Atopic eczema is a common skin condition which causes dry, red, itchy skin. In fact, it’s the most common inflammatory skin condition in the world.
Atopic eczema is a common skin condition which causes dry, red, itchy skin. In fact, it’s the most common inflammatory skin condition in the world.
The word eczema comes from the Greek word ‘to boil’ – used to describe the itchy, red, dry skin linked with eczema, so this is a condition that’s been around since ancient times.
Dr. Ann Nainan of Healthily says: “If you have dry cracked skin, it can be very sore, which makes doing your usual tasks like housework hard, and if your rash is visible it can make you anxious about your appearance. Although there’s no cure, there are many effective treatments and self-care tips you can try at home, so make sure you treat it as soon as possible.”
The word ‘atopic’ is used to describe a group of conditions caused by allergies, such as eczema, asthma and hay fever. These conditions are linked together by an overactive immune system. You’re more likely to get atopic eczema if you or your family members have one of these atopic conditions, as they often occur alongside each other.
As a child, you may remember days when you were constantly itching and had a red, dry, irritated rash. This is because atopic eczema is most common in children, but as you get older you can often outgrow the condition. There are different types of eczema and the type you have will affect how it looks, where it occurs and the best treatment for it.
Atopic eczema affects
, with recent studies showing that around 4% more women are affected – it’s often triggered by hormonal changes. Women also seem more likely to get more severe eczema.The constant itching can lead to sleepless nights and difficulty concentrating, as well as impacting your emotions. Young people in particular can feel self-conscious about their dry skin and scars.
But there are many treatments you can use to ease your symptoms, including self-care, treatments you can buy from the pharmacy and prescriptions from a doctor.
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.Common symptoms of atopic eczema include:
How it looks and the parts that are affected might vary depending on the color of your skin. With eczema on black skin or darker skin tones, it might be harder to see and look brown, purple or gray. If you have a lighter skin color, eczema usually looks redder.
How your eczema looks and feels will often depend on the parts of the body it's affecting. If it's on areas of your body exposed to more triggers, like your hands or face, you might notice more symptoms. Scratching, especially at night, can make it difficult to sleep, make your skin bleed and cause infection.
If your eczema gets worse over time it might become thicker (referred to as lichenification). This is more likely to happen if you have darker skin.
People with eczema can feel very self-conscious about their appearance, as well as find daily life more difficult.
Alice was worried people thought she had lice or scabies and was “dirty”. She said “the itchiness can be frustrating” and trying not to scratch can feel like “a battle of willpower.”
Molly struggled with both the impact of her eczema and the scars: “There was one year when my eczema was really bad and then it scarred that summer, and I was as insecure about the scars as I was when the eczema was visible.”
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.You may notice patterns as to when your eczema flares up, which may be linked to your lifestyle and diet. It's important to note these down as this will help you work out your triggers, so you know what to avoid.
You might have wondered “is eczema genetic.” The answer is yes, you’re more likely to get dry skin and have a higher risk of developing atopic eczema because of your genes – research has shown about 70% of people with atopic eczema have family members with the condition.
There’s no single known cause for atopic eczema, and it's not completely understood. It's thought to be linked to a complex range of factors including:
This combination means your vital skin barrier is more vulnerable and unable to retain moisture or prevent irritants, allergies and skin bugs from entering your skin. So your skin tends to feel more dry and itchy, is more likely to get inflamed and is more susceptible to allergens.
A flare-up is when your eczema gets worse. You’ll usually have periods when it’s better, too. Sometimes, it can flare up as often as 2 or 3 times a month.
How long the flare lasts will depend on lots of factors like how severe it is, where it is and how quickly you start treatment.
Triggers for a flare-up can include:
The severity of your eczema can affect how it feels and looks. But if you treat eczema early, before it becomes severe, it’s usually much easier to manage.
Once your eczema has improved, you could still be left with darker or lighter skin for a time, which is often more obvious in darker skinned people. This is usually a result of inflammation, but the skin will usually return to its normal color over time.
There are eczema causes that are specific to women and often, hormones can be involved. Women may find that their symptoms are worse before a period or related to pregnancy, for example.
Carol Kim, 28, had atopic eczema most of her life and could usually manage it with steroid cream. But following the birth of her child she said “the skin all over her face was flaking, itching and painful” and her pregnancy eczema meant she couldn't sleep or complete her daily activities.
Whilst some people experience a worsening of their eczema during pregnancy, others actually find it improves. But after the baby’s born, all the hand washing and cleaning that comes with nappy changes can also cause eczema to flare. Be sure to get any new itching in pregnancy checked out by a doctor, in case there’s another cause.
