The Skin Condition That Affects 1.6 M Adults In The UK

The Skin Condition That Affects 1.6 M Adults In The UK

A recent study revealed 15 million people in the UK suffer from eczema, however even with the discomfort and distress, adult eczema remains an unrecognised skin condition. We spoke to Dermatologist, Dr Juber Hafiji and Dr. Rick Woodin at ZO Skin Health about the common triggers and treatments and how to manage eczema flare-ups during the warmer months.


What exactly is eczema?

Eczema refers to several related skin conditions that cause red, itchy, dry, crusted, scaly, bumpy or thickened patches of skin. Such patches commonly appear on the face, hands and feet, or in the creases behind elbows and knees, although they can show up in other places. Atopic dermatitis is the most common type of eczema, regularly plaguing children but it can occur at any age. There are several different sub-categories of eczema:

Contact dermatitis: when the skin comes in contact with an external irritant i.e. detergent or chemicals.
Dyshidrotic eczema: small itchy blisters on feet, toes, fingers, which can be triggered by moist hands & feet, metal plated jewellery (i.e. nickel).
Nummular eczema: round, coin shaped spots triggered by insect bites or a reaction to skin inflammation.
Seborrheic dermatitis: often appears on the body where there are many oil-producing glands (upper back, nose, and scalp). The exact cause of seborrheic dermatitis is unknown, although genes and hormones play a role. Unlike many forms of eczema, seborrheic dermatitis isn’t the result of an allergy.
Stasis dermatitis: triggered by problems with the blood flow in the veins and pressure develops. The pressure can cause fluid to leak causing stasis dermatitis.

What causes eczema?

The cause of eczema remains unknown although it is believed to occur when the immune system goes into overdrive in response to an allergen or irritant inside or outside the body. The condition, which often occurs alongside asthma or hay fever, seems to run in some families, suggesting genetics play a role. Recent studies also suggest eczema affects more women than men, those in developed countries, in cold climates and among people with food allergies. Other common triggers include:

Irritants: including shampoos, soaps, fabric softeners and detergents; disinfectants such as chlorine and juices from certain fruits, vegetables and meats.
Allergens: Environments that cause allergies can also cause eczema to flare. Watch out for dust, mould, mildew, animal fur, feathers and pollen.
Microbes: Bacteria, viruses and certain fungi can agitate eczema. Bacteria may create a film on the skin that blocks sweat glands and interferes with the skin’s ability to regulate itself.
Weather: Hot weather, as well as weather that is very dry or very moist can cause eczema. In addition, sweat that stays on the skin after exercise can be a trigger.
Food allergies: Many people with eczema also have a food allergy that can trigger the condition. Common food allergies include dairy, nuts and seeds, soy, wheat and eggs.
Stress: Stress can trigger and exacerbate eczema.
Hormones: Women may experience fluctuations in their eczema linked to high and low levels of hormones in the body.
Sweat: Moisture and heat may aggravate eczema, especially in areas like the insides of the arms and behind the knees.

Who gets it?

Around 80% of eczema cases develop before the age of five and around 15-20% of children have atopic eczema compared to 2-10% of adults. Adults who have contact dermatitis tend to be people with occupational exposure to allergens, including chefs, hairdressers, nurses and cleaners.

Is it contagious?

No – eczema isn’t contagious, this is a myth. Eczema can look very sore and make people very self-conscious but it definitely isn’t contagious.

How can you tell if you have eczema?

Eczema is almost always itchy, so if you have persistent itching which leads to a rash or scabbing you should seek advice from your GP or dermatologist. However, avoid the temptation to self-diagnose –to get the most effective treatment, it’s always best to see a doctor.

How to avoid eczema flare-ups? 

Avoid things that dry out the skin. Be careful with everyday items such as shower gels, soaps and washing detergents and make sure you chose one that is gentle on the skin with not too many chemicals or fragrances. Water can act as an irritant too as it can remove moisture out of the skin, so it's important to regularly apply moisturisers and emollients after bathing. Other techniques for eczema management include keeping a ‘trigger’ diary to identify allergens, using mindfulness techniques to reduce stress, using and wearing soft loose cotton materials and taking steps to avoid scratching the skin, which can make symptoms worsen.

How best to treat it?

