Dry skin, itchiness, irritated red areas and patches of thickened skin are symptoms of eczema (also called dermatitis), which is an inflammatory skin condition. This inflammatory reaction is triggered by the immune system, and when combined with a compromised skin barrier, it can lead to dry, itchy, and irritated skin that we recognise as eczema.
Epidermal spongiosis and lymphocytic exocytosis
Hyperkeratosis
Lymphohistocytic infiltrate sometimes accompanied by eosinophils
A dermatologist (skin, hair loss and nail specialist) is the best person to treat eczema and help identify individual triggers. Proper eczema treatment requires continual strengthening and protection of your skin barrier, preventing infection, and managing triggers.
Eczema is a non-contagious, long-term condition that currently has no cure. If you live with eczema, it may affect your confidence and comfort in your skin. However, it can be managed effectively with professional advice and evidence-based interventions to feel in control of your triggers and confident in your skin.
To understand eczema, it is important to know the science behind your skin. Made from a delicate balance of water and fats, your skin is an external ‘shield’ that protects the inside of your body from the outside world. Although this shield is robust for many people, if you experience eczema, you lack the fats and oils required within your skin to properly retain moisture. This weakened skin barrier creates a greater risk of drying, cracking and invasion by irritants or infection.
Eczema is also the result of a disorder within your immune system, which are the organs and cells in your body that actively fight off infection. In the case of eczema, your immune system goes into overdrive when it is triggered. Since it is a multi-faceted condition, it can be challenging to feel in control of your eczema without careful and considered treatment.
Eczema most commonly appears on the face, eyelids, hands, legs, scalp and lips. Eczema is often called “the itch that rashes” because the itching frequently begins before the rash appears. Scratching makes the rash worse, and we understand that makes it difficult to alleviate discomfort. If you have a rash that won’t go away, gets crusty or forms a pus-filled blister, you should seek professional advice promptly.
Other skin conditions, such as psoriasis, rashes and fungal infections can also present similarly, so the first step to successfully treating eczema is an accurate diagnosis.
For mild to moderate eczema, the primary goal of treatment is to provide relief from itchiness, calm inflammation and reinforce your skin barrier. The first step is usually introducing a medical moisturiser or cream that is suitable for your skin. Eczema creams keep your skin hydrated to prevent drying, cracking, and improve its protective function. Some eczema creams require a prescription, as they are formulated with specialised active ingredients.
For best results, topical steroids can also be used in short bursts to reduce redness and stop itchiness. It is important to seek a dermatologist’s advice before using a topical steroid for eczema treatment to effectively manage flare-ups. It needs to be prescribed at the correct strength to match your age, eczema severity and affected bodily areas.
For patients with moderate to severe eczema who are not achieving results through current interventions, a more advanced, multi-step treatment plan would be recommended. This can include:
It is important to understand your individual triggers. What causes a flare-up in one person may have no effect on another. Eczema symptoms may appear for weeks to months before disappearing again, which can make it difficult for you to track and manage it on your own. Common triggers can include allergens (such as dust mites, animal hair or pollen) diet, stress, bacterial infection, certain fabrics, and harsh chemicals.
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