Eczema

Eczema’s exact cause is unknown, but evidence suggests it may be genetic because it often affects people who have a personal or family history of asthma, hay fever or other allergies. Eczema symptoms typically flare up when a person is exposed to certain triggers, which may include skin irritants, allergens, climate factors, the environment and stress.

Adult eczema most often develops on hands, elbows and “bending” areas, such as the inside of an elbow or back of a knee. In young children, eczema most often develops on the elbows, knees, face, neck and scalp. You might notice that your skin itches intensely at first, with a rash appearing later.

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 crust.
• 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.
• You have swollen glands in the neck, underarms 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.

Many people find that the cold winter months can exacerbate their eczema. Here are some measures you can take to reduce the impact.

• If you want to wear wool clothing or gloves, wear cotton or silk clothing underneath and avoid direct contact of wool
  with the skin.
• 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. Apply routinely twice a day.
• If you find that your skin is drier in winter, switch to a heavier emollient ointment during this season.
• Avoid fast changes of temperature extremes, such as getting out of a hot bath and going into a cold room.
• Do not have your central heating on too high, as sweating can aggravate eczema.
• Central heat can also dry out the air in a home, making regular use of an emollient that much more important. Consider using a humidifier during the winter months.
• Resist the temptation to take very hot, long showers in the winter, as this can dry out skin more. Instead, use warm water and limit baths or showers to 5-10 minutes.

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.

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.