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.