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
WHAT IS ECZEMA?
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
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.
WHAT IS CRADLE CAP?
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.
ECZEMA IN ADULTS
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
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.
HELP FROM DRUGS
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
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