The 'Ins' & 'Outs'
Click on any of the links below to find out more about each topic:
Put simply, eczema is a dry, itchy, red skin condition. As you'll know all too well, it typically comes and goes, in a cycle of flare-ups and periods of remission. For some people the time when their eczema is not active can be a period of a month or more, while for those with more severe eczema flare-ups can be more frequent.
Eczema can appear anywhere on an adult's body and is often widespread, which can make it difficult to hide, particularly when your eczema is really bad. Sometimes it will be dry and cracked, and at other times weepy and crusty.
CloseAlthough we don't really know what causes eczema, we do know it occurs when the oils in the skin become defective. While healthy skin forms a natural protective barrier (keeping water inside the body, and dirt, irritants and bacteria out), skin with eczema does not provide the same protection, which means the skin dries out and is more likely to crack and become infected.
Why not download our guide What does my emollient do? to get a better understanding of how your skin is affected by eczema? Emollients are used to replace lost moisture and restore your skin's barrier function.
You can find out more about emollients in the Treating eczema section of this zone.
CloseThe reason why some people get eczema and others don't (and why some people outgrow it, while others don't), remains a bit of a mystery. Eczema often runs in families, which means one or both of your parents may have had it, and if you have children they may develop eczema too. In the UK, more than 5 million people have eczema, so you are not alone.
Click to enlarge and print this diagram
People who suffer from atopic (allergic) eczema are also more likely to suffer from other allergic conditions, like asthma and hayfever.
This is sometimes called the 'Allergic triangle' because all three conditions can be triggered by the same things – find out more by reading the 'What causes eczema?' section.
CloseHow can I stop my eczema from flaring up?
Many factors can make eczema worse or cause a flare-up – these are often referred to as 'triggers'. Hopefully, you've already got an idea of the things that make your eczema worse, and how to avoid them, but just in case you are