Eczema (Atopic Dermatitis)

Different types of eczema

There are several types of eczema, each with its own distinct characteristics. The most common types as a result of an allergen include:

Atopic dermatitis: This is the most prevalent form of eczema and often begins in childhood. It is associated with a family history of allergic conditions, such as asthma or hay fever. Atopic dermatitis is characterized by dry, itchy skin and may be accompanied by redness and inflammation.

Contact dermatitis: This type of eczema is triggered by contact with specific substances or allergens. There are two main types of contact dermatitis:

• • Irritant contact dermatitis: Caused by direct irritation of the skin from substances like soaps, detergents, or chemicals.
  • Allergic contact dermatitis: Triggered by an allergic reaction to substances like metals, latex, fragrances, or certain plants.

Symptoms of eczema

The symptoms of eczema can vary from person to person, but they often include:

• Itching is typically associated with eczema, which can be severe and lead to scratching. Scratching, in turn, can worsen the inflammation and potentially cause infections.
• Red or inflamed skin is a common symptom of eczema.
• Dry and sensitive skin is often seen in people living with eczema and in some cases, the skin may become cracked and scaly.
• Skin may become swollen or inflamed.
• In severe cases, eczema can lead to the formation of blisters that may ooze or weep.

Although eczema can affect any part of the body, it most often affects the hands, insides of the elbows, backs of the knees and the face and scalp in children. People with atopic eczema usually have periods when symptoms are less noticeable, as well as periods when symptoms become more severe (flare-ups).

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Triggers and causes of eczema

Individual trigger factors vary from person to person and often you will find that more than one trigger factor can cause a ‘flare’ of your eczema. Some trigger factors may be easy to identify whilst others may not be so easy to work out. If you suspect something in the environment may be a trigger factor keeping a symptom diary can be helpful to work out patterns of exposure and signs and symptoms. This can be useful when speaking to your health care professional to identify potential triggers.

Food allergens and eczema

In individuals with both eczema and food allergies, consuming trigger foods may lead to allergic reactions that manifest not only in typical allergy symptoms but also in eczema flare-ups. The immune system responds to the allergenic proteins in these foods, releasing chemicals that can contribute to skin inflammation and itching.

Some foods, such as eggs and cows’ milk, can trigger eczema symptoms, but you should not make significant changes to your diet without first speaking to a GP. It may not be healthy to cut these foods from your diet, especially in young children who need the calcium, calories, and protein from these foods. If a GP suspects a food allergy, you may be referred to a dietitian (a specialist in diet and nutrition). They can help to work out a way to avoid the food you’re allergic to while ensuring you still get all the nutrition you need. If you’re breastfeeding a baby with atopic eczema, get medical advice before making any changes to your regular diet.

Allergy UK’s free Dietitian Service

We know that being a parent isn’t easy at the best of times, so when you add a poorly baby with suspected allergy into the mix, we understand that family life can become complex and emotionally challenging. If you are a parent of a child whose eczmea flare ups may be exacerbated by a food allergy, Allergy UK’s Dietitian Service provides specialist allergy advice to help inform and guide parents of children from 0-5 years old who are presenting with symptoms of food allergy.

Find out more here

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Treatments for eczema

Eczema is a chronic condition, meaning that it can come and go over time. While there is no cure for eczema, various treatments are available to manage symptoms and improve the quality of life for individuals affected by the condition. These treatments may include moisturizers, topical corticosteroids, antihistamines, and, in some cases, systemic medications. It’s important for individuals with eczema to work closely with their healthcare providers to develop a treatment plan tailored to their specific needs.

• Emollients. Emollient lotions and creams are prescribed for treating atopic eczema and dry skin, and are, in their simplest form, mixtures of oil and water.
• Topical steroid creams. It is sometimes necessary to apply topical corticosteroids (e.g. hydrocortisone), as these reduce inflammation in the skin caused by eczema.
• Wet wraps. Sometimes, special pyjama-like garments (known as ‘wet wraps’) that are used for children may also help certain areas of your body that have not responded to the usual topical application of emollients and steroids.
• Calcineurin inhibitors. Calcineurin inhibitors are an alternative to steroid creams. Like steroid creams, they reduce the skin inflammation and can lessen itching.
• Oral antihistamines can help control itching, especially at night. Non-drowsy options are available, but some people may prefer taking them before bedtime due to the potential for drowsiness.
• Biologics are a newer class of medications that target specific components of the immune system. Biologics are often reserved for severe cases of eczema that do not respond to other treatments. More information about biologics can be found in our information factsheet or our informative video.

