Eczema

COVID 19 UPDATE

Frequent hand washing with soap and water or using hand sanitizers can damage the skin barrier leading to inflammation, itching and in severe cases infection. Hand washing is paramount when there is a real risk of covid 19 exposure.  However, when you are washing your hands within your own home after cooking or using the bathroom a soap substitute could be used. These are cream products that clean without causing any drying effect.– your pharmacist may be able to direct you to a suitable product.

Moisturisers (emollients) are an essential part of treating hand dermatitis. They help repair the damaged outer skin and lock moisture in the skin, making it soft and supple again. They should be applied after hand washing, repeatedly through the day and whenever the skin feels dry.

Some people find overnight moisturising treatments beneficial. Apply a generous layer of a plain moisturiser just before you go to bed, then put on a pair of clean cotton gloves and leave overnight.

Consider wearing gloves when coming into contact with soap and water not directly related to hand washing such as washing up.

Those with severe hand dermatitis may need to ask their GP for further advice and should do so by telephone during the outbreak. Usually a potent steroid cream is required daily for 10 to 14 days

Further information can be found at:

https://www.skinhealthinfo.org.uk/statement-on-coronavirus-and-skin-disease-affecting-the-hands/

Eczema (also called dermatitis) is an increasingly common skin condition seen in all ages. There are different types of eczema:

– Atopic or inbuilt (endogenous), where one is prone to getting dry skin
– Dyshidrotic eczema or hand eczema- a intensely itchy form of eczema usually located along the sides of fingers and toes.
– Allergic contact dermatitis occurs through repeated exposure to chemicals found within daily skin care products, clothing dyes, preservatives or within the work environment.
– Irritant dermatitis caused through chronic exposure to chemicals that damage the skin
– Discoid eczema
– Facial eczema

Treatments for eczema can be life changing but are dictated by the type, site and extent.

Atopic eczema (atopic dermatitis) is the most common form of eczema, a condition that causes the skin to become itchy, dry and cracked. Atopic eczema is more common in children, often developing before their first birthday. It may also develop for the first time in adults. It’s usually a long-term (chronic) condition, although it can improve significantly, or even clear completely, in some children as they get older.

Causes of atopic eczema

The exact cause of atopic eczema is unknown, but it’s clear it is not down to one single cause. Deficiency in a protein called filaggrin found within skin is linked to atopic dermatitis. Filaggrin plays an important role in holding the skin cells tightly together which in turn helps retain moisture and prevent small particles from the environment entering into the skin.

Atopic eczema often occurs in people who are prone to allergies. It can run in families, and often develops alongside other conditions, such as asthma and hay fever. The symptoms of atopic eczema often have certain triggers, such as soaps, detergents, stress and the weather.

Treating atopic eczema

Many different treatments can be used to control symptoms and manage eczema, including:

– Self-care techniques, such as reducing scratching and avoiding triggers
– Emollients (moisturising treatments) – used on a daily basis for dry skin  
– Topical corticosteroids – used to reduce swelling, redness and itching during flare-ups

Useful information often not given to patients with eczema is how to dose topical steroids using the fingertip unit, the steroid ladder and also when to consider patch testing (allergy testing). Ensure your doctor has made the correct diagnosis and has explained the rationale behind the treatment recommended

Is eczema an allergy?

Eczema can be brought on by developing an allergy to something you have come into contact with such as perfumes or soaps. If you suspect you are allergic to a daily skin care product or something you are exposed to at work, you may need to have allergy testing called patch testing.

Are topical steroids safe?

Yes. Topical steroids come in many different strengths ranging from hydrocortisone, the mildest form, to clobetasol, estimated to be some 600 times stronger. As long as you use the correct strength steroid for an appropriate length of time you will not come to any harm. More harm is often caused through not using enough steroid to control the eczema promoting infection (impetigo or eczema herpeticum) , disturbing sleep through itch which has a knock on effect to daily life.

https://www.guysandstthomas.nhs.uk/resources/patient-information/dermatology/topical-steroids.pdf

Download our steriod weaning regime chart