How to manage atopic eczema
Posted on 3 October 2016
Atopic eczema is a genetic condition which causes a broken skin barrier and is further triggered by certain allergens. Here is expert advice on the symptoms, causes and how to treat it.
What is atopic eczema?
According to the Allergy Society of South Africa (ALLSA), atopic eczema is described as a chronic, often debilitating skin disorder with a high prevalence in young children.
Dr Sian Hartshorne, a dermatologist at Mediderm in Plettenberg Bay, says the word eczema comes from the Greek word meaning ‘to boil’. She explains that it is an inflammation which, seen under the microscope, looks like tiny water blisters in the top layer of the skin.
‘There are many types of eczema, but the most common is atopic dermatitis, also called atopic eczema or AE, which is genetic,’ says Dr Hartshorne.
‘The gene responsible for atopic dermatitis has been identified. This gene produces a protein called filaggrin, which is basically part of the “glue” that holds the skin cells together. Due to a defect in this gene, patients with AE have less filaggrin in their skin, and so the skin barrier breaks down.’
The symptoms of atopic eczema include:
- Dry, scaly skin
- Cracks behind the ears
- A rash on the cheeks, arms and/or legs
- Open, crusted or ‘weepy’ sores (usually during flare-ups)
What causes atopic eczema?
Though genetic, ALLSA reports that patients with AE are more prone to flare-ups when exposed to an aggravating factor or allergen. Dr Hartshorne agrees: ‘Patients with atopic eczema tend to be very sensitive and can be allergic to many different substances such as nickel and perfumes.’
‘We expose the skin to so many ingredients these days, including chemicals and environmental pollutants, that pre-disposed skins tend to develop more eczema. Using soap makes the skin drier and breaks down the barrier, and as soap is very alkaline, it also inhibits further production of filaggrin,’ says Dr Hartshorne. She recommends that eczema sufferers try to identify and avoid anything that could further irritate their skins.
How to treat and manage atopic eczema
‘Now that we know more about why eczema occurs we can focus our treatment on improving the skin barrier and helping the skin to make more filaggrin protein,’ says Dr Hartshorne. She lists these steps to manage and treat AE:
- Treat eczema early to avoid aggravating and spreading the rash.
- Don’t use soap.
- Moisturise and wash with an emulsifying ointment (it’s more acidic and therefore better for the skin).
- Avoid the use of washcloths and use your hands instead.
- Pat the skin dry with a towel after bathing.
- Rub emulsifying ointment liberally into dry patches.
- If active, eczema requires cortisone treatment – consult your dermatologist.
- Where an infection occurs on the skin, antibiotics may be prescribed.