Treating eczema: the power of knowledge
Eczema Without good management, life with eczema can be desperately miserable – but being informed means the scratch can be more easily soothed.
Eczema occurs at all ages and its management and challenges are always different, says Margaret Cox, Chief Executive of the National Eczema Society – who has had eczema her whole life.
But across all experiences of eczema the common challenge is first and foremost the itching, she says. “Living with your skin constantly driving you mad is obviously pretty miserable, and has an impact on your entire quality of life,” says Margaret. “And then the connected challenge is that eczema is so often dismissed as just a bit of dry skin – and only really if you have experienced it do you know just how wrong that is.”
“The example I always give is that most of us know sunburn and its discomfort – if you imagine that you have that every single day without doing anything to get it, it gives you some idea of what eczema is like. Of course, the majority of those with
eczema are children, for whom it can be even harder.” Most eczema will respond to good management – however, that can be difficult to achieve, Margaret points out.
The first-line treatment is obviously to moisturise using a medical moisturiser known as an emoillient – if you have eczema your skin is much drier than other people’s and the skin’s barrier is not working as well, so irritants and allergens which other people do not notice penetrate that barrier and set up an immune reaction, which sets up further skin breakdown causing irritation and itching – and setting up a vicious cycle. Moisturising means anything from twice a day to up to eight times daily, Margaret says, and knowing how to use them is important – smoothing on downwards following hair growth, and using the right emollient for you.
“Over my 51 years of having eczema I have learnt that I have needed different emollients for different times of year and different parts of the body – there’s quite a science to this moisturising,” she laughs.
People tend to use less than they need and not everyone manages to access all the creams and lotions they need on prescription where sometimes a ‘one size fits all’ approach can prevail, points out Margaret. Many people also wrongly stop treatment use prematurely, as soon as they see a relief. It is important leave a gap of at least 20 minutes between applying the emollient and a steroid cream - “people underestimate how much time we lose to treatment”.
For some people a topical steroid will also be needed – many are frightened of but when used properly has a good safety profile, Margaret points out, and if people do not respond to creams there is additional treatment available orally, from a steroid to immuno- suppressants. “Accept that eczema is an individual condition – triggers and responses to treatment will vary, so know what works best for you - and don’t give up.”