Eczema (atopic dermatitis)

Atopic dermatitis (commonly known as eczema) is an inflammatory skin condition that usually appears in early childhood. The skin becomes red, scaly and itchy. Sometimes, tiny blisters containing clear fluid can form and the affected areas of skin can weep. Weeping is a sign that the dermatitis has become infected, usually with the bacterium Staphylococcus aureus (‘Golden Staph’). Eczema is not contagious.

Eczema can vary in severity and symptoms may flare up or subside from day to day. Use of moisturisers and cortisone-based ointments can help ease the symptoms. It is also important to avoid skin irritants such as soap, hot water and synthetic fabrics.

If your eczema becomes worse, see your doctor.

Causes

Eczema is caused by an inability to repair damage to the skin barrier. This is due to a mutation in the gene called filaggrin. Filaggrin is important for formation of the skin barrier. Normally every cell in the skin has two copies of the filaggrin gene. However, people who are susceptible to eczema only have one copy of this gene.

Although only one copy of the gene is required to form a normal skin barrier, two copies are important for effective skin barrier repair. If the skin is exposed to irritants and the skin barrier is disrupted, people with only one copy of the gene may find that their ability to repair the skin barrier is limited.

Once the skin barrier is disrupted, moisture leaves the skin and it will become dry and scaly. Environmental allergens (irritants from the person’s surrounds) can also enter the skin and activate the immune system, producing inflammation that makes the skin red and itchy.

Physical effects

The physical effects of eczema can include:

• Skin dryness
• Red and scaly areas on the front of the elbows and the back of the knees
• Watery fluid weeping from affected skin
• Itch
• Lesions that may become infected by bacteria or viruses.

Triggers

Some things make eczema more likely to appear. These include:

• Contact with irritants in the environment
• Heat, which can aggravate itch and make affected people more likely to scratch
• Occasionally, allergic reaction to particular foods – this is rare. Food allergy appears as redness and swelling around the lips within minutes of eating the offending food.

How to manage eczema

Ways to manage eczema include:

• Avoid long, hot showers, soap and other skin irritants.
• Apply moisturisers immediately after bathing or swimming.
• Keep the skin cool, especially in bed at night. Doonas are best avoided.
• In most cases, eczema isn’t caused or aggravated by diet. If you feel a food is to blame, see your doctor or dietitian for proper allergy testing and dietary advice.

Treatment

Treatment options for eczema include:

• Moisturisers (emollients)
• Anti-inflammatory ointments – either topical corticosteroids or non-steroidal anti-inflammatory ointment
• Coal tar – to reduce the itch
• Dietary changes – seek professional advice before changing your diet
• Ultraviolet radiation therapy (phototherapy).

The importance of eczema treatment

There is growing evidence that allergens introduced into the body through the skin can lead to the later development of food allergy, asthma and hayfever. Treating eczema in children aggressively and taking steps to restore normal skin barrier function might lower the future risk of these conditions.

Where to get help

• Your doctor
• A specialist dermatologist referred by your doctor
• Pharmacist
• Your local Maternal and child health nurse
• Eczema Association of Australasia Tel. 1300 300 182 or (07) 3206 3633

Things to remember

• Atopic dermatitis (commonly called eczema) is a type of inflammatory skin condition with symptoms including dry, itching and reddened skin patches.
• Eczema is not contagious.
• Avoiding triggers such as contact with irritants in the environment, heat and (in rare cases) particular foods is advised.
• If your eczema becomes worse, see your doctor.

You might also be interested in:

• Aromatherapy.
  
• Ayurveda.
  
• Breathing to reduce stress.
  
• Chinese herbal medicine.
  
• Eczema - coping tips.
  
• Eczema treatments.
  
• Homeopathy.
  
• House dust mite.
  
• Latex allergy.
  
• Skin explained.
  
• Staphylococcus aureus - golden staph.
  

Want to know more?

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St Vincent's Hospital Melbourne

Last reviewed: May 2011

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Atopic dermatitis, or eczema, is a skin condition that usually appears in early childhood and affects people with a genetic susceptibility. The skin becomes red, dry and itchy and may weep. Damage to the skin barrier allows moisture to escape and allergens and infection to enter. In response, the immune system produces skin inflammation. Eczema is not contagious.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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