• What are the different types of Eczema?

    The name ‘eczema’ is given to a group of similar skin conditions which lead to dryness and irritation. There are a number of different forms:

    • Atopic eczema – the most common type; though more common in children, it also affects adults
    • Discoid eczema – occurs in circular patches on the surface of the skin
    • Contact dermatitis – a reaction following contact of the skin with certain substance
    • Varicose eczema – an eczema affecting the lower legs, resulting from poor blood flow
    • Seborrhoeic eczema – characterised by discoloured, scaly patches on the nose, ears or scalp
    • Dyshidrotic eczema – small blisters on the palms
  • What causes Eczema?

    Eczema is a chronic skin condition whereby patches of skin become very dry and red. In some cases, and especially for children, eczema will gradually improve over time. Eczema most frequently affects the knees, elbows, neck, face and hands.

  • Is Eczema contagious?

    Eczema is not contagious.

  • Is Eczema hereditary?

    People within a family often have similar susceptibilities to some skin conditions, including eczema. Eczema tends to develop concurrently with other hereditary conditions like hay fever and asthma.

  • How is Eczema diagnosed?

    A doctor will usually be able to discern whether your skin condition is eczema or another similar condition. If normal eczema treatment is ineffective, you may be referred to a dermatologist to identify the root cause of the condition. As eczema is often associated with an allergic response, you may be advised to have an allergy test. Common allergens linked to eczema symptoms include mites, fungal spores, pollen and some foods.

  • Does Eczema worsen with age?

    Twenty percent of British children will develop atopic eczema to some extent. In the majority of cases, eczema will first develop while the child is a toddler, and often in infancy.

    Around half of children with eczema will see significant improvement by the age of eleven, and many will see the condition clear entirely by the time they reach adulthood. In some cases, however, eczema will remain through adulthood, or otherwise appear for the first time when the individual is an adult.

  • How can I find an Eczema specialist?

    There is no medical specialty devoted to eczema; it falls under the umbrella of skin conditions, which are covered by dermatologists. A GP will refer you to a dermatologist if your eczema is particularly severe or if regular treatment is ineffective.

    If you need help with a referral you can contact us and we will also be happy to help.

  • What will a dermatologist prescribe for Eczema?

    Dermatologists will review your current treatments and offer support to ensure that they are being used correctly. Further treatments they might offer include:

    • Topical calcineurin inhibitors – these are ointments that will suppress your immune system, which include tacrolimus and pimecrolimus
    • Topical corticosteroids
    • Wet wraps or bandages
    • Phototherapy – ultraviolet light which will combat further inflammation
    • Immunosuppressants – tablets that work to suppress the immune system, which include ciclosporin, azathioprine and methotrexate
    • Alitertinoin – medicine specifically for adults to treat severe eczema of the hands
    • Psychological support if necessary
  • Are Eczema symptoms generally symmetrical?

    Symmetrical symptoms usually indicate atopic eczema or psoriasis. Asymmetrical symptoms are typically due to causes from outside the body, like fungal infections or tinea.

  • Is it normal to have dry, flaky skin with Eczema?

    This is normal – dry itchy skin is one of the characteristic symptoms of eczema.

  • What factors can trigger Eczema to worsen?

    Many external factors can cause eczema to flare up. Though these will vary depending on the individual, common triggers will include:

    • Allergens such as pollen, animal fur, mites, moulds, peanuts, eggs or soya. Reactions to lactose are very often associated with eczema
    • Environmental factors such as dampness or dry weather
    • Irritants in certain types of shampoo and cleaning products
    • Contact with certain fabrics including wool and synthetics
    • Hormonal changes in women, such as in the days preceding a period or whilst pregnant
    • Stress

    Your GP will counsel you on how to identify eczema triggers and how best to avoid them.

  • Is there a cure for Eczema?

    As atopic eczema is a chronic condition, there is no cure. However, treatments are effective at combating symptoms, and most children with eczema will find that their condition improves significantly with age.

  • What is the difference between creams, ointments, lotions? Which is the best one type use?

    The best emollient is the one you use most often - the most important thing about emollient use is that it is regular (up to four times daily).

    Different emollients can be used depending on your own routine - for example, a cream can be applied easily in the morning as it soaks in more quickly and an ointment can be applied at night as it is more greasy and takes longer to absorb.

    Terminology is important in treating skin conditions, so here are the differences between the types of topical products:

    A solution is a liquid with a base of water or alcohol. They are thin and easy to apply, but can cause further dryness for some people.

