What Is Eczema?

Eczema, also referred to as dermatitis, is a very common skin condition affecting up to 25% of children and 10% of adults. Despite its high number of affected individuals, the exact cause of eczema remains somewhat of a mystery. And unfortunately, so too does a cure. So, what do we know about eczema? And what can be done to better manage the symptoms?

Eczema Explained

Eczema (or dermatitis) is classified as an inflammatory skin disorder, which disrupts the functioning of the skin’s barrier. The ‘skin barrier’ is a term used by skin and healthcare practitioners to describe the outermost layers of the skin, its natural glue-like substance which binds these together, natural oils within the tissue, and the natural microbiome which resides on the surface. Disruption of barrier function can lead to many of the classic signs exhibited in eczema such as redness, heat, flaking, swelling, itchy rashes, and rough texture. Symptoms can occur on any area of the body including the face and scalp, and each individual experiences them in differing levels of severity. Some may experience the occasional patch of dryness and flaking, while others can suffer extreme and frequent bouts of intense, body-wide rashes and insufferable itching.   

What Worsens Eczema?

One of the most frustrating elements of eczema for most individuals is skin itching. When the skin’s barrier function is impaired, inflammation is triggered, which leads to a cascade of pro-inflammatory cellular functions in the area. One of these is the release of histamine, a chemical released as part of the body’s innate immune response. Histamine acts on sensory nerves, which provokes the feeling of itching. Sadly, scratching the skin only stimulates the release of more histamine, creating a nasty self-perpetuating cycle.

 

Potential Causes

Decades of scientific research on eczema/dermatitis suggest several potential causes. There may be a genetic component to the condition, as many patients report other family members also experiencing eczema. Some will experience the condition as a direct response to coming into contact with a specific external substance or allergan. This is referred to as Contact Dermatitis. In these cases, there may also be an increased association with allergy-type conditions such as asthma, hayfever, allergic conjunctivitis, etc. For some, symptoms flare up during periods of high stress, potentially due to the inflammatory effects of our primary stress hormone cortisol. Others report eczema symptoms without any triggers whatsoever.

As for the original onset of symptoms, this can vary greatly as well. Eczema often starts during infancy or early childhood, though many patients report spontaneous onset of the condition as they grow into adolescence or throughout adulthood.

 

Managing Symptoms

Whether mild or severe, eczema can have serious and lasting impacts on one’s self confidence, day-to-day functioning, and long-term wellbeing. Eczema flares often cause disturbed sleep, when associated itching and discomfort becomes too severe. In adults this can disrupt work and daily tasks, and in children can lead to behavioural issues and even longer-term developmental concerns. Eczema in adults may be linked to anxiety and depression. Particularly in those exhibiting chronic eczema symptoms in highly visible areas like the face, scalp, or hands for example; anxiety and depression can be made much worse when self-esteem is reduced. Many of our patients express feelings of embarrassment and shame as a result of their eczema symptoms, worried that it may even affect their professional and romantic relationships.

We have therefore made it our mission to offer clear direction and treatment support, in order to provide relief and improved quality of life for eczema patients.

 

Topical Therapies

Over-the-counter topical creams, topical immunomodulators, and corticosteroid prescriptions are the first line of defence for early-onset and/or mild forms of eczema. Our eczema specialists will work closely with you to design a topical treatment plan which is tailored to your individual needs, ensuring the correct prescription dosage, strength, and duration of treatment that will optimise your chance of success without causing further damage. If your symptoms are resistant to topical methods, your next line of defence against eczema is likely UVB Phototherapy.

 

UVB Phototherapy

Narrowband UVB (nbUVB) phototherapy is a safe, effective eczema treatment that has provided excellent results and significant relief of eczema symptoms for many years. Unlike UV radiation from the sun, which is not safe to expose your body to in uncontrolled dosages, UVB phototherapy utilises a specific wavelength of the UV spectrum, which is highly controlled and artificially produced through medical bulbs. UVA was used in previous years to address a number of skin conditions like eczema and psoriasis, in combination with oral or topical photosensitising drugs. This has since been largely replaced with nbUVB, a much safer alternative and a standalone treatment which does not require oral medications. Though many imagine UVB phototherapy to resemble a solarium and attribute it with the same risks, it is a highly researched, medically proven, safe wavelength of light treatment which does not resemble natural UV exposure.

 

Treatment of eczema with UVB Phototherapy typically requires patient attendance 2-3 times per week for an initial period (approximately 6 weeks) and will continue at a reduced frequency until the eczema is under control. The length and regularity of your treatments is very patient-specific, and carefully monitored by our specialist dermatologists.

 

Eczema Medications

Systemic and Biologic Therapy are the final line of defence for patients whose eczema symptoms are unresponsive to other approaches. These include oral medications as well as injections that can be utilised to reduce the underlying inflammation on even the most severe cases of eczema, and if all other treatments have been unsuccessful. There are a number of medications available in this group, all of which work via different pathways of the immune system. Targeting these pathways can reduce over-activated inflammation and itchiness, reducing these symptoms in order to improve your comfort and overall quality of life.

For most people, eczema cannot be ‘cured’, but it can certainly be managed and improved – with the help of passionate experts. At Eczema Clinics Australia, our team is devoted to improving and enriching the lives of our patients through individualised treatment plans, education and resources, and ongoing support. We hope to provide all Australians with the information, skills, and treatment options that will help reduce the discomfort of eczema and maintain the skin’s health long-term.

Regardless of your age, profession, or personal circumstances, learning to manage your eczema is critical for improving general health and quality of life – and we are here to help you take the first step forward. As Australia’s only dedicated eczema-specialty clinic, we are purpose-built to be able to begin your treatment journey within just one week. Click here to book your free initial review and find out what’s next.

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