What is eczema?
The word eczema comes from the Greek and means 'to
boil over'. Eczema or dermatitis are two medical terms used to describe
numerous skin conditions. Like many allergic conditions the severity
of the disease can vary. Although it can sometimes look very unpleasant
eczema is not contagious.
What are the symptoms of eczema?
The main symptoms of eczema is skin that is dry,
red and inflamed. The area of skin that is affected is often very itchy
and in some cases small blisters may form, which can weep and become
crusted. Eczema is usually found on the face, hands, the insides of
the elbows and the backs of the knees, but it can cover most of the
What causes eczema?
The cause of eczema depends on what type you have,
read below for more information on the different
types. However, in adults, eczema can be triggered off by certain chemicals
so care may need to be taken in some jobs. Areas of work with a high
risk include: hairdressing, nursing, cleaning, engineering, animal handling
Types of eczema
There are many different forms of eczema, which
may look and appear very similar but have very different causes.
Two of the most common types of eczema are atopic
eczema and contact dermatitis:
Atopic eczema also known as atopic dermatitis is
probably the most common form of eczema and is believed to affect up
to 1 in every 5 children. Atopic eczema is thought to be a hereditary condition which is usually linked to hay
fever and asthma so you may also suffer from one of these at the same time.
Both adults and children can be affected by atopic
eczema though children will often grow out of it by the time they reach
People who have atopic eczema are sensitive to things
found in the environment, these are known as allergens and may include any of the following:
- House dust mites - they occur in all homes all
over the world and are commonly found in mattresses, bedding, carpets
and soft toys. They are completely harmless and many of us are totally
unaware of their presence.
- Animals - e.g. cats or dogs.
- Grass, tree or weed pollens.
- Occasionally foods, such as milk, eggs, chocolate
The main symptom of atopic eczema
is the unbearable itchiness, if you constantly scratch you can cause
your skin to split, leaving it prone to infection. Other symptoms include,
dryness of the skin, redness and inflammation. Factors, such as stress
and infections, like the common cold have been known to make the symptoms
of atopic eczema worse. Atopic eczema is commonly seen in skin folds.
Contact dermatitis develops when the skin has been
in contact with something in the outside world. There are 2 types of
contact dermatitis both with similar symptoms to atopic eczema, though
it is usually the hands that are affected.
Allergic contact dermatitis
People are not born with allergic contact dermatitis
but develop it over a period of time through repeated contact to an
allergen. It is not known why some people develop an allergic reaction
to a substance when to others it remains harmless.
Symptoms, when they appear, may include itching,
redness, flaking and cracking of the skin. An example of allergic contact
dermatitis is, a rash that appears on the wrist after wearing a watch
that contains nickel. Nickel is the most common cause of allergic dermatitis
Common allergens include:
- Nickel - e.g. spectacle frames, cheap jewellery
or belt buckles.
- Wet cement.
- Rubber and latex e.g. condoms or rubber gloves.
- Cosmetics, hair dyes and perfumes.
- Plants and flowers- e.g. dahlias or chrysanthemums.
In order to prevent reactions occurring, you must
try to avoid contact with any allergen that you know causes your eczema
symptoms to flare up.
Irritant contact dermatitis.
This is a type of eczema, which is caused by frequent
contact with everyday substances, such as soaps and detergents, causing
an irritation and damage to the outer layer of skin. Adults are most
commonly affected, especially on their hands.
Common irritants include:
- Washing-up liquid, soaps and fabric conditioner.
- Cleaning chemicals such as disinfectants and
This form of eczema can be prevented, by trying
to avoid the irritants that cause the problems and by keeping the skin
Are there any complications with eczema?
The most important thing to do if you have eczema is to
keep the skin moisturised to prevent it from drying out. If the skin
is dry it becomes a good home for the bacteria Staphylococcus aureus.
If the eczema becomes infected with Staphylococcus the skin may become
very red, weep a lot and produce yellowish dry crusts. You may also
notice blisters filled with a yellow pus. If this condition develops
it will need to be treated with antibiotics,
such as penicillin.
