By Dr. Columba Quigley
Eczema, which is also known as dermatitis, is a skin condition that can occur at any age, but usually starts in childhood. Australia has one of the highest incidences of eczema worldwide, affecting one in three children.
Atopic eczema is the most common type of eczema, and is associated with allergic conditions such as hay fever and asthma, all of which tend to run in families.
What happens in eczema?
Eczema usually appears before five years of age, when those affected develop itchy, dry patches on their skin, often with little bumps or blisters.
The rash usually starts on the cheeks, forehead or scalp, but can spread to the arms, legs and trunk. You can also get scaly patches in skin creases like in the bends of your elbows and behind your knees, as well as on the back of your wrists or ankles.
The rash can be very itchy, but scratching makes it worse, which is why the involved areas can become rough and 'leathery' from rubbing and scratching.
The itchy skin also becomes sore and broken when scratched, and may even bleed. The cracks make infections more likely too. When the rash is itchy and sore, sleeping can be difficult, so you might feel tired during the day.
Eczema tends to come and go, with flare-ups when the rash reappears, and remissions when it goes away for a while.
Eczema usually improves with age, but it can persist into adulthood.
What causes eczema?
Eczema is not an allergic condition itself, and so allergies do not cause the rash, but they can trigger a flare. The common allergies that can do this include house dust, pets, pollen, wool, soaps and detergents.
Sometimes stress and anxiety can make the rash worse too. On the other hand, some people have no identifiable triggers at all.
Nobody knows what causes eczema, but it may be a defect in the skin that allows allergens to get in, as well as a particularly sensitive immune system.
How can eczema be treated?
Most treatments involve topical products that are put straight onto your skin:
These are a mixture of oil and water. They plug the gaps in your skin, keeping bugs out and keeping water in. They can be put straight onto your skin or used as a replacement for soap and bath oils. You usually use them several times a day. They are cooling and soothing for the soreness and the itch. They also give your skin time to repair by easing the need to scratch.
Steroids reduce inflammation, making your skin less red and painful. They come as lotions, creams, ointments, gels, sprays and foams.
Sometimes, for moderate or severe eczema, you may need stronger medicines, particularly where topical steroids have not helped or are causing problems.
If bugs get in and you have a skin infection, you may need a course of antibiotics.
It is also important to avoid triggers as much as possible.
- Eczema is not anyone's fault
- Eczema doesn't mean your skin is dirty
- You can't give eczema to other people
- It's important to take your treatments just like your doctor or nurse told you
It can be hard having eczema, especially when your friends notice or comment on your rash. But you are not alone! Eczema is very common and many other children have it too.
Kumar & Clark's Clinical Medicine. Kumar P & Clarke M (eds). 7th edition. Edinburgh, London, New York, Oxford, Philadelphia, St Louis, Sydney, Toronto: Saunders Elsevier, 2009.
About Dr. Columba Quigley
Dr. Columba Quigley is a medical writer and managing editor at Medikidz, an organisation that provides children with informative, accessible and fun comics to help them understand health and illness.