What is eczema and how can I treat it?

Published in Medicinewise Living

Date published: About this date

eczema

There is no known cure for eczema, but it can be treated.
Image: Berents /shutterstock.com

One in three Australians will have eczema — an inflammatory condition that causes the skin to become itchy, red, dry and scaly — at some stage in their lives.

Eczema (also called atopic dermatitis) typically follows a pattern of flaring up (getting worse) and then improving. In severe cases, the skin can crack, weep, bleed, crust over or become infected.

There is no single known cause of eczema, but a number of genetic and environmental factors are thought to be involved.

While there is no known cure, eczema treatments aim to heal the skin, and minimise and prevent flare-ups.

How do I get eczema?

You are more likely to develop eczema if you have a family history of eczema, asthma or hay fever. If both your parents have one of these conditions, you have an 80% chance of getting eczema. You can’t catch eczema from another person.

Eczema commonly occurs in babies and children younger than 1 year, but it can occur at any age. Most children who have eczema will grow out of it by the time they are six years old, but for some people eczema may continue into, or begin in, adulthood.

Factors that can aggravate eczema include overheating; irritants like wool, soap, shampoo, perfumed products, chlorinated water; and allergies including dust mites, grass, pollen and pets.

How do I treat eczema?

Treating eczema involves healing and maintaining the skin, and minimising and preventing flare-ups. A health professional can advise you about the most suitable treatment for you and how to use the treatments safely.

Skin maintenance

Maintenance treatments are used every day, whether eczema is present or not, to reduce itching and prevent flare-ups.

Emollients (therapeutic moisturisers) containing ingredients such as dimethicone (e.g. Dimethicream) or liquid paraffin and soft white paraffin (e.g. Dermeze) — not cosmetic moisturisers — soothe and heal sore skin, ease itching, and protect skin from infection and damage (e.g. cracking).

Treating flare-ups

Treat flare-ups as soon as you see the signs (e.g. increasing skin redness, dryness or itching). Gradually stop using them as symptoms improve.

Corticosteroid creams are the mainstay for managing eczema flare-ups as they reduce inflammation and itchiness. They are available in various strengths for different age groups, parts of the body and types of eczema.

Other medicines include:

  • antibiotic creams
  • other creams (e.g. coal tar, icthammol, pimecrolimus)
  • antihistamines
  • corticosteroid tablets
  • immunosuppressants.

Symptom management

Non-medicine treatments include:

  • wet dressings
  • cool compresses
  • bleach baths
  • phototherapy.

Alternative treatments

A variety of complementary and herbal medicines and traditional therapies on the market claim to treat or even to 'cure' eczema. Unfortunately, there is no known cure for eczema. Speak to your health professional before using any medicine.

When should I see a doctor?

Visit your doctor if your, or your child’s, eczema has:

  • started to weep or bleed
  • developed pustules or blisters
  • become too itchy to sleep
  • become painful to touch
  • not responded to usual treatment.

See your doctor if an eczema flare-up is also accompanied by fever, lethargy, being generally unwell, distress (in children), or if you suspect that the rash and symptoms may not be caused by eczema.

Corticosteroid creams myth-busted

Skin thinning from corticosteroid creams is very rare, and won’t happen if the creams are used as directed by your health professional.

Increase in body hair in areas treated with corticosteroid creams is very rare. It only occurs when creams are used for prolonged periods, and is reversible once you stop using the cream.

Scarring, discolouration and other forms of skin damage are far more likely to occur from rubbing and scratching untreated eczema than from using corticosteroid cream.