Eczema (also known as atopic dermatitis) is a very common, chronic, itchy skin condition. It most commonly starts in infancy to early childhood, but can start at any age.
Those with eczema usually have an ‘atopic tendency’, and have a tendency to develop any or all of three closely linked conditions; eczema (atopic dermatitis), asthma and hay fever (allergic rhinitis). These conditions usually run in families. A family history of asthma, eczema or hay fever is helpful in diagnosing eczema in infants.
There are multiple factors involved in the pathogenesis of eczema. These include a genetically impaired skin barrier, making the skin more susceptible to environmental factors such as soaps/detergents, and dry weather. Airborne allergens including house dust mite, as well as surface microorganisms (Staphyloccus aureus and Malassezia), stress hormones, immunological factors and autoinflammatory factors, can all play a role. Whilst food allergies (a separate condition) often coexist, food usually plays a minor, if any, role in most cases of eczema. Allergic contact dermatitis is a separate condition to eczema (atopic dermatitis). Usually the two can be easily separated on clinical grounds, but sometimes allergy patch testing can help.
Unfortunately the complex pathogenesis of this condition makes it difficult for patients / parents to understand the reason for the disease, and therefore many search tirelessly for a single elusive causative factor and cure, often at considerable financial cost, and unfortunately often whilst neglecting simple treatments which can safely control the disease. There is also a lot of misinformation from different sources (friends, family, pharmacists) about different treatments, making getting appropriate management harder still.
Your dermatologist can help you understand the various factors involved in your or your child’s eczema, and tailor a simple and safe management program. This will include general advice, and non-pharmacological measures, as well as prescription treatments tailored to your specific case.