What Are The Different Severities Of Eczema

What Are The Different Severities Of Eczema?

What is eczema?

Eczema, or atopic dermatitis as it is also known, is the most commonly diagnosed inflammatory skin disease in the world, affecting up to 3% of adults and up to 20% of children1.  The physical symptoms and the toll it can take on our emotional wellbeing can be severe, but the cost of treatments and missed days at school or work can add up for the sufferer, their family and the healthcare industry as a whole, especially for more severe cases2

Eczema is a chronic condition that has no known cure. It may continue into adulthood for some people, but many cases may improve or clear up during childhood3. Key symptoms of the disease include intense itch, dry sensitive skin, and the presence of inflamed lesions on parts of the body such as the joints4

The severities of eczema

Eczema is broken up into three distinct grades of severity: mild, moderate and severe. Mild eczema is classed as just perceptible, meaning the symptoms are apparent just enough to diagnose the disease; moderate eczema is classed as obvious, so the symptoms are clear and apparent; and severe eczema is when, as the name suggests, the symptoms are severe5.

There are numerous tools for assessing and grading eczema severity, with the two most common being Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI)5. These tools all work in a similar way, and assign numbers to areas affected by eczema, with higher numbers denoting a greater presence of the disease. These numbers are based on the severity of the symptoms, such as itch, redness and inflammation.

For example, the SCORAD tool grades eczema severity as follows6

Subjective SCORAD is based on the sufferer’s perception of the severity of the disease, whereas objective SCORAD is based on a doctor’s perception.

How are the different severities of eczema treated?

As it has no cure, successful treatment strategies for eczema relies heavily on the management of symptoms. Treatment options that are common to all severities of eczema includes the use of unperfumed moisturisers, or emollients, alongside short-term topical corticosteroid use to control flare-ups3. The reason that unperfumed moisturisers are recommended is because fragrance is a common irritant, and this should obviously be avoided for a sensitive skin condition such as eczema. More treatment options are recommended as the severity of eczema increases, from wet bandaging to pharmacotherapy, or the use of systemic medications.

By Ian Harrison BSc (Hons), PhD.

Ian is Ego Pharmaceutical's Scientific Communications Manager. He is a medical scientist and communicator with a bachelor's degree and PhD in Pharmacology, and over a decade's worth of experience across research and industry.

Recommended Products

  • QV Dermcare Eczema Daily Cream With Ceramides

    Intensely hydrating moisturiser for symptomatic relief of mild to moderate eczema.
  • QV Dermcare Eczema Daily Wash With Ceramides

    A pH-balanced cleanser for the face, body and hands for symptomatic relief of mild to moderate eczema.
  • QV Dermcare Sting-Free Ointment

    Ointment-based moisturiser with ceramides to help soothe dry, cracked skin without stinging.
  • QV Flare Up Bath Oil

    For relief of atopic eczema skin flare ups.

References:

1. Avena-Woods C. Overview of atopic dermatitis. Am J Manag Care 2017;23(8 Suppl):S115–23.

2. Chung J, Simpson EL. The socioeconomics of atopic dermatitis. Ann Allergy Asthma Immunol 2019;122(4):360–6.

3. National Institute for Health and Care Excellence. Atopic eczema in under 12s: diagnosis and management [Internet]. 2007 [cited 2019 Mar 12]. Available from:

https://www.nice.org.uk/guidance/cg57/resources/atopic-eczema-in-under-12s-diagnosis-and-management-pdf-975512529349

4. Sweetman SC, editor. Eczema. In: Martindale - The Complete Drug Reference. London, Chicago: Pharmaceutical Press; 2009. page 1579.

5. Chopra R, Vakharia PP, Sacotte R, Patel N, Immaneni S, White T, et al. Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atopic Dermatitis Severity Index and body surface area in adolescents and adults with atopic dermatitis. Br J Dermatol 2017;177(5):1316–21.

6. Clinical Guidelines (Nursing) : Eczema management [Internet]. [cited 2021 Mar 3];Available from:

https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Eczema_management/