Some of the most effective treatments for atopic eczema are emollients (moisturisers). VENN Chief Scientific Officer and co-founder, Kevin Mun says “skincare products can help relieve eczema by deeply hydrating the skin, restoring and soothing the skin barrier and delivering potent anti-inflammatory actives to the skin.” Emollients cover your skin with a protective film to trap water, relieve itchiness and soothe soreness; try to apply at least twice a day for the best results. Topical corticosteroids – creams and ointments used to reduce swelling and redness during flare-ups – can also be used. You can buy the weakest type (1% hydrocortisone) from pharmacies, but stronger ones - used for short periods to control flare-ups - need to be prescribed. It could also be worth investing in anti-allergy sheets and pillows, which are hypoallergenic, anti-bacterial and resistant to dust mites, mould and fungus - as all can exacerbate symptoms.

What skincare ingredients should be avoided? 

Parabens and Sodium Lauryl Sulfate (SLS) are allergens that can aggravate eczema and people can be sensitised to them so it’s best to avoid them if you can.

How can you control eczema in the sun?

In the warmer months, there is more humidity and hotter temperatures and, for some individuals, this can make eczema worse. This is unusual as sunshine and UV treatments can often help soothe symptoms of eczema thanks to its anti-inflammatory properties on the skin. But, for those individuals who have photo-aggravated eczema (eczema affected by sunlight), they should be much more diligent in terms of sun protection, using appropriate sunscreen and sun protection methods to avoid flares during the summer months.

How to choose the right suncream?

There are two types of sunscreens. Chemical absorbing sunscreen which absorbs the UV light, and therefore provides skin protection. Or, mineral based reflective sunscreens which reflect the UV light.  Although individuals often have to try out various sunscreens to see what works best for them, patients with eczema tend to get on with the mineral based reflective ones, which contain titanium dioxide. As a general rule, alcohol- and fragrance-free sunscreen is better, and always use an SPF 30 or greater.

Is there a cure for eczema?

Eczema symptoms are often worse in young children and while they may improve as you get older, they’ll never completely go away. Once you find a way to manage your symptoms, it’s highly likely you’ll have to keep this system up for the rest of your life. If left untreated, eczema can get worse.

7 tips to prevent eczema flare ups this summer

Drink lots of water
Naturally with eczema, there is an increased loss of water from the skin and in summer, people tend to sweat more and therefore, lose valuable electrolytes from the body. It should be no surprise that dehydration has significant effects on your skin. When you are dehydrated, your skin becomes more tight, flaky and even wrinkly as fine lines appear more visible. Keeping hydrated is crucial for keeping your skin supple and flushing out toxins which may irritate your skin.

Watch where you swim
Remind yourself that you know your skin best when it comes to swimming in summer. For some eczema suffers, saltwater in the ocean can relieve their symptoms but for others it is an irritant. Chlorine in pools is particularly harsh on the skin, so check the times at your local pool for when it is added or avoid it altogether if your flare ups are particularly bad and regular.

Eczema prone skin needs plenty of moisture as the skin tends to be dry and prone to flaking. Unfortunately, it can be hard to find a moisturiser that does not irritate or burn the skin for eczema sufferers. The humidity can make eczema more fiercely itch so it is important to find a moisturiser that soothes your skin and does not irritate it further. Try fragrance free, thick lotions which are suitable for all skin conditions. There are plenty of lotions designed for dermatitis so remember to do your research and always patch test on a small section of skin before applying the product everywhere.

Don’t turn on the fan/ AC
It can be tempting to combat the heat with cold air from your AC or fan to cool you down but moving from two extremes of temperature is not the answer! Removing any moisture from the air will not only dry your skin out more but increase the chance of a flare up. Instead try showering in lukewarm water or bathing in a lukewarm oatmeal bath. After bathing, moisturise immediately and let it soak in before applying wet wraps to further hydrate and cool down the skin.

Manage your sweat
Naturally with hotter weather, our body sweats more to cool us down. For eczema sufferers, the accumulation of sweat can trigger flare ups and the sodium in sweat can further dehydrate the skin. Obviously, a lukewarm shower is the best way to manage your sweat but if you are out and about, blotting papers or a non-abrasive towel will do the trick.

Wear breathable clothing
Many people crave to wear tight, form fitted clothing in summer, but this is not the best option for eczema sufferers. Not only does tight clothing make you sweat more by increasing your body’s natural temperature, but it does not allow your skin to breathe. Instead, opt for that cute summers dress or breathable, cotton-based clothes that do not cling to the body.

Choose the right sunscreen
Sunscreens with a good SPF to protect your skin are pivotal during summer. However, it is important to find a sunscreen that works with your eczema instead of triggering it. Eczema friendly organisations have created sunscreens with ‘seals of approval’, but if you are shopping locally you ideally want a natural sunscreen with as little artificial ingredients as possible. Again, remember to do a patch test with products that have not previously been tested with your skin type.

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