One of the most serious complications with atopic eczema
is eczema herpeticum, this develops when eczema becomes infected with
virus. Eczema herpeticum is a serious condition and medical help
must be sought. The symptoms of eczema herpeticum may include a high
temperature, an extensive rash with small skin blisters filled with
yellow pus and you may generally feel unwell. The rash can cover the
whole of the skin surface. Eczema herpeticum can occur when anyone with
eczema, especially if it is sore and open has skin to skin contact with
someone who has active facial (cold sores) or genital
herpes. Eczema herpeticum is treated with oral anti-virus
antibiotics. However, considering how common the herpes simplex virus
and atopic eczema are, this condition is fortunately quite rare.
If at any time the skin is very
sore, weepy or you develop small blisters with pus then the eczema may
have become infected, you should visit your doctor for advice and treatment.
What tests will I have to diagnose eczema?
Eczema is usually diagnosed from the appearance
of the skin alone. However, a test may be needed to decide what allergen
is causing the skin problems. You can read more about the types of tests
available in the section "How are allergies diagnosed?" on
What treatments are available?
There is no cure for eczema but there are many
treatments available, which reduce the inflammation and ease the discomfort
of itchy skin. However, even after treatment the skin will always be
sensitive and will often need special care. Remember, as with all types
of allergies the best treatment is to find out what causes the eczema
and then avoid it! Treatments available to minimise your eczema symptoms
may include any of the following:
Emollients are moisturisers that provide the skin
with a barrier, which softens and hydrates the skin. This barrier will
prevent dryness and make the skin feel more comfortable. Emollients
are available in many forms - ointments for very dry skin, creams and
lotions for moderate eczema, gels for eczema that is under the hair
and bath oils. As there is such a wide range of emollients available,
it may be a case of trial and error before the most suitable one is
found for you. Like all new products, it is advisable that you test
a little on your skin first to ensure no irritation occurs. E45
cream is probably one of the most popular emollients. Emollients should
be used at least twice daily but you can use them as often as you need.
When eczema flares up a steroid cream may be needed
to reduce the inflammation. Topical steroids come in four different
strengths: mild, moderate, potent and very potent. Your doctor will
decide what treatment is needed for you. The cream is applied thinly
to the affected area. Topical steroids should only be used as directed
by your doctor or nurse. The mildest steroid is available over the counter
at pharmacies and is called hydrocortisone, ask you pharmacist for advice.
If eczema is severe a short course of oral steroids
could be prescribed, this is usually in situations when topical steroids
have failed to improve the eczema.
If other methods have failed and your eczema is severe
your doctor may discuss the use of artificial light treatment (sunbeds)
but only for older children and adults. Antihistamine tablets to reduce
severe itching, stronger medication or wet wrapping are other treatments
that your doctor may recommend. Wet wrapping consists
of a type of bandaging that is applied to moisturised skin. The bandage
is soaked in lukewarm water and then cut to size so that it covers the
affected area. The bandage can be applied overnight to the limbs, trunk,
neck and even face (holes are cut in the dressing for eyes, ears, nose
and mouth). This treatment is highly successful for severe weepy eczema.
Bandages can also prevent the sufferer from itching irritated skin.
You should remember what works well
for one person might not work well for another. Eczema is a very individual
To minimise the symptoms and avoid further attacks:
- Regularly dust and vacuum your house to reduce
the population of house dust mites.
- Wash your child's soft toys frequently to kill dust
- Avoid scratching yourself
and keep your child's nails short to minimise skin damage.
- Keep to a strict skin care routine.
- Take lukewarm baths with emollients and don't stay
in too long.
- Apply only advised or prescribed moisturisers
instead of highly perfumed products.
- Wear cotton fabrics and avoid clothes made of
wool and other rough fibres.
- Dry yourself thoroughly after washing by patting
the skin, rather than rubbing. .
- Keep your skin moisturised with your chosen emollient.
- Use gloves when handling chemicals, solvents
- Most importantly try to avoid the allergens that
cause your skin to flare up.
Insect Bites & Pet allergies