Eczema or dermatitis is a condition caused by inflammation of the skin and is characterised by red, itchy, dry skin. Dermatitis can be caused by different processes and is broken down into four main categories; atopic, allergic contact, irritant contact and stasis.
Atopic dermatitis is what most people are referring to when talking about eczema. This is a chronic genetic condition that usually develops in childhood and is caused by a malfunctioning immune response, exposure to allergens and poor skin function. Genetic predisposition to dry skin leads to water loss which weakens the skins barrier function leading to irritation and inflammation which further exacerbates water loss and the cycle continues. It normally affects skin creases; elbows, knees, the neck, hands and eyes.
Allergic contact and irritant contact dermatitis are caused by direct contact with a known allergen (allergy-causing substance) or irritant (this can be chemical or physical) and causes a localised skin reaction.
Stasis dermatitis is caused when blood pools due to poorly functioning veins, this usually affects the legs.
Where possible the first aim is to remove or avoid the cause of the inflammation, this is simpler in allergic or irritant contact dermatitis where a clear trigger can be identified. In atopic dermatitis, where multiple independent factors contribute to the disease this is more tricky, however, altering diet, and avoiding common allergens such as dust mites or house pets can improve symptoms.
Regular use of moisturisers forms one of the cornerstones of treatment. By moisturising the skin regularly you improve the skins barrier function and reduce inflammation. Moisturisers fall into 3 categories; occlusive - block moisture loss, humectants - bind water and emollients - smooth the skin. Use of moisturises is both an effective treatment and preventative measure.
Anti-inflammatory products form the other cornerstone of treatment. These usually come in the form of cream-based (topical) steroids and are usually used over a short-course to break the cycle of inflammation and moisture loss.