You can have eczema anywhere on your body. You might notice it more commonly in areas such as your hands, especially your fingers, the inside of your elbows, wrists, the backs of your knees, the face and the scalp.
You may have mild eczema, with small patches of dry skin. In more severe cases, you can also develop a rash that covers large parts of your skin and is really itchy.
It’s also possible to get breast eczema or nipple eczema. In some cases, nipple eczema can appear independently, but it’s more likely if you have a history of eczema. If you have a flare-up of nipple eczema it’s often itchy and painful, especially if you’re breastfeeding.
See a doctor if you get nipple eczema, particularly if it’s only on one side – in rare cases, it can be a sign of a rare type of breast cancer called
.Female genital eczema can be very uncomfortable. Let’s be honest – anything affecting your genitals can feel very uncomfortable, but things can be even worse with eczema, because of the itching and soreness.
There are a range of conditions that can affect your genital area, so it's always better to speak to your doctor, who can diagnose genital eczema, if that’s the cause. It's always worth considering an STI screen as well, especially if you've recently had unprotected sex.
If you have eczema, the irritation can be caused by sweating, the clothes you wear, and the friction as it rubs. Any skin care products used around the area can also trigger flare-ups, such as personal deodorants, feminine wipes and shower gels.
It's always best to stick to washing with just simple water and a soap substitute if you have eczema, to stop your skin from getting too dry.
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.It's not always easy to tell them apart, especially in children.
Psoriasis tends to cause well-defined, thick, red scaly patches in areas like your outer elbows or fronts of the knees, but it can also be on other areas of your body. Whereas eczema tends to be in the creases of your joints, such as your knees and your elbows.
The conditions also have different complications – in psoriasis, you can get nail changes and related joint problems called psoriasis arthritis. Eczema tends to cause intense itching, whereas psoriasis tends to be milder itching.
A doctor can usually tell the difference by asking you about your symptoms and seeing where it is on your body.
The simple answer is no. Atopic eczema isn’t infectious and cannot be passed on, even through skin contact. But if you have an eczema flare-up, it's good to avoid close skin contact with someone with an active cold sore, as this could lead to complications.
Aside from atopic eczema, other types include:
A pharmacist can recommend over-the-counter steroid creams like hydrocortisone and emollients (medical moisturizers), which can control symptoms.
If a treatment is not helping, it’s better to see a doctor, who will be able to increase the doses and strength of medication, if needed, or talk to you about an alternative diagnosis.
In some cases, your pharmacist may suggest treatments if they think you have a mild infection. These could include antiseptic or anti-fungal creams. They will also advise you to see a doctor if they are worried, or if the treatments don’t help.
As eczema can affect your daily life, it's important to see a doctor if it’s disrupting your routine and lifestyle. It's also important to see a doctor if your eczema is getting worse, or you’re getting complications, and if self-care hasn’t helped.
Some of the complications develop quickly, and some develop over a longer period, like thickened skin. In some cases, your atopic eczema might be infected and you’ll need to see a doctor.
Common symptoms of infections to watch out for, are if your skin:
If you have a severe infection you might start to feel hot and shivery and very unwell. If you think you have a severe infection, such as cellulitis or sepsis, go to the emergency department immediately, or call an ambulance.
If your eczema is affecting your self-confidence, you might consider getting psychological support, including counseling. The
can also be a great place to get help and support.There are lots of different causes of a rash, so to get diagnosed with eczema (atopic), the doctor will usually ask questions and look at any rashes you have.
They will also ask about your symptoms, the impact this is having on you and other conditions which could be linked, like asthma, hay fever and your family history. This will help to identify any triggers or patterns.
Common criteria for an eczema diagnosis includes:
You may be advised by your doctor to keep a food diary if you’ve noticed any food triggers. In some cases, you may be referred to a specialist like a dermatologist, who can do further tests, if needed, like allergy tests to identify more triggers.
The best eczema management usually involves a combination of lifestyle changes, as well as medications.
Moisturizers, known as emollients, are the most important part of the treatment process for eczema. They should be applied frequently and used instead of soap in the shower.
There are lots of different emollients available to buy and they vary in how they feel, how they look and how greasy they are. Usually, the best one to use is the greasiest one you can, but it’s also really important to find one you like. Sometimes a doctor or pharmacist may recommend an emollient with an antiseptic if you are getting a lot of infections.
Remember to take care when near any open flames and avoid cigarette smoking, as emollients contain oils that can easily catch fire.
If your atopic eczema is severe your doctor may prescribe:
You may need to see a specialist dermatologist if your symptoms are not under control with regular treatments, if you need to keep coming back for treatment, or if you’re using steroid creams very often.
Specialist treatments include:
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.