ECZEMA

What is eczema?

Introduction

Eczema is a condition that makes patches of your skin become dry, red and itchy. Scratching can make the skin bleed. It can also make the eczema worse. Sometimes the skin becomes thick and scaly.

If you have a child with eczema, there's a good chance they will grow out of it. But some people have eczema all their life. There's no cure for eczema, but there are many treatments that can help with the itchiness and inflammation. There are also things you can do at home to keep eczema under control.

There are several types of eczema. The most common type is atopic eczema. If a condition is described as atopic, it means that it's caused by an allergy. The information here is about atopic eczema, but we just call it 'eczema'.

Key points about eczema

• About 60 in 100 children who have eczema grow out of it or get milder symptoms as they get older.
• Some people have mild symptoms that last a few days at a time, while other people may have more severe symptoms that last longer or never go away completely.
• Eczema can be irritating and painful, but it shouldn't prevent you or your child from taking part in normal activities.
• There are good treatments that can help keep symptoms under control.
• If you or a relative have eczema, and you've had a baby, you may be able to prevent eczema in your baby by breastfeeding and avoiding certain foods.

Your skin

To understand what happens in eczema and how to treat it, it helps to know something about your skin.
• Your skin protects your body from infection and injury. The surface of your skin is made up of a thick layer of dead skin cells. These form a tough barrier that keeps poisons and germs such as bacteria from getting into your body. That barrier also helps to keep in your body's moisture. The dead cells eventually flake off or are washed away. They are always being replaced by new cells that grow from underneath.
• Your skin keeps itself moist and soft so that it can bend and stretch without breaking. The layer of dead cells in your skin holds water, which makes it feel soft. Your skin also makes a kind of thick, oily liquid called sebum that helps it stay moist. Without sebum, the layer of dead cells would dry out and get brittle. When you wash with soap, you take sebum off your skin. This is why your skin and scalp can feel dry after you've washed.

Your skin does many other jobs, too. For example, when it's hot it helps keep your body temperature normal by letting extra blood flow to the surface and by making sweat. Your skin also contains a lot of nerves that give you your sense of touch. When you're in the sun, your skin makes vitamin D.
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The top layer of your skin starts to get flaky and dry.
• When skin is dry and flaky, bacteria and irritants, such as dust or chemicals, can get into your skin. This can lead to an infection and make the itchiness worse. (See Infections and eczema to find out more.)
• Your skin can become thick and scaly, with small raised bumps or blisters.
• If you scratch the blisters, they may ooze and even bleed.
• Scratching makes the itch worse, and this leads to more scratching. Doctors call this the 'itch-scratch' cycle.

What is an allergy?

The type of eczema we talk about here happens because of an allergy. If you have an allergy, your immune system (your body's system for fighting infection) is supersensitive to certain things that are harmless to other people. Your body overreacts when it comes into contact with those things. It triggers changes called allergic reactions.

For example, in eczema your immune system's reaction makes your skin itchy. Other conditions that are linked to allergies are hay fever and asthma. In hay fever, an allergy to pollen makes people sneeze and makes their eyes runny. If you have asthma, something irritates your lungs, making you wheeze, cough and feel short of breath.

Allergies often run in families. But not everyone with eczema has it in their family.
There are other types of eczema that aren't caused by an allergy.

Your immune system

Doctors think that people with eczema might have an overactive immune system. If you have this, your immune system will cause an allergic reaction when you come into contact with certain things that don't bother most people. Things that set off an allergic reaction are called allergens. This is how the cycle of symptoms in eczema usually starts.

Eczema happens differently in different people. Not everyone who has eczema reacts to the same things that trigger flare-ups in others. See Things that can trigger eczema for more information.
Some of the things that can trigger allergic reactions in people who have eczema are:
• House dust mites (their droppings trigger allergies)
• Animal fur, feathers or skin
• Stress
• Some foods.

Researchers aren't certain about the part food plays in triggering eczema. It may be important for some people but not for others. The same is true of stress. For some people, things such as moving to a new house or starting a new job or school cause stress that's tied to eczema flare-ups.

Why me?

Some people are more likely to get eczema than others. It's more common in families where a lot of people have allergies such as asthma and hay fever. Doctors think that eczema is inherited in the genes we get from our parents.

If both parents have eczema, a child has an 80 percent chance of getting it too. If just one parent has eczema, a child's chances of getting it is just over 50 percent.

Eczema and the family

Children who have very bad eczema can get upset about their condition. And parents who are trying to help a child with eczema may find it stressful, too.