Eczema and Atopic Dermatitis
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Introduction
Eczema, also known as atopic dermatitis, is a chronic skin condition characterised by episodes of redness, itching and inflammation of the skin. Affecting both children and adults, it is one of the most common dermatoses in the world. According to the World Health Organisation, nearly 20% of children and 3% of adults are affected by eczema at some point in their lives.
Although its exact cause remains uncertain, eczema is thought to result from a combination of genetic and environmental factors. In addition, it is often associated with other atopic conditions such as asthma or allergic rhinitis.
The aim of this article is to provide an overview of conventional solutions for treating eczema, while exploring complementary natural approaches that can offer relief to sufferers. By better understanding this condition and the various treatment options available, patients can be better equipped to manage their symptoms and improve their quality of life.
Causes and Risk Factors of Eczema
Eczema, although a complex disease, is often the result of an interaction between genetic and environmental factors. Here is an exploration of the main causes and risk factors associated with this skin condition :
Genetics
Genetic predisposition plays a crucial role in the development of eczema. Individuals with a family history of atopic dermatitis or other atopic conditions (such as asthma or allergic rhinitis) are more likely to develop the disease.
Environmental factors
Allergens: Dust, pollen, dust mites and certain foods can trigger or aggravate eczema symptoms in some individuals.
Irritants: Chemicals, perfumes, soaps and detergents can irritate the skin and cause a flare-up of eczema.
Climate: Dry or cold environments can dry out the skin, increasing the risk of flare-ups.
Infections: Skin infections can make eczema symptoms worse.
Allergies
Food allergies, particularly in children, can be linked to eczema. Commonly associated foods include eggs, milk, nuts, soya and wheat.
Contact allergies, such as those caused by nickel or latex, can also cause or aggravate eczema.
It is essential to recognise that each individual is unique, and what may trigger an eczema flare-up in one person may not have the same effect in another. Understanding the causes and risk factors is the first step to effectively managing the condition and avoiding potential triggers.
Symptoms Characteristics of Eczema
Atopic dermatitis, or eczema, manifests itself through a variety of symptoms that can vary in intensity and frequency from person to person.
The following is a description of the most commonly observed clinical signs:
Redness:
Reddened areas of skin are often the first visible sign of eczema. This redness can appear on any part of the body, although in children it is frequently localised on the face, cheeks, neck and joints of the arms and legs.
Itching:
Itching, which is often intense, is a characteristic symptom of eczema. It may precede the appearance of other visible signs of the disease. Scratching in response to this itching can aggravate the skin lesion and increase the risk of infection.
Dry, flaky skin:
The skin of people with eczema tends to be dry, which can contribute to the intensity of itching. Over time, the skin can also become thickened, rough and flaky.
Skin lesions:
Following scratching, oozing or crusty lesions may form. These lesions can sometimes become infected, leading to the formation of pus or thickening of the skin.
Vesicles:
In some cases, small fluid-filled blisters may appear on the skin. These can burst when scratched, increasing the risk of infection.
Hyperpigmentation or hypopigmentation:
After a flare-up of eczema, the skin may show changes in pigmentation, becoming either darker (hyperpigmentation) or lighter (hypopigmentation) than the surrounding skin.
It is crucial to note that eczema can develop differently in different individuals. While some may experience mild, intermittent symptoms, others may suffer from severe, persistent flare-ups. A consultation with a dermatologist is essential for an accurate diagnosis and appropriate treatment.
Conventional treatments for Eczema
The main aims of eczema management are to reduce inflammation, relieve itching and prevent future flare-ups. Although the disease cannot be completely cured, several conventional treatments have been proven to effectively control symptoms:
Hydrating creams:
Regular moisturising of the skin is fundamental for people with eczema. Emollients and moisturising creams help to restore the skin barrier, reduce dryness and prevent flare-ups. It is recommended to apply these products after showering or bathing, when the skin is still damp.
Topical corticosteroids:
These cortisone-containing creams or ointments are commonly prescribed to reduce inflammation and itching. They should be used as directed by the doctor, as prolonged or inappropriate use can lead to side effects.
Antihistamines:
These drugs, often used to treat allergies, can also help reduce the itching associated with eczema. Some antihistamines can cause drowsiness, which can be beneficial for people with night-time itching.
Immunomodulators:
These creams, such as Tacrolimus and Pimecrolimus, are used to treat moderate to severe eczema. They work by modulating the skin's immune response, reducing inflammation.
Phototherapy:
This approach uses ultraviolet light to treat moderate to severe eczema. Phototherapy can be effective for some people, but requires several sessions under the supervision of a dermatologist.
Systemic medications:
In severe cases or when eczema does not respond to topical treatments, oral medications, such as oral corticosteroids or immunosuppressants, may be prescribed.
It is imperative to consult a dermatologist to determine the treatment best suited to the severity and location of the eczema. An individualised approach and regular monitoring are essential to ensure effective management and minimise potential side effects.
