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February 12, 2018

Top Tips for Managing Eczema

Top Tips for Managing Eczema

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We explore dry skin conditions and how you can keep flare-ups to a minimum

What causes skin complaints such as eczema and psoriasis?

Eczema and psoriasis are chronic skin conditions with no one cause. They are both inherited skin conditions so the main cause is genetic. Eczema and psoriasis both have many trigger factors that are responsible for the flaring of both conditions. Common triggers for eczema may include: irritants on the skin including soap, detergent and fragrance, overheating, climate, inhalant allergies including house dust mites, tree/grass pollen. Common triggers for psoriasis may include: injury to the skin, some medications, infection, hormonal changes and stress or anxiety.

What is the difference between eczema and psoriasis?

Eczema and psoriasis are separate skin conditions, most people have either eczema or psoriasis but a small number of people have both. They are both skin conditions with defects in the immune system and skin barrier; but the immune pathways are different. Eczema affects the skin barrier (startum corneum), as the skin is not able to produce as many fats and oils which results in being less able to retain water. This means the skin, as a protective barrier is compromised and gaps open up between the skin cells and moisture is lost through the skin from the deeper skin layers. This means that bacteria, irritants and allergens are able to pass through the skin, which irritates the skin and causes eczema to flare. In psoriasis the stratum corneum is affected in an opposite way, it is thickened, as the skin replacement process speeds up, taking just a few days to replace skin cells that usually take 21-28 days. This accumulation of skin cells builds up to form raised ‘plaques’ on the skin, which can also be flaky, scaly, red on Caucasian skin, darker patches on darker skin tones. Eczema and psoriasis can both affect any part of the body, classically eczema is seen on skin creases and psoriasis on outer parts of skin (i.e. elbows, knees, the scalp and lower back), both conditions are itchy.

What happens when you don’t keep eczema moisturised?

People with eczema need to keep their skin well moisturised by using emollients (medical moisturisers) at least twice a day. Emollients are used to treat eczema and a good skincare routine, using emollients for both washing and moisturizing the skin, soothes, protects and repairs the skin barrier, which can also help reduce itch and eczema flares. If a person with eczema does not moisturise, their skin will be constantly dry and itchy, it could also crack and infection could become a complication. Dry skin is always itchy skin, which is scratched and then damaged, which results in an eczema flare. This is known as the itch-scratch-damage cycle—the first point at stopping this cycle form developing is to keep eczema well moisturised to prevent dry and itchy skin.

Can diet have a positive/negative on skin conditions?

A healthy well balanced diet with plenty of fresh fruit and vegetables and a good daily fluid intake will always have a positive effect on any skin condition. Diet is a huge topic and the public is always very keen for information on diet and skin conditions. Current research has not found a link between diet causing a negative effect on psoriasis, nor does any specific diet show a positive effect on psoriasis.

Many parents and adults with eczema question whether food is the cause of eczema. It is true that food can cause allergies, although generally in children under 2 years, and less commonly in older children/adults, though not unheard of. It is important to keep bearing in mind that food is unlikely be the sole trigger for eczema. So the estimation is that approximately 10 percent of children with severe eczema have food as an aggravating factor, this would be a diagnosed food allergy. If an older child or adult with a skin condition is concerned that diet may be having a negative effect, it is best to keep a food diary for six weeks to try and identify any individual food triggers.

Do people with eczema have to wear special clothes?

People with eczema have sensitive skin, which is easily irritated. It is recommended that natural fibers, such as viscose, cotton, bamboo and silk be worn next to the skin, rather than man-made fibers or wool. There are some special clothes for eczema, which can be purchased and, in the UK, in very severe cases may be prescribed. These include viscose and silk garments with in-built mittens and feet for babies and young children as well as a range of other garments. These clothes are also useful as a layer next to the skin under synthetic school uniform. Special clothing is also used to prevent damage form the itch-scratch-damage cycle.

Does the weather have an effect on eczema?

Yes, changes in climate and the weather are common triggers for people with eczema. Hot, sunny weather increases sweating, which can cause more irritation and itching. Cold weather with less humidity causes skin to become drier. Some people find their eczema is better in the summer months, but for others the sun can be a trigger. Moving between different temperatures, from the cold outside to a centrally heated inside can also be a trigger.

Does childhood eczema eventually go away?

Childhood eczema, also known as atopic eczema (or dermatitis) is very common in childhood – in the UK around 20 percent of children under 11 years of age develop eczema. Eczema improves in about two-thirds of children but one-third will continue to have it – this is why it cannot be said that children will ‘grow out of eczema’ and it does not, for all ‘eventually go away’. Even if eczema gets better in childhood, it can return during the teenage years or adulthood, sometimes as a different type of eczema.

What more extreme treatments are when moisturizing alone doesn’t work?

Moisturising is an eczema treatment, which is ongoing and part of daily management to prevent dry skin. Eczema treatment refers to creams or ointments, which are used when eczema is red, sore and itchy – called an eczema flare. The first-line topical treatment for eczema, recommended in NICE and UK dermatology guidelines are topical steroids. These come in four different strengths, mild, moderate, potent and very potent, so are regular treatments apart from the very potent steroid, which may be described as a more extreme treatment. Other treatments, prescribed by dermatologists and generally for adults only (sometimes older children) are phototherapy, immunosuppressant drugs and in the near future, biologic therapies.

Ganodex is an effective cosmetic cream with natural ingredients that is proven to provide relief from itchy, irritated, and scaly skin.   Customers describe their improved confidence as they bring out the best in their skin.  Based on feedback and trial data over several years1, over 85 percent of Ganodex testers or users reported an improvement in their psoriasis, and an even higher proportion with their eczema.  The cream is quickly absorbed, has a honey aroma, and is non-greasy after application.

1. GlycaNova data on file (2013-2017) including dermatologist studies and TalkHealth 2017 reviews.