In brief

Atopic eczema is inherited. You will normally find someone in your family who has eczema, asthma, hayfever or allergies. It can start in childhood and clear up by adulthood but sometimes starts in adulthood. Symptoms include itchy, dry skin that becomes red and inflamed during flare ups. If it becomes infected, often through scratching, it may become wet eczema when the skin cracks and oozes.

Allergic contact dermatitis happens when an allergy to something the skin touches develops. It can take a while to develop. Common allergic reactions include nickel (jewellery, buckles and buttons), detergents, rubber, perfumes and other additives in skin care products. Treatment involves identifying the cause and avoiding it.

Irritant contact dermatitis is a type of eczema that comes from everyday contact with chemicals and detergents, most commonly on hands. The skin needs to be kept moisturised and the substance that causes it avoided.

Infantile seborrhoeic eczema, also called cradle cap, is very common in babies and although it doesn’t look nice it doesn’t seem to hurt or discomfort the baby. It begins on the head, sometimes the nappy area, and can spread further. It normally clears up itself, although massaging a little vegetable oil into the scalp can help it to go.

Adult seborrhoeic eczema looks like dandruff and affects the scalp, ears and face sometimes becoming red, inflamed and flaky. Skin care preparations with anti-fungal properties may help as yeast is a possible cause.

Varicose eczema is related to poor circulation, the calves and ankles becoming speckled, itchy and inflamed. Do get treatment as ulcers can form.

Discoid eczema looks are small round patches of red, itchy and weepy skin, often around the stomach and thighs. Moisturisers and emollients can sometimes help.

Conventional treatment is often topical or oral steroids prescribed by a doctor which can have side effects if used inappropriately or over a long period of time. New drugs are often developed and your doctor may prescribe Tacrolimus ointment (Protopic™), Pimecrolimus cream (Elidel™), anti-histamines, wet wraps or UV light treatment. More information about these can be found at www.eczema.org

Self help

There is no specific or guaranteed cure for eczema and what works for one person will not necessarily work for another. However, there are things that often help and reduce itching. Above all keeping the skin well moisturised is essential.

~ Emollients, like bath oils and bath melts, help to seal the skin, stopping dry skin that leads to itching. Salt, especially Dead Sea mineral salts, often helps in baths, as does oatmeal for some people. ~ Try to avoid allergens and use simple skin care products with as few ingredients as possible (if you are allergic to one of them it may be easier to identify it). ~ Avoid products that are obviously loaded with chemicals, for example, instead of commercial hair dyes try henna instead. Unfortunately though, you can be allergic to anything, even natural products, so always test any new products on a small patch of skin first. ~ Changing what you eat does not always work but some people have had good results, for example, in avoiding dairy products. Keeping a food and drink diary can help to identify skin reactions. Professional advice should be sought before putting children on any sort of a diet. ~ Wear loose, comfortable clothing in cotton and silk fabrics, particularly next to the skin, and use cotton sheets. Synthetics and wool can be irritating. ~ Use a non-biological washing liquid (powders don’t always rinse out) and avoid fabric conditioners unless they are eco-friendly, phosphate-free. Eco balls and ceramic discs will clean all but the dirtiest loads without any washing powders. ~ Keep house dust mites at bay, as they are a suspected allergen, with regular vacuuming and damp dusting. Try to air and change bedding frequently. With children keep as few toys and clutter in their bedroom as possible.