Understanding Eczema – Causes and Symptoms
Eczema, also known as atopic dermatitis, is a common skin condition characterised by red, itchy, and inflamed skin. It is caused by a combination of genetic and environmental factors, resulting in increased inflammation of the skin and a weakened skin barrier that is more susceptible to irritants and allergens.
Common symptoms of eczema include:
- Dry, sensitive skin
- Red, inflamed skin
- Itching
- Dark-coloured patches of skin
- Rough, leathery, or scaly patches of skin
- Oozing or crusting
- Swelling
General Lifestyle Measures for Eczema Management
Taking care of your skin and overall health can have a significant impact on managing eczema. Here are some general lifestyle measures that may help:
Keep your skin moisturised: Apply a fragrance-free moisturiser regularly, particularly after bathing, to lock in moisture and protect your skin barrier.
Avoid triggers: Identify and avoid common eczema triggers, such as harsh soaps, fragrances, essential oils, certain botanical ingredients, certain fabrics, and allergens like dust mites or pollen.
Maintain a healthy diet: Eating a well-balanced diet rich in fruits, vegetables, and whole grains can help support your skin and immune system.
Manage stress: Stress can exacerbate eczema symptoms, so practice stress-reducing techniques.
Keep your nails short and clean: This can help prevent skin damage from scratching.
Skincare for Eczema Relief
Suitable skincare is crucial for managing eczema symptoms. Here are some tips to help you maintain healthy skin:
- Choose gentle, fragrance-free cleansers and moisturisers designed for sensitive skin.
- Avoid hot showers or baths, as they can strip your skin of natural oils.
- Pat your skin dry after showering or bathing instead of rubbing.
- Use a humidifier in your home to maintain a healthy humidity level.
Treatments for Eczema
Medical treatments may be necessary is eczema is not controlled with skincare and lifestyle measures. Your GP or dermatologist may recommend one or more of the following treatments:
- Topical corticosteroids
- Topical calcineurin inhibitors such as tacrolimus
- Short courses of cortisone tablets
Specialised Treatments for Eczema
For more severe cases of eczema, specialised treatments may be necessary. Your dermatologist may recommend one or more of the following treatments:
Phototherapy
Phototherapy, also known as light therapy, is a proven and effective treatment for managing eczema, particularly when topical treatments are not sufficient. During phototherapy, the affected skin is exposed to controlled amounts of ultraviolet (UV) light, which can help reduce inflammation, itchiness, and improve the overall appearance of the skin.
There are several types of phototherapy used to treat eczema:
- Narrowband UVB (NB-UVB): The most common and thought to be the safest form of phototherapy for eczema, which emits a specific wavelength of UVB light that is less likely to cause sunburn.
- Broadband UVB (BB-UVB): An older form of phototherapy that uses a wider range of UVB wavelengths, which may be less effective and have a higher risk of side effects compared to NB-UVB.
- UVA1: A form of phototherapy that emits long-wave UVA light, which penetrates deeper into the skin and is less frequently used.
Phototherapy treatment typically involves multiple sessions per week for several weeks, with the frequency and duration determined by your dermatologist based on your specific condition and response to treatment. While phototherapy is generally considered safe, potential side effects may include skin redness, burning, and an increased risk of skin aging and skin cancer with long-term use. It is essential to discuss the risks and benefits with your dermatologist before starting phototherapy treatment.
Phototherapy treatments are bulk billed at Melbourne Skin & Dermatology.
Other Treatments: Dupilumab, Upadacitinib, and More
In some cases, advanced treatments may be necessary to manage moderate-to-severe eczema that has not responded to traditional therapies such as cortisone creams and phototherapy. These treatments include:
- Dupilumab: A biologic medication that works by blocking specific proteins (interleukin-4 and interleukin-13) that contribute to inflammation and eczema symptoms. It is administered via subcutaneous injection, typically every two weeks.
- Upadacitinib: An oral medication that inhibits Janus kinase (JAK) enzymes, which play a role in inflammation and immune response. Upadacitinib is typically prescribed for moderate-to-severe eczema when other treatments have not been effective.
- Methotrexate, cyclosporin, mycophenylate and azathioprine: These are traditional oral medications that suppresses the immune system and reduces inflammation, which can be helpful in managing severe eczema.
As with any medication, there may be side effects, and it’s essential to discuss the risks and benefits with your dermatologist before starting treatment.
When to See a Dermatologist
If you’re struggling with eczema symptoms despite following lifestyle measures and skincare tips, you may wish to consult a dermatologist. They can evaluate your condition, identify potential triggers, and recommend appropriate treatments, including specialised and advanced options if necessary.