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Your Skin 2020

Everyday tasks can be painful with eczema

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Andrew Proctor

Chief Executive, National Eczema Society

Most people have heard about eczema, but few realise just how difficult and painful it can be. The skin is often unbearably itchy and uncomfortable, and the relentless daily challenge to care for it can be exhausting.

For some people with eczema, doing everyday tasks like cooking or even bathing can be extremely painful, because the skin is so cracked, sore and raw. Alongside the painful physical symptoms, many children and adults experience related sleeplessness, low self-esteem, bullying, anxiety and other mental health problems.

Eczema is a serious, debilitating, long-term medical condition that has a huge impact on millions of children, adults and their families. The most common form, atopic eczema, affects one in five children and up to one in 10 adults in the UK. Around a third of those with eczema have either moderate or severe symptoms.

Eczema and dry skin

Using emollients is essential to help repair and protect the body’s natural skin barrier and reduce the itch associated with eczema. Skin is made up of several layers, each containing skin cells, water, oils and fats. Together, these help maintain and protect the condition of the skin.

If you have eczema, your skin is less able to retain water. Gaps open up between the skin cells and the protective barrier doesn’t work as well as it should. Moisture is lost from the deeper layers of the skin, allowing bacteria or irritants to pass through more easily. Emollients are therefore needed to repair and protect the skin barrier, to stop the skin from drying out and being damaged.

If you have eczema, your skin is less able to retain water. Gaps open up between the skin cells and the protective barrier doesn’t work as well as it should

How should emollients be used?

Emollients should be used for moisturising the skin several times a day, and for washing, even when the skin isn’t red and inflamed. Emollients come in various forms, lotions, creams, gels and ointments. People with eczema often need more than one kind of emollient, depending on the dryness of your skin, the part of the body affected and the time of year.

NHS emollient rationing

Having a good skincare routine is crucial if people are to self-manage their eczema well, and in doing so reduce the need for more expensive medical treatments.

It is not always straightforward to find the right emollient with such a wide range of products available. Different emollients suit different people and finding the best ones for you usually involves some trial and error. The best emollients are the ones that people are willing to use regularly because they work best for them.

This is why National Eczema Society is so concerned about moves by the NHS to restrict the availability and range of emollients on prescription, for both children and adults. We hear from many people that they are having their emollient prescriptions changed, reduced or stopped.

NHS England prescribing guidance on leave-on emollients says that emollients can be prescribed for people with eczema. Even so, this is not always followed. The Society has produced its own guidance for people on how to advocate with their GP or nurse for access to emollients on prescription, citing the research evidence and clinical guidelines.

The Society is also hugely concerned about the latest moves to stop making bath emollients and therapeutic silk garments available on prescription, including for people with more severe eczema. Despite strong feedback from patients and compelling research evidence, decision makers are seemingly not listening.

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