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This distressing skin condition is very common. There's no cure but it can be brought under control with drugs and skin creams, while sufferers of some types of severe eczema find that Chinese herbal medicine helps.

One in ten of us will suffer from eczema at some time in our lives. For some, this may mean no more than a few occasional itchy red spots on their hands. At the other extreme, eczema can cover the whole body with a constantly itching, painful and disfiguring rash which can prove extremely distressing.

The word 'eczema' is derived from the Ancient Greek language and means to 'boil over'. It's an apt way to describe such a disorder where the skin is red and inflamed, then dry and flaky. Some sufferers find
that their eczema 'weeps' and develops a crusted appearance.

The rash can appear in patches in places like behind the knees and in the crooks of the elbows, or it can cover the entire body. Wherever it strikes, it makes the skin feel extremely itchy and hot, driving the sufferer to scratch it to provide some temporary relief.

Inevitably, continual scratching leads to the development of patches of hard, dry skin which may bleed and become infected, although eczema itself is not infectious.

Atopic eczema is most common in children and is one of the so-called sensitivity conditions which also include asthma and hay fever. These disorders tend to run in families of people who are prone to allergic reactions.

As many as one in eight children are affected by this type of eczema. It often appears in early babyhood or infancy, between the ages of two months and 18 months.

The first signs may be a fretful baby who rubs his face against his bedding and who sleeps badly. Later on, as his fingers become more co-ordinated, scratch marks may appear on his face. The skin of his body then becomes dry and itchy and the child will often rub his skin at bath time.

By the time the baby becomes a toddler, the eczema may well have spread from the face to the neck, hands and those areas of the feet covered by shoes. At the nursery or play school stage, when the child becomes more active, the worst areas may be the backs of the knees, the crooks of the elbows and the backs of the thighs.

In older children or adults, eczema often affects the same areas or else the body in a more generalized way. Even when the skin feels normal, it may still itch unbearably and a sudden change of temperature can easily trigger off an intense urge to scratch.

A lot of those with atopic eczema have chest problems caused by the other sensitivity conditions asthma or hay fever. Some also experience itchy eyes in the spring - a condition known as allergic or vernal conjunctivitis.

The good news is that the condition often clears of its own accord as the child grows older, although it may come and go for several years before disappearing completely. By puberty, most children with atopic eczema have grown out of it. However, it is possible for it to return in adult life.

Cradle cap is another common type of eczema affecting young babies and is a form of seborrhoeic eczema. Thick, flaky yellow scales appear on the scalp which can look very unsightly. Though parents often find this upsetting, cradle cap is harmless. Sometimes this type of eczema also occurs on the face and neck, behind the baby's ears. In the groin area, it looks like a a bad nappy rash and occasionally, if it affects the underarms, the skin in this area may become red.

The best way to deal with cradle cap is to use a simple shampoo which will help remove the flaky scales. Alternatively, you can gently rub warmed olive oil into the baby's scalp, leaving it on overnight to loosen the scales. The following morning, the baby's scalp can be washed in a mild shampoo. You may need to repeat this procedure over several days until all the scales have been removed. In most cases, cradle cap and other infant forms of seborrhoeic dermatitis disappear before the baby's first birthday. But if the condition persists, or if the skin looks very sore and inflamed, you should consult your doctor.

Nummular or discoid eczema normally affects adults. Sometimes those who had eczema as children get this type of eczema in later life. It's characterised by large circular red patches that may ooze. Closely resembling ringworm, it can appear anywhere, but most often on the arms and legs.

Contact dermatitis is most often caused by skin coming into contact with a particular irritant - biological washing powders are a common example. Touching certain plants can also irritate some people's skin. Itchy blisters appear up to 2.5cm (l in) across, usually on the palms and the hand may be covered with scales and cracks.

People with varicose veins sometimes develop stasis or varicose eczema. This is is where the skin around their ankles becomes itchy or painful and discoloured. This condition must be treated by a doctor because there is a risk that difficult-to-heal ulcers may eventually develop on or around the site of the eczema.

Anxious and highly strung individuals can get into a nervous habit of rubbing their skin in a particular place. In time, the rubbed patch of skin becomes thickened and itchy. Doctors call this condition neurodermatitis.

Finally, there is eczema craquele that affects the skin of the elderly. This may be partly caused by the sebaceous or oil glands in the skin becoming less efficient with age.

In all kinds of eczema, rubbing emollients and moisturisers into the affected areas helps to replace the skin's natural moisture. In most cases, this is is all that's needed but, if the eczema is more severe, it may be combined with topical steroid or non-steroid preparations to reduce inflammation.

There is also a wide range of bath oils and skin cleansers that are specially formulated for people with skin problems like eczema. They can be prescribed by your doctor or bought in pharmacies.

Skin preparations based on tar and ichthyol can be very effective at controlling eczema. These ingredients are very soothing and have the added advantage of helping to thin thickened skin.

Preparations containing steroids can quickly damp down eczema when it flares up, but they should only be used under a doctor's direction. This is because over-use of the stronger preparations can lead to permanent skin changes such as skin thinning.

The strength of the steroid treatment and the amount you apply are important to get right. Generally speaking, they should be applied sparingly and not more than twice a day. As they begin to work, the steroid treatment should be reduced in strength and applied in smaller amounts.

Antihistamine tablets can help combat itching. They can be particularly helpful for those who find their sleep is interrupted by the constant desire to scratch and many have a sedative effect, too. Young children with eczema can wear cotton mittens in bed, so that if they scratch in their sleep, it won't cause any damage.

If you are an eczema sufferer, there is a great deal you can do to help yourself. It obviously helps if you avoid anything that triggers these sensitivity conditions. For example, a waterproof mattress cover and hard floors in the bedroom can reduce contact with house dust mite droppings.

Emollients (skin softeners) and moisturizers can be used as often as you like, as they contain no drugs, although some people may become sensitive to a particular ingredient. Special preparations for use in the bath can also be helpful.

Over-heating your skin can also trigger an attack. Even getting into a hot bath may be enough to set off an attack of itching, so check water temperature carefully before immersing yourself.

Wearing soft, all-cotton clothes helps the skin to 'breathe' so it is less likely to become irritated. Many sufferers find that they react to low temperature or biological washing powders because they contain certain enzymes. Fabric conditioner may also provoke irritation. Your doctor or an eczema information group should be able to advise which detergents cause the least problems.


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