What is eczema?

Eczema or dermatitis is the medical term for a skin flare-up where patches of skin become itchy, red, dry and inflamed. Your doctor may already have told you that you have eczema, which affects people of all ages.

Eczema is one of the commonest reasons for dry, sensitive skin, and affects up to 20 per cent of people in the UK.

Your eczema may flare up when your skin comes into contact with everyday things. This can be triggered by a reaction to substances that irritate your skin, or by a sensitivity to specific substances that develops, over time, into an allergic reaction.

What triggers skin irritation?

There are many different types of eczema/dermatitis and the causes are often difficult to identify. Triggers for skin flare-ups can be either common irritants or allergens, including household soaps and detergents, engine oils, cold winds, food and plants, nickel and chrome, perfume, and rubber. Avoiding contact with a specific substance, may help to reduce the symptoms.

What is the itch-scratch cycle?

The first sign of irritation is usually itching and the most natural response is to scratch - the more you scratch, the more you itch. This is known as the itch-scratch cycle and it is how a skin flare-up becomes established.

How do I control my skin flare-up of eczema and dermatitis?

The best way to break the itch-scratch cycle is to treat the irritation at the first sign of symptoms, or as soon as you can after onset. The earlier you start the treatment the more effectively you will be able to relieve the itching and clear the inflammation.

What treatment options are available?

Finding the right treatment is important. These treatments include emollients, steroid creams (also known as corticosteroid creams), antihistamines and antibiotics. Some of these treatments can be obtained from your pharmacist while others will need a prescription.

Emollients: these are one of the most important treatments for preventing dryness and cracking. Frequent, regular use will keep the skin moisturised and supple, helping prevent a skin flare-up. They are available in various formulations including creams, ointments and bath oils.

Steroids: when you have eczema or dermatitis you need a treatment with an active ingredient that works directly on the underlying inflammation. Steroid creams help to break the itch-scratch cycle before it takes hold and can reduce the inflammation so that skin can heal. Some steroid preparations are available to buy over the counter - ask your pharmacist what is available. Over-the-counter steroids are for short-term use of no longer than seven days for treatment of a skin flare-up. They are not suitable for use on the face and contact with the eyes should be avoided. If the skin becomes infected you may need a prescription for antibiotics.

Adults with severe cases of eczema that have not responded to other treatments may be prescribed an immunomodulator, a type of drug that suppresses the immune system. These drugs block the production of some immune cells and curb the action of others. There are currently two immunomodulators that can be prescribed for eczema, pimecrolimus (Elidel® cream) and tacrolimus (Protopic® ointment).

Alitretinoin (Toctino®) is a type of drug known as a retinoid that can be given orally to adults with severe longlasting eczema on the hands that has not responded to treatment with strong steroid creams or ointments.

Self-help measures

  • Speak to your pharmacist or doctor for advice on how best to treat the condition.
  • If you can identify the trigger(s) of your eczema, try to avoid it (them) as contact will make treatment more difficult.
  • Maintain your skin moisture levels by using emollients regularly to help stop your skin from drying out.
  • Consider using steroid preparations that can be bought from the pharmacy without a prescription.
  • When using steroid creams read the instructions carefully. Ensure you use the right amount. DO NOT apply to the face.
  • If your skin irritation has not cleared or has worsened after 7 days of treatment with a topical steroid consult your doctor.

Fact sheet provided by MIMS

Date last reviewed: May 2014

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