    Lotions are slightly thicker than solutions. These can be used for large and/or hairy regions of skin.

    Creams are thicker than lotions. They are used for smaller areas of skin, especially when a region is weeping.

    An ointment is a product with high oil content. They can be greasy, and are used to treat dry and scaly skin.

    For quite hairy parts of the body including the scalp, gels are used, which are more solidified. An alternative for the scalp is a mousse, a foamy product.

  • What treatments are there apart from emollients and steroids?

    If your eczema does not respond to normal treatments, you may be prescribed topical treatments like tacrolimus or pimecrolimus. To combat itching, you can take antihistamines. If necessary, dermatologists might recommend more powerful treatments including special bandages to allow the skin to heal.

  • What is the best time to apply my Eczema treatment?

    Emollients, such as Diprobase, Balneum and Cetraben, moisturise the skin and should be applied as often as necessary. This is normally two to four times daily depending on your routine and the severity of your eczema.

    Special care should be taken to moisturise often, especially after washing, this will ensure the skin is protected from drying out. The skin absorbs moisurisers particularly well after washing so using emollients after showering or bathing is always a good idea. Washing the skin with soap, gels or even very hot water can strip the skin of moisture and is not recommended. 

    Emollients can also be used in bath water and in the shower as a soap substitute. 

    Steroid creams, including Hydrocortisone, Betnovate and Eumovate, are applied as a think layer once or twice daily for a course of 7 - 10 days to treat a flare-up (always check the individual product instructions).

    They should be applied in the morning and/or evening, leaving at least 15 minutes between applying your regular emollient and the steroid cream to allow both to absorb separately.

  • How much cream/ointment should I apply?

    Emollients can be applied as often as you need them. As a general rule, you should always apply more emollient than you think - people tend to underestimate the amount of moisturiser required. 

    Application of steroid creams is measured in Finger Tip Units (FTU) - the amount of cream from the end of the finger to the first crease. Typically, one FTU would cover the equivant area of skin of one hand.

  • What if I forget to apply my Eczema treatment?

    Emollients can be applied as often as required. It is important to keep the skin hydrated so apply frequently and regularly. If you forget an application, apply at the earliest opportunity.

    Thick emollient ointments sometimes block the hair follicles in the skin. This may cause a mild inflammation or infection of the affected hair follicles, which is called folliculitis. Ensure you apply emollients in the direction of hair growth to hep to prevent this.

    If you forget to apply your steroid cream, apply the correct dose when you remember, and then carry on as before. If it is nearly time to apply the next dose, skip the current application and apply the next dose at the normal time.

     

  • Should I be worried about side effects?

    The side effects of emollients are limited and minimal.

    Over-the-counter creams and ointments can contain colors and perfumes. It is possible you may be sensitive to, or react to, these ingredients rather than the emollient itself.

    Medical emollients don’t have colours or perfumes and are less likely to cause any irritation or reactions. 

    To avoid block pores or causing other problems from frequent emollient application, ensure you are applying in the direction of hair growth.

    Steroid containing medicines applied to the skin are well tolerated and cause minimal effects when used in their short courses as prescribed.

    If used for longer periods, or when short courses are often repeated, there is an increased likelihood of developing side effects including thinning of the skin.

  • What does infected Eczema look like?

    Eczema causes skin to dry and break apart, so the risk of bacterial infection increases around the cracks. Excessive scratching or incorrect treatment regimens will further increase this risk. Typical symptoms of infected eczema include:

    • Swelling and soreness
    • Yellow discolourations on the flaked skin
    • White or yellow spots on the affected skin
    • Fluid or pus around the affected area
    • Fever and other flu-like symptoms

    Infections can cause existing symptoms to worsen, and prevent normal treatments from being effective. You should consult your GP immediately if you notice that you or your child might have infected eczema.

    Infections are typically treated with antibiotics and by ensuring the skin is clean and protected from further infection. When the infection has cleared, you will be required to switch to brand new creams, so as to prevent further contamination.

  • When using an emollient and a steroid, which one do you apply first?

    You should apply the emollient first and allow it be absorbed.

    Absorption usually takes around 10 - 15 minutes. When it is complete, the skin should feel slightly tacky to touch.

    You are then ready to apply a thin layer of steroid cream.

  • What is the difference between the different steroid creams?

    Corticosteroid creams vary based on their strength. Mild corticosteroids such as hydrocortisone can be purchased at pharmacies. You will require prescriptions for more potent types such as betamethasone dipropionate. Your GP will prescribe the lowest potency that will effectively combat your symptoms.

     


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