It’s crucial to work closely with a healthcare professional to develop a personalized treatment plan, as the effectiveness of treatments can vary from person to person. Additionally, lifestyle modifications, stress management, and proper skincare practices can contribute to managing eczema symptoms.

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How can I manage eczema?

It’s crucial to work closely with a healthcare professional to develop a personalized treatment plan, as the effectiveness of treatments can vary from person to person. Additionally, lifestyle modifications, stress management, and proper skincare practices can contribute to managing eczema symptoms. You can find a whole host of useful tips on our eczema resources but here are 3 top tips to follow:

1. Apply your emollients regularly. The chore of a twice daily skin cream regime can become annoying, especially if your symptoms have improved. But remember that the eczema symptoms have improved because the eczema is under control. Without the cream, it may flare up again. Keep up the routine so that your efforts to keep your skin healthy and hydrated do not go to waste.
2. You could need to apply your emollients from two to four times a day. It can be useful to have extra emollients available should you need them when you are away from home. For example, keep spares at work or in the car.
3. It is important to be aware of, and look for, the signs of bacterial infections (weeping and crusting), since the skin of eczema sufferers is more prone to infection due to the cracks and constant scratching.

How to avoid causing damage to the skin from scratching

Eczema is often itchy, and it can be very tempting to scratch the affected areas of skin, but scratching usually damages the skin, which can itself cause more eczema to occur. The skin eventually thickens into leathery areas as a result of chronic scratching. Deep scratching also causes bleeding and increases the risk of your skin becoming infected or scarred.

Try to reduce scratching whenever possible. You could try gently rubbing your skin with your fingers instead. If your baby has atopic eczema, anti-scratch mittens may stop them scratching their skin. Keep your nails short and clean to minimise damage to the skin from unintentional scratching. Keep your skin covered with light clothing to reduce damage from habitual scratching.

Avoiding triggers with eczema

A GP will work with you to establish what might trigger the eczema flare-ups, although it may get better or worse for no obvious reason. Once you know your triggers, you can try to avoid them, for example:

• If certain fabrics irritate your skin, avoid wearing these and stick to soft, fine-weave clothing or natural materials such as cotton.
• If heat aggravates your eczema, keep the rooms in your home cool, especially the bedroom.
• Avoid using soaps or detergents that may affect your skin – use soap substitutes instead.

Although some people with eczema are allergic to house dust mites, trying to rid your home of them is not recommended as it can be difficult and there’s no clear evidence that it helps.

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Living with eczmea

In the UK, eczema affects 1 in 5 children and 1 in 10 adults and those who are affected know that living with eczema is more than a physical challenge; it’s a journey that deeply influences both your skin and mental health, however living with eczema doesn’t mean compromising your mental health. It’s about finding balance and embracing a holistic approach to overall wellbeing.

Here are some tips to improve your mental health if you are affected by eczema:

1. Understanding your condition is the first step. Learn about eczema, its triggers, and various management strategies. This knowledge can empower you to make informed decisions and reduce anxiety.
2. Maintain open and honest communication with your healthcare providers. Discuss not only the physical symptoms but also the emotional impact of eczema. They can provide tailored advice and may refer you to mental health professionals if needed.
3. Develop a skincare routine that caters to your skin’s needs. Consistency can be reassuring, and taking care of your skin can positively impact your self-esteem.
4. Eczema and stress often go hand in hand. Explore stress-relief techniques such as meditation, deep breathing exercises, yoga, or mindfulness to help manage stress and anxiety.
5. If you find that eczema is significantly impacting your mental health, consider talking to a mental health professional. Therapy can provide a safe space to express your feelings and develop coping strategies.
6. Regular exercise has been linked to improved mood and reduced stress. Choose activities that you enjoy and that are gentle on your skin, such as swimming or walking.
7. Be kind to yourself. Eczema is a chronic condition, and there will be good and bad days. Treat yourself with the same care and understanding that you would offer to a friend facing similar challenges.

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