perfect excuse to take some time out for you.

We still have a great deal to learn about eczema, but there is support for anyone who needs it. The National Eczema Society has some good tips for management and where to go for support. Researchers are still studying the impact of diet and supplements, new therapies whilst evaluating those already out there, so hopefully, a greater understanding and better treatments are on the horizon!

Eczema – NHS Choices
http://nationaleczema.org/eczema/causes-and-triggers-of-eczema/
Eczema – The Bitish Skin Foundation
http://www.worldallergy.org/public/allergic_diseases_center/atopiceczema/
Prevalence of Eczema in the US
Treatment of Eczema: Corticosteroids and beyond
What’s new in atopic eczema? An analysis of systematic reviews published in 2012 and 2013. Part two. Treatment and Prevention
Quality of life and psychosocial issues are important outcome measures in eczema treatment
Zinc Therapy in Dermatology