What is Eczema?
What is eczema? Medically speaking, Eczema (atopic dermatitis) refers to a chronic inflammatory condition of the skin characterized by a defective skin barrier. It is a very common skin condition, mostly appearing in childhood and may be associated with asthma or allergic rhinitis (sensitive nose) in two thirds of cases. As itching tends to be chronic, it can cause profound sleep disturbance and interfere with social, behavioural and educational development. Eczema is a complex disease, influenced by genetic and environmental factors. The defective skin barrier allows allergens to trigger an eczema flare. It is rather common for individuals with eczema to be sensitive to house dust mites, pollen and animal dander. Cow’s milk, eggs, wheat, soy and nuts can cause an eczema flare in young children.
The management of eczema aims to reduce eczema flares, improve symptoms such as itching and sleep disturbance, and reduce complications like infection. Restoring the skin barrier and dry skin with an emollient is central to eczema management. An emollient helps to trap water within the skin, and protects the skin from external irritants and allergens. Common brands include Physiogel, Atopiclair, QV and Cetaphil. You may ask what is the best emollient. Well, there isn’t one really, but the best one is the one that you prefer and works well for you. We recommend regular use of an emollient both as a daily moisturizer and for bathing (best to avoid soaps and detergents if you have eczema).
Prescription topical medications help to reduce the inflammatory reaction of an eczema flare, and is safe to use under medical supervision. What is not safe is using creams of dubious source that may contain very potent anti-inflammatory ingredients. Recently, the development of a topical medication that alters the immune response to inflammation has been introduced in the market; the topical calcineurin inhibitors. Topical calcineurin inhibitors are approved for use in children more than 2 years of age who do not respond to standard therapy.
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- Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014 Feb. 70(2):338-51.
- Leung DY, Bieber T. Atopic dermatitis. Lancet. 2003 Jan 11. 361(9352):151-60.
- Sidbury R, Tom WL, Bergman JN, Cooper KD, Silverman RA, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol. 2014 Sep 25.