Eczema. We all seem to either have it, have experienced it, or know someone close to us that has. There is a lot of sometimes contradictory and just plain wrong information going around about this disease and how to manage it, but knowing the symptoms, and having an idea of how it can affect you, can sometimes be half the battle.
Eczema, also known as atopic dermatitis, is the most commonly diagnosed inflammatory skin disease in the world, and can affect up to 3% of adults and 20% of children1. It has no known cure. While it can last into adulthood in some instances, many cases may improve or clear during childhood2. Yet it can be traumatic- physically and emotionally- for sufferers and their families. The pain and discomfort in children with eczema is plain to see, yet the emotion of seeing your child suffer can take a toll on parents too. What’s more, eczema also puts a huge strain on the healthcare industry as a whole3.
Understanding the Skin
As eczema is a disorder of the skin, a basic understanding of how the skin functions is important. Your skin, which is the body’s largest organ, is also its first line of defence to the outside world. It is made up of three main layers: the hypodermis (deepest layer), the dermis (middle layer) and the epidermis (upper layer). The outermost layer of the epidermis, the stratum corneum, forms the protective skin barrier between the inner body and the outer world4.
A properly working stratum corneum is important for maintaining the skins function as a protective barrier and stopping allergens and irritants from entering the body, but is equally important for preventing the loss of crucial moisture from the skin to the outside world. If your skin barrier is not working properly, this can lead to the development or worsening of many conditions, including eczema5.
The Symptoms and Physical Effects of Eczema
While we don’t completely know the exact causes of eczema, we do know the classic symptoms: intense itch that doesn’t go away6,7 and inflamed, dry and scaly skin in areas such as the joints8. In children, we typically see eczema symptoms on the face, scalp and the arms and legs, whereas symptoms usually only involve areas such as the elbow joints and behind the knees in late-childhood or adult eczema9.
People with eczema also tend to be more prone to skin infection, as irritants and allergens can more easily take advantage of the damaged skin barrier and weakened immune function10. As the skin is also dryer with eczema, people tend to scratch more, which damages their skin barrier and, in a vicious cycle, worsens dryness, itching and scratching. This sequence of events is commonly termed the “itch-scratch cycle”11,12.
The Emotional Effects of Eczema
In addition to all the physical effects mentioned above, eczema and the itch-scratch cycle can have severe emotional and psychological effects. Anxiety and depression are often linked with eczema, and these conditions also tend to be worse if the eczema itself is severe13. The itch-scratch cycle can also have other effects too: sleep quality can be noticeably impacted as you toss and turn trying to get comfortable at night, making it harder to function properly at work or school14. As if that isn’t bad enough, infants with eczema may experience issues with early development around touch, which could have a negative impact on their emotional and/ or physical development15.
Eczema is a condition that can be hard to live with, but it can be managed with the right approaches. These include things like avoiding irritating skincare products like soap and fragrance, keeping an eye on your diet and environment, and using skincare products like high quality moisturisers that are designed to help manage dryness and sensitivity. If you are ever in doubt, speak to your pharmacist or GP about management strategies that could work for you.
▪ Eczema is a common skin condition, especially in children
▪ Its key symptoms are inflammation, itch and dry skin
▪ Eczema can have serious emotional effects in addition to its physical effects