Natural Complementary Medicine for Eczema
Aside from conventional treatments, many people turn to natural complementary medicine to relieve the symptoms of eczema. These natural medicines offer alternatives and/or complements to conventional treatments:
Aromatherapy and Eczema: The effectiveness of Essential Oils:
Aromatherapy, which is based on the use of essential oils extracted from plants, is increasingly recognised for its therapeutic benefits in a variety of conditions, including eczema. These oils, concentrated in active compounds, can offer anti-inflammatory, antimicrobial and soothing properties. You can find essential oil preparations to treat eczema. Here are some details on essential oils commonly used to treat eczema:
Roman or Noble Chamomile essential oil:
Properties: Chamomile is known for its anti-inflammatory and soothing effects. It can help reduce the redness and itching associated with eczema.
Use: Dilute a few drops of chamomile essential oil in a vegetable oil (such as sweet almond or jojoba oil) and apply to the affected areas. You can also add a few drops to your bath for an overall soothing effect.
Lavender officinalis or true lavender essential oil:
Properties: Lavender essential oil has antiseptic and healing properties. It promotes the healing of skin lesions and prevents infections.
Use: Like chamomile, lavender can be diluted in a vegetable oil and applied topically. It is also beneficial when added to baths.
Tea tree or Tea tree essential oil:
Properties: This oil is renowned for its antimicrobial properties. It can help prevent secondary skin infections that can occur when eczema is scratched.
Use: Due to its potency, it is essential to dilute tea tree oil before applying to the skin. It can be mixed with a moisturiser or vegetable oil.
Precautions for using essential oils:
Before using an essential oil for the first time, it is recommended that you carry out a skin tolerance test. Apply a small amount of the diluted oil to a discreet part of the skin and for at least one hour to check that there is no allergic reaction.
Essential oils are powerful products. It is essential to use them with care and to follow the dilution recommendations.
Always consult a healthcare professional or certified aromatherapist before incorporating essential oils into your skincare routine, especially if you are pregnant, breastfeeding or treating a child.
In conclusion, aromatherapy can offer a promising complementary approach to managing eczema. However, as with any therapeutic intervention, informed and careful use is essential to ensure safety and efficacy.
Food supplements:
Probiotics: These beneficial bacteria can boost the immune system and reduce the frequency of eczema flare-ups, particularly in children.
Fish oil: Rich in omega-3, it can help reduce skin inflammation.
Alternative therapies:
Acupuncture: This ancient Chinese practice can help balance the immune system and reduce itching.
Biofeedback: This relaxation technique allows patients to become aware of and control certain physiological functions, which can help manage the stress associated with eczema.
Dietetic advice:
Avoid food allergens: Certain foods can trigger or worsen eczema symptoms. It is advisable to keep a food diary to identify and avoid trigger foods.
Increase omega-3 intake: Foods rich in omega-3, such as oily fish, flaxseed and walnuts, can help reduce inflammation.
It is essential to consult a healthcare professional before adopting any complementary approach to ensure it is safe and suitable for your situation. In addition, it's crucial not to abandon conventional treatments prescribed by a dermatologist without discussing them first.
Prevention and Practical Advice for Eczema
Preventing eczema flare-ups and managing symptoms on a daily basis are essential for improving the quality of life of sufferers. Here are some recommendations and practical advice to help control this skin condition:
Avoid triggers:
Identify and avoid factors that trigger or aggravate your eczema, whether allergens, irritants or stressful situations.
Skin care routine:
Warm baths: Prefer warm baths to hot showers, and limit their duration to 10-15 minutes.
Gentle soaps: Use fragrance-free, hypoallergenic soaps to avoid irritating the skin.
Hydration: Apply a moisturiser within minutes of getting out of the shower or bath to lock in moisture.
Clothing:
Wear clothes made from cotton or natural fabrics, avoid synthetics or wool which can irritate the skin.
Wash new clothes before wearing to remove any dye or chemical residues.
Stress management:
Stress can be a trigger for some people. Adopt relaxation techniques such as meditation, yoga or deep breathing to manage stress.
Avoid infections:
Keep your nails short and clean to reduce the risk of infection when scratching. In the event of oozing lesions, consult a doctor to avoid superinfection.
Environment:
Use a humidifier in dry periods to maintain optimum humidity levels in your environment. Avoid extreme temperatures which can worsen symptoms.
Regular consultation:
Consult a dermatologist regularly to monitor the progress of your eczema and adjust treatment if necessary.
Prevention is an essential part of eczema management. By adopting a suitable routine and avoiding triggers, it is possible to reduce the frequency and severity of flare-ups, thereby significantly improving day-to-day well-being.
Conclusions
Eczema, or atopic dermatitis, is a skin condition which, although common, can have a significant impact on the quality of life of sufferers. Its management requires a holistic approach, combining proven conventional treatments and, where appropriate, complementary natural methods. The key to success lies in understanding individual triggers, adopting an appropriate skincare routine and consulting a dermatologist regularly. By remaining informed and proactive, patients can not only manage their symptoms effectively, but also live life to the full despite the presence of this dermatosis. It is essential to remember that each individual is unique, and what works for one person may not be suitable for another. Working closely with healthcare professionals will enable a personalised treatment plan to be devised, optimising the chances of success and well-being.
Dermatologist
This advice on eczema is brought to you by Dr Anetta Draculova, dermatological physician.
Dr Draculova is in private practice. She studied at the Clinical Department of Dermatovenerology at the Faculty of Medicine at the University of Bratislava.
Warning!
Don't try to treat your eczema on your own. Consult a dermatologist who will be able to advise you on the right treatment for your physical and mental condition.
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