Eczema

What is eczema? A medical overview

Eczema is a skin condition which often affects children and young people, although it can occur at any age. Some children ‘grow out’ of having eczema when they get older but this is not always the case. Eczema can affect different areas of skin on a person’s body. Common sites for eczema include the hands, scalp, inside of the elbows and behind the knees, but it is possible to have eczema on any area of skin including the genitals.
There are different types of eczema and the main symptoms are itchy, dry and sore skin. Eczema is not infectious and it cannot be passed to other people. However, because there is often broken skin with eczema, the skin can more easily become infected. Scratching itchy skin can introduce bacteria, viruses or fungi. Medical treatments, such as antifungal treatments and antibiotics, may be needed to clear up these infections.
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The causes of eczema are complex and they are not the same in all people with the skin condition. Normally the top layer (the epidermis) of the skin helps keep in moisture and natural oils. However, with eczema, there are changes in the surface of the skin which means it does not work as well as a barrier. This makes it difficult to keep this moisture in, making the skin dry. Things which irritate the skin can add to the problem by damaging the skin further and making it more likely that the skin will react badly to any irritants. The immune system (which helps resist against infections) may work differently in people who have eczema, by ‘over-reacting’ to normal things in the environment.
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A ‘flare-up’ describes when someone’s eczema is more severe and irritated than usual. A trigger for one person’s eczema may not be a trigger for another person’s. For atopic eczema, triggers can include pollen, dust, mould, animal fur and some types of foods.
There are different medical treatments available for eczema. Some types of treatment can be bought from a shop (‘over-the-counter’), such as emollients. Other treatments must be prescribed after visiting a medical professional such as a General Practitioner (GP), nurse or dermatologist. Regular use of leave-on emollients (medical moisturisers) and sometimes bath oils or soap substitutes can help manage the condition. Other treatments can help with flare-ups or if a person’s eczema is severe, such as topical steroids (applied to the skin), immunosuppressant creams/ointments, immunosuppressant tablets and phototherapy (light therapy).

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