Eczema

Managing Eczema

Eczema, or atopic dermatitis, is a common skin condition characterized by dry, itchy, and inflamed skin. While it can be challenging to manage, understanding triggers and following a structured treatment approach can help control symptoms effectively.

Lifestyle Measures

1. Moisturise Regularly:

   • Use emollients (moisturisers) frequently to keep the skin hydrated. Apply moisturisers at least twice daily and after washing.
   • Choose fragrance-free and hypoallergenic products to minimize irritation. Look for thicker creams or ointments, which may be more effective than lotions.

2. Avoid Scratching:

   • Scratching can worsen eczema and lead to infections. Keep nails short and consider wearing cotton gloves at night if scratching is a problem.

3. Take Short, Lukewarm Baths or Showers:

   • Hot water can strip the skin of natural oils. Use lukewarm water and limit bath time to 10-15 minutes.
   • After bathing, gently pat the skin dry and apply moisturiser immediately to lock in moisture.

4. Choose Gentle Cleansers:

   • Use soap substitutes or gentle, non-irritating cleansers. Avoid products with fragrances, alcohol, or harsh chemicals. These can be bought directly and include cetraben  or QV gentlewash.

5. Wear Soft, Breathable Fabrics:

   • Opt for cotton clothing and avoid wool or synthetic fabrics, which can irritate the skin.

6. Manage Stress:

   • Stress can exacerbate eczema. Consider relaxation techniques such as deep breathing, yoga, or mindfulness to help manage stress levels.

Avoiding Common Aggravating Factors

• Allergens: Identify and avoid allergens that may trigger your eczema, such as dust mites, pollen, pet dander, or certain foods.
• Heat and Sweat: Hot weather, sweating, and humidity can worsen symptoms. Dress appropriately and stay cool.
• Irritants: Limit exposure to irritants like detergents, soaps, and cleaning products. Use rubber gloves when handling these substances.
• Environmental Factors: Use a humidifier in dry environments and avoid rapid temperature changes.

Treatment Ladder for Eczema in the UK

1. Emollients (Moisturisers):

• Start with regular application of emollients as the first line of treatment. They help to maintain skin hydration and prevent flare-ups. Suitable products include epaderm, aveeno, zerocream, doublebase gel, or E45 cream.

2. Topical Corticosteroids: NHS Topical corticosteroid information

• If emollients alone are insufficient, topical corticosteroids can be introduced to reduce inflammation and itching. These should be applied to affected areas as directed.
•  A mild steroid suitable for sensitive areas (e.g., face, genitals).
•  A medium-potency steroid for more significant flare-ups.
•  A stronger steroid for severe eczema or stubborn areas.

Application Guidelines:

• Apply a thin layer to affected areas, usually twice daily, for a short period (up to two weeks).
• Gradually reduce the frequency as symptoms improve.

3. Topical Calcineurin Inhibitors:

• If corticosteroids are not suitable or if long-term use is a concern, tacrolimus (Protopic) or pimecrolimus (Elidel)may be prescribed. These medications help reduce inflammation without the side effects of steroids.

4. Systemic Treatments (Require a referral to the dermatologists)

• For severe or persistent eczema that doesn’t respond to topical treatments, your GP may consider referring you to the dermatologists to consider systemic therapies, immunosuppressants, or biologics.

When to Seek Medical Advice

• If symptoms do not improve with over-the-counter treatments or if eczema becomes severe or infected (signs include increased redness, warmth, pus, or fever), consult your GP using Anima
• Regular follow-ups may be necessary to monitor treatment effectiveness and adjust the management plan.

Managing eczema effectively involves a combination of lifestyle measures, avoidance of triggers, and a stepwise approach to treatment. Starting with emollients and progressing to topical corticosteroids or other treatments as needed can help control symptoms and improve quality of life. Always consult your healthcare provider for personalized advice tailored to your specific needs.