Atopic Dermatitis (Eczema)
Effective Eczema Relief: Treatment Options and Tips
The prevalence of allergies worldwide has been consistently increasing, making them a common disease of the 21st century. According to data from the World Allergy Organization, approximately one in five children is affected y allergies. While the exact causes of allergies are not fully understood, genetics are believed to play a role. If one parent has allergies, there is a 20-30% chance of their child developing allergies. If both parents have allergies, the likelihood increases to over 50%. Early sensitivities in infants and young children can progress into various types of allergies over time, a phenomenon known as the “allergic march”. Eczema and allergies are closely related and may gradually manifest as children grow. Around half of all eczema patients develop symptoms before the age of one, and over 95% experience onset before the age of five. However, most cases tend to improve before adolescence, with only a small percentage persisting into adulthood. Eczema patients often have a predisposition to other allergies, such as food allergies, allergic conjunctivitis, and asthma.
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Content
- What is eczema?
- Symptoms of eczema at different stages
- Which moisturizers are suitable for eczema-prone skin?
- Is coconut oil beneficial for eczema?
- Precautions for bathing with eczema
- Do eczema patients need to avoid certain foods?
- Treatment options for eczema
- Children with Eczema have a 4-fold higher risk of developing food allergy
What is eczema?
Eczema, also known as atopic dermatitis, is a form of skin inflammation. It is an autoimmune condition that is not contagious and can affect people of all ages. The primary symptoms experienced by individuals with eczema include dry and itchy skin, which can have a significant impact on their daily lives. It can cause difficulties with sleep and even lead to emotional distress. In severe cases, patients may be referred to clinical psychologists for additional support. How common is eczema? Statistics indicate that approximately 20% of the global population experiences eczema to varying degrees.
Symptoms of eczema at different stages
Eczema can be classified into three stages: acute, subacute, and chronic.
Acute Eczema
Acute eczema can develop at any age, during any season, and on any part of the body. It is characterized by itchy and inflamed skin. Small blisters may form within the skin tissue, and the affected area appears red and swollen. The skin may also release fluid.
Subacute Eczema
Subacute eczema falls between acute and chronic eczema in terms of severity. It is a stage marked by recurring flare-ups. Problems with the skin's keratinocytes hinder the production of natural moisturizing factors and sebum, leading to a vicious cycle that results in drier skin. In low humidity conditions, the outermost layer of the skin, known as the stratum corneum, fails to undergo normal turnover, resulting in increased thickness and flaking resembling scales.
Chronic Eczema
Recovery in the chronic stage takes a longer time, and symptoms typically persist for several months or more. Individuals with chronic eczema experience extreme dryness and may develop atrophic lines on their skin. The skin appears dull, rough, and persistently itchy, but there is no fluid discharge.
Eczema can occur at different stages, and the condition may fluctuate during the lengthy treatment process, causing frustration and discouragement for patients and their families. It is crucial to follow the doctor's instructions regarding medication, maintain proper skin hydration, and adopt healthy lifestyle habits. With proper management, eczema can be controlled.
Which moisturizers are suitable for eczema-prone skin?
The stratum corneum serves as the skin's natural barrier, protecting against allergens. When this barrier is compromised, irritants can trigger skin inflammation. Additionally, the loss of lipids between the cells of the stratum corneum can lead to increased moisture loss from the skin, exacerbating inflammation. Therefore, moisturizing is crucial for preventing eczema flare-ups. When humidity is below 70%, it is recommended for parents to regularly apply fragrance-free moisturizers to their children's skin. Research has shown that proper and consistent use of moisturizers can help reduce the need for corticosteroid creams.
Moisturizers typically contain two types of ingredients:
1 Humectants - These ingredients, such as urea or glycerin, increase moisture content in the skin.
2 Emollients - These ingredients, such as petrolatum, help prevent moisture loss from the skin.
It is advised to apply moisturizers two or more times per day to effectively alleviate skin itching. Recent medical literature suggests that moisturizers containing components like Filaggrin and Ceramides can enhance skin barrier repair and prevent allergens from entering the body. However, these specialized moisturizers may require a doctor's prescription. If the skin is currently inflamed, it is recommended to follow the doctor's instructions and apply any prescribed medication first, allowing it to be absorbed before applying the moisturizer.
Is coconut oil beneficial for eczema?
Although some home remedies suggest using pure oil-based products like coconut oil as a replacement for moisturizers, it is important to note that these products can actually increase moisture loss and are not recommended for use in eczema management.
Precautions for bathing with eczema
Proper bathing practices are essential for individuals with eczema, and both the duration and water temperature should be taken into consideration.
- Keep the bathing time as short as possible, preferably within five minutes, as prolonged exposure to water can lead to increased moisture loss from the skin. It is recommended to use warm water between 27-30 degrees Celsius, avoiding water that is too hot.
- Avoid using soap, as it can be drying for the skin. Instead, consider adding a suitable amount of bath oil to the water to help prevent dehydration of the skin's surface.
- After bathing, while the skin is still moist, it is beneficial to apply a fragrance-free moisturizer to nourish and hydrate the skin.
Do eczema patients need to avoid certain foods?
About one-third of children with moderate to severe eczema also have food allergies. Common allergenic foods include milk, eggs, peanuts, soy, nuts, and fish. Allergy tests, such as IgE blood tests or skin prick tests, can help identify specific allergens to avoid. It is important to note that assumptions about certain food triggers, such as beef or seafood, can be incorrect. It is recommended to consult a doctor for proper testing and guidance to avoid unnecessary dietary restrictions. Additionally, household allergens like dust mites, animal dander, and mould can also contribute to eczema flare-ups.
Treatment options for eczema
1. Topical corticosteriods
Topical corticosteroids are the recommended first-line treatment for eczema. They come in different strengths and can reduce inflammation, itching, and redness. While some parents worry about side effects and their impact on their child's development, the newer generation of corticosteroids is generally safe when used as directed by the doctor. It's important to follow the doctor's instructions and not stop treatment without consulting them, as this can delay healing and worsen the condition.
2. Topical Immunomodulators
Topical immunomodulators are used as a second-line treatment for eczema. They help reduce the dependence on corticosteroids and enhance the effectiveness of eczema treatment.
3. Antibiotics
There are two types: oral and topical. They are used when the skin is infected by bacteria.
4. Antihistamines
Oral medications used to reduce itching.
5. Diluted bleach baths
Diluted bleach baths can be beneficial for improving eczema symptoms as they effectively eliminate viruses, bacteria, and fungi and reduce the presence of Staphylococcus aureus. However, this treatment should be performed under the guidance of a doctor.
6. Wet wrap therapy
Wet wrap therapy is beneficial for severe eczema. It involves applying moisturizing materials to the skin, increasing moisture retention, reducing redness and inflammation, and enhancing medication effectiveness. Consult a doctor before trying this therapy.
Children with Eczema have a 4-fold higher risk of developing food allergy
Children with moderate to severe eczema are at a significantly higher risk, two to four times, of developing food sensitivities compared to children without eczema, according to research. Doctors advise parents to seek medical consultation and have their children undergo allergen testing. They also recommend introducing a diverse range of foods to children at an early age to lower the chances of developing food allergies in the future.
