Eczema

Also known as: Mate harehare, Atopic dermatitis, Infantile eczema (eczema in babies), Childhood eczema (eczema in children)

• Eczema is a really common skin condition that causes skin dryness, itch, and rash
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• It’s much more common in babies and children with around 15–20% of kids developing eczema but fortunately most kids will grow out of it by adulthood.



• Eczema isn’t contagious. Eczema is not an infection. Your child cannot give eczema to another child, and your child cannot get eczema from another child.



• Hay fever, asthma and eczema are related conditions. People often have more than one.



• In severe cases or during particularly bad eczema flares, skin may blister or weep – in these instances the skin may become infected. 



• While eczema can’t be cured, it can be effectively managed with moisturisers, steroid creams and by avoiding irritants. 



• People who have eczema will have good days and bad days. It’s the nature of the skin condition to be settled at times and flare up at others. 



• Antibiotics can be used if skin infections occur. 


• The exact cause of eczema is unknown – but it appears to be triggered by different causes.
• Eczema is associated with having an impaired skin barrier. That means the skin has less protection against irritants or infection.
• Genetic factors – eczema can run in families
• The most common type of eczema is atopic dermatitis. This tends to run in the family as well as asthma and/or hayfever.
• Some people will experience eczema flare ups as a response to allergens like grass, wool, dust, or cat/dog fur.
• People with eczema often have other allergic conditions, including food allergy, but food allergy does not cause eczema.
• If someone is prone to eczema and their skin dries out, they’re likely to experience a flare up.

Seasonality

• If particular environmental allergens affect a person’s eczema, they may find certain times of year worse than others. For example if dog fur causes flare ups, it may be worse in spring when some dogs start shedding.
• Long, hot showers tend to dry out the skin, so some people may find their eczema is worse during winter when it takes a little more willpower to get out!

In children

• Dry, rough, itchy skin.
• Inflamed red or darker patches of skin.
• Raw, weeping or blistered skin that may have yellow crusting, especially if the child has been scratching.
• A rash across the cheeks – this is most common in babies.
• Dry or inflamed patches on hands, around the neck and/or in the creases of knees and elbows – this is most common in older kids.
• Some kids may have a rash over their whole body.

In adults

• Big patches of red, itchy and even weeping skin, most often found on a person’s wrists, ankles, neck, elbow creases and/or behind their knees.
• Dry or cracked, itchy red patches on hands (hand dermatitis) – this can occur  after coming into contact with irritants and allergens.

For children and adults

• Steroid creams and ointments may be used during flare ups.
• In severe cases, a strong steroid cream may be required. It’s recommended that these should only be used for a few days at a time.
  
• Moisturisers (or emollients) should be used on an on-going basis to keep the skin hydrated. They assist the skin’s barrier, keeping moisture in and irritants out. They work in one of 2 ways: Adding a protection layer onto the surface of the skin. Pulling water to the surface of the skin, from deeper layers.
  

• There are 3 types of emollients: Soap substitutes – these replace regular soaps and are washed off the skin. Bath additives or bath emollients – these are added to the water and leave a film over the skin, protecting it from drying out. Leave-on emollients – these are rubbed into the skin and left on.
  

• Common emollients that are prescribed are; Fatty cream, Urea cream, Paraffin, Cetomacrogol cream, Sorbolene + 10% glycerine
  

• If both a steroid cream/ointment and an emollient are being used at the same time, the steroid should be applied 15–30 minutes after the emollient.
  
• If emollients and steroids don’t work, a person may need to be referred to a dermatologist but usually eczema can be managed by your GP.

Medication

• Topical steroid creams and ointments may be used to get flares ups under control.
• Antibiotics may be used if the skin becomes infected.

For your face, a mild corticosteroid cream or ointment such as hydrocortisone 0.5% or 1% is usually used.

If you don't respond to emollients and steroids for your eczema and continue to have significant symptoms, there are other treatments that may be effective and are available by referral to a dermatologist. These include phototherapy and systemic immune modulators.

Common over-the-counter medications

• Many emollients or moisturisers can be purchased over-the-counter. These include:
• Fatty cream
• Urea cream
• Paraffin
• Cetomacrogol cream
• Sorbolene + 10% glycerine

Proactive protection

• Moisturising the whole body at least once a day can help the skin stay hydrated and prevent flare ups. The best time to moisturise is a couple of minutes after having a shower. The pores will be open and so the moisture will be absorbed better.
• Try to avoid irritants like soaps and detergents.
• Resist the urge to scratch any itches – scratching only makes it worse.
• Avoid scratchy materials like wool.
• Have short daily baths or showers with warm (not hot) water. It’s important to keep the skin clean but not dry it out. When drying off, softly pat your skin with a towel – rubbing may irritate it.
• Antiseptic baths a couple of times a week may also help to relieve your skin or prevent flare ups.

• If your child is starting to show symptoms, take them to a doctor to get a proper diagnosis and a eczema management plan in place.
  
• If you or your child has already been diagnosed with eczema, you should see your doctor if; The eczema is disrupting sleep, It’s stopping you/them from going to school/work, The eczema hasn’t improved after 1–2 weeks of using a steroid cream, The skin becomes infected, Other people in your household develop skin infections

Eczema? Skin issues? Tend doctors can help

If you have eczema or skin issues and would like medical advice without needing to leave the house, you can book an online appointment with a Tend doctor through your app.

After the appointment, your doctor may advise that an additional, in-person appointment is required, to ensure you receive complete care. In some cases, we may require this before administering a prescription.

If this is the case, we'll book you for an in-person appointment at a time that suits you, at no extra charge.

• Eczema flare ups can last anywhere from a day to a couple of weeks.
  
• Often a person’s eczema will improve significantly by the time they reach adulthood. They may even grow out of it completely. Eczema is rare in elderly people.