Is there a cure for eczema?
Unfortunately at present there is no cure for eczema but it can be well managed.
What are the main treatments for managing eczema?
There are a number of ways to manage eczema, all of which begin with an effective skin care routine. The following are main treatments used to help manage eczema.
Emollient is the medical term for a non-cosmetic moisturizer. Emollients are required to reduce water loss from skin, preventing the dryness that is typically associated with eczema. By providing a seal or barrier, the skin is less dry and itchy, and more comfortable.
Emollients are safe to use as often as is necessary and are available as lotions, creams, gels and ointments. Ointments are preferable for very dry skin, creams and lotions are lighter and suitable for mild to moderate eczema, and are particularly suitable for ‘weeping eczema’.
When eczema is under control the continued use of emollients is all that is needed. However, when the eczema flares up and the skin becomes inflamed, a steroid cream or ointment may be required.
Topical steroids act by reducing inflammation and are used in most types of eczema and should not be confused with the steroids used by body-builders. Topical steroids come in four different potencies, mild, moderate, potent and very potent and are also available in different strengths.
The strength and potency of steroid cream/ointment that a healthcare provider prescribes depends on the age of the patient, the severity of the condition, the part of the body to be treated and the size of the area of eczema to be treated.
Your doctor will also take into account any other medications being taken. Topical steroids are applied to the affected area, as directed by the prescribing doctor.
Why is cotton recommended for people with eczema, and what other fabrics are suitable for wearing next to the skin?
Many people with eczema find cotton clothing and bedding preferable, as it is more comfortable than wool or synthetic fibers. Cotton is smooth and cool, as it allows the skin to breathe and prevents overheating.
Most people prefer 100% cotton, but some can tolerate a mixture of cotton and another material. Many people with eczema can also wear silk, linen or soft acrylic next to their skin.
Always pre-wash colored cotton to remove potential irritants such as dyes. Cheaper products can cause problems as they may have been finished with an irritant chemical called formaldehyde, which can trigger a flare-up in some people.
Be wary of 100% cotton that can only be washed at low temperatures, as this may have also been coated with a chemical finish.
Look out for rough seams or edges on cotton clothing and bedding. Labels can be cut out of clothing if they cause irritation.
How can I reduce the Itching?
Itching is one of the worst symptoms of eczema. There are many methods of reducing the itchiness of the skin and minimizing the damage of scratching. Cotton clothing and bedding keep the skin cool and allow it to breathe, whereas synthetic fabrics and wool can irritate.
The use of a non-biological washing powder and avoidance of fabric conditioner can also help to reduce the itchiness of the skin. Nails should be kept short and the skin moist by frequent application of emollients. At nighttime, a cool bedroom temperature can be helpful as heat can trigger itching.
For children in particular, the itchiness of eczema can be very distressing. Distraction is often the best way of reducing scratching. Cotton mittens or all-in-one sleep suits can be helpful in reducing the damage to the skin occurring during sleep.
How can I tell if my eczema is infected? What are the signs?
If you think that an infection is present, you should see your doctor as early as possible so that it can be treated accordingly. Infection may be suspected if:
- the skin has blisters, pustules or dry crusts;
- the skin is weeping a clear or yellow fluid;
- there is reddening, itching, soreness and sudden worsening of the eczema;
- yellow pus spots appear;
- there are small, red spots around the body hairs;
- you have a raised temperature, and flu-like symptoms; or
- you have swollen glands in the neck, armpit or groin
The possibility of infection should always be considered in eczema that is getting worse or not responding to emollient and topical steroid treatment.
I find that winter makes my eczema worse. What can I do to keep it under better control?
Many people find that the cold winter months can exacerbate their eczema. Here are some measures you can take to reduce the impact.
- Wear cotton gloves when you are outside, underneath your ordinary gloves or mittens
- If you want to wear a woolly jumper, try wearing cotton or silk clothing underneath so that the jumper does not come into direct contact with your skin. Avoid woolly scarves around your neck as they can make you itch.
- Wear loose, thin layers of clothing so that items can be added or removed according to temperature.
- Apply emollient ointment or Vaseline to lips to stop them from drying out.
- Apply your preferred emollient, especially to exposed areas such as your face, neck and hands, before going outside.
- If you find that your skin is drier in winter, you could change your emollient cream to an ointment.
- Avoid extremes of temperatures, such as getting out of a bath and going into a cold room.
- Do not have your central heating on too high, as sweating can aggravate eczema.
Is there a mosquito repellent suitable for people with eczema?
Unfortunately, all mosquito repellents applied to the skin can cause some irritation. This is especially true of liquid repellents, which are alcohol-based and can sting. Test any repellent on your own forearm first and wait 24 hours to see if you have a reaction.
Some people have found that ankle and wrist bands, which are impregnated with DEET, cause fewer problems. However, long cotton sleeve tops, trousers and socks, especially at night, will provide the most protection.
A mosquito net at night or a repellent that you plug into an electrical outlet are also beneficial in warding off the mosquito.
Will my child grow out of her/his eczema?
Unfortunately, there are no guarantees that a child will grow out of eczema. However, research has shown that 65% of children will be free of eczema by the time they are 7 years old, and 74% by the time they reach 16 years of age.
My child is starting school - have you any advice?
School or nursery should not present problems for a child with eczema if time is taken to ensure that the teachers and nursery staff have eczema explained to them and are given written information about it.
Well before the child’s first term, approach the school/nursery and speak to the teacher or staff. Explain that your child has eczema and what things can be done to manage her skin during the day. Tell the school if the child has to take antihistamines as sometimes they can make a child a little drowsy first thing in the morning.
Provide the school or nursery with a pump dispenser of her emollient. In the classroom ask the teacher if your child can have a desk away from direct sunlight or a radiator as this will help prevent the child getting too hot and itchy.
Can changing mine or my child’s diet help?
Dietary changes can be quite helpful in babies and young children, where the emollients and topical steroids have failed to control the eczema. Children under 5 are at the greatest risk of having their symptoms worsened by food allergies.
It is thought that in about 30% of children with eczema, food may be one of the causes, but a much smaller group than this (about 10%) will have food as their main or only trigger. This means that only a small number of children will be helped by changes in their diet. In other words, it is rarely diet alone that triggers eczema.
The evidence for changing diet in older children and adults is inconclusive and only a small number of adults are helped by diet changes. Also, finding the trigger can be difficult because of the wider variety of foods typically eaten by adults.
In children, dietary changes should not be made without the advice of a healthcare professional.
*Source: National Eczema Society