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Skin Health Q4 2022

Improving the outlook for eczema sufferers

iStock / Getty Images Plus / Aleksei Morozov

Dr. Emma Wedgeworth

Consultant Dermatologist and British Skin Foundation Spokesperson

As the weather gets colder, skin becomes increasingly dry and sensitive. For eczema sufferers, this often translates into worsening of their condition.

Eczema is an inflammatory skin condition characterised by patches of red, flaky, itchy skin. Eczema and dry skin are inextricably linked, so it’s important to tackle dryness as soon as it appears.   

Hydration of the skin is essential for healthy functioning and is controlled by the skin barrier, the outer layer of skin, known as the stratum corneum. Dry skin occurs due to depletion of natural lipids and water holding molecules that hydrate the skin barrier.  

Genetics account for much of the reason why children develop eczema. Eczema goes alongside other conditions such as asthma, hayfever and food allergies. This tendency is known as atopy.  

If both parents have eczema, asthma or hayfever then there is a one in two chance their child will have eczema. Rates of eczema vary significantly across the world. In the UK, it’s estimated 20% of children suffer from it. However, the dramatic rise in eczema in previous decades and the significant variation across the world tells us that genetics alone are not responsible.   

Eczema can impact on children’s physical and psychological health, as well as relationships, school and self-esteem.

Lifestyle interventions  

Day to day skincare habits impact our skin. The pandemic and increased hand washing has resulted in an increase in skin problems and eczema, with over half of young children reporting skin problems with their hands.  

Finding suitable treatments  

Treatment of dry skin, and indeed eczema, starts with gentle skin care. Avoid soaps, harsh washes and detergents. There are newer cleansing formulations, known as syndets, which are much gentler on the skin and don’t disrupt the natural acid mantle. Dry skin requires regular application of unfragranced emollients (moisturisers) to affected skin and can help compensate for increased moisture loss. Optimise your environment as well; lower the indoor heating temperature and consider a humidifier.   

For active eczema, medicated creams such as steroids or other anti-inflammatory creams can usually be used safely and effectively to reduce the itch and discomfort of eczema. In a small proportion of children, creams alone do not control eczema. We have an ever-increasing armamentarium of treatment options to tackle severe eczema. This includes light therapy, tablets and new targeted injections using monoclonal antibodies.   

Eczema can impact children’s physical and psychological health, as well as relationships, school and self-esteem. Increasing understanding of the pathogenesis of dry skin and eczema has led to increased treatment options, and the future is brighter for eczema sufferers.  

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