Atopic eczema is a frustrating condition that makes the skin red, itchy and flaky. It mainly affects children, but it can occur in people of any age. It is commonly found in areas with folds of skin, such as the inside of the elbows, behind the knees and around the ears. The condition is of unknown cause, but it tends to occur alongside other common conditions, such as hay fever and asthma.

Eczema Atopic

Atopic eczema tends to be a long-lasting condition that flares up periodically and then subsides. In children, the condition often clears up or improves over time. In about half of cases, it clears up by the time a child reaches the age of 11 and in 65 percent of cases, it resolves itself before a child turns 16.

Treating atopic eczema

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There is no cure for atopic eczema, but treatments and self-help measures can go a long way towards treating the symptoms and preventing unwanted outbreaks.

Medications for atopic eczema

There are many different types of treatment for atopic eczema, but two of the most commonly used medications are emollients, which are suitable for daily use, and topical corticosteroids, which are suitable for use during eczema flare-ups.

Choosing and using emollients

Emollients reduce water loss from the skin, helping to soften it and prevent it from drying out and cracking. Emollients are available as creams, ointments, lotions and soaps, and they differ in the amount of oil and water they contain. Ointments contain the greatest amount of oil and so can feel greasy when applied to the skin. However, they are highly effective at keeping the skin soft and moist. Lotions contain only a small amount of oil, and are therefore less greasy, but they tend to be less effective than ointments when it comes to managing very dry or scaly skin.

Atopic eczema sufferers should use an emollient all the time, even when they are symptom-free. When applying an emollient, use a generous amount and smooth it into their skin in the direction that the hair grows. Ideally, you should apply emollient after taking a bath or shower as this is when the skin is moist. Emollient should be applied to the skin according to the manufacturer’s instructions, and used frequently during flare-ups because this is when the skin craves moisture.

Selecting and taking topical corticosteroids

Topical corticosteroids are creams, gels, ointments, solutions and lotions that reduce skin inflammation. They can provide temporary relief from the pain and distress of bad eczema flare-ups. These medications come in four different strengths:

  1. Mild – for mild cases of eczema
  2. Moderate – for more troublesome cases of eczema
  3. Strong – for eczema that does not respond to other treatments
  4. Very strong – for severe flare-ups that do not respond to other treatments

Atopic eczema sufferers should apply their topical corticosteroid medication sparingly to affected areas of their skin. They should ideally apply their emollient first and then wait at least 30 minutes to allow the emollient to soak into their skin before applying their corticosteroid medication.

The recommended dosage of a corticosteroid medication will depend on the area of the body receiving treatment. This is because certain areas of the skin are thinner and more sensitive to corticosteroids than others. Corticosteroid dosages are typically measured in fingertip units or FTUs for short. One fingertip unit (FTU) is the amount of corticosteroid medication required to squeeze a line from the tip to the first crease of an adult finger. Usually, this is enough to treat an area of skin double the size of the flat of an adult hand. For children, the recommended FTU dosages will depend on factors such as age, body size and symptom severity.

The duration over which an individual will need to use topical corticosteroid treatment will depend on the severity of their eczema symptoms and the strength of their medication prescribed. Topical corticosteroids of mild to moderate strength are usually suitable for long-term use while strong corticosteroids are usually only suitable for short-term use. Most people only require corticosteroid treatment when they experience eczema flare-ups; it is very unusual for a person to require ongoing daily corticosteroid use.

Preventing eczema outbreaks using self-help techniques

To help prevent flare-ups, atopic eczema sufferers should use their medication as directed. They should also try these self-help measures:

Take oral allergy medications

Over-the-counter antihistamines such as cetirizine, fexofenadine or diphenhydramine can help reduce skin inflammation. However, sufferers should not use these medications if they need to drive a vehicle or operate machinery, as they can cause drowsiness.

Avoid scratching

While it can be hard to resist the urge to scratch itchy skin, keeping nails short and blunt will minimise the damage scratching causes to the skin. Pinching or tapping the skin during flare-ups may offer some welcome relief.

Apply cool, wet compresses

Covering itchy skin with wet bandages and dressings helps to protect the skin and reduce the urge to scratch.

Use a humidifier

Hot, dry air can parch dry skin, worsening itchiness and promoting cracking. A humidifier will add moisture to the air, helping the skin to retain water.

Choose cool, cotton clothing

Natural materials such as cotton and cotton blends are the best choice for people with atopic eczema as wools and synthetic materials can irritate the skin. Sufferers should wear loose clothing in humid conditions to keep sweating to a minimum.

Avoid stress

Relaxation techniques such as visualisation, yoga and deep breathing can help prevent stress from worsening eczema flare-ups.

Avoid dietary triggers

Research reveals that foods such as milk, nuts and eggs can trigger eczema flare-ups in some people. However, sufferers should only cut these foods out of their diet following seeking advice from their GP.

When to see a doctor

People with eczema should see their GP if:

  • Their eczema is so uncomfortable they are losing sleep or are distracted from their daily routines
  • They suspect their skin may be infected
  • They have tried lifestyle changes and self-care techniques without success

Atopic eczema can be challenging to treat, and sufferers may need to try a range of treatments before finding the best option to control their symptoms.

Article written for ahealthytalk.com by Nick Davison, for more great articles on Atopic Eczema check out the Covance blog at uk.testwiththebest.com.

About The Author

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I've worked as an Occupational Therapist for many years dealing with physical and mental health patients, both in hospitals and the community. Living a healthy, well balanced life with a good diet, regular exercise and a taking a positive outlook are crucial to becoming a very well being indeed - sometimes easier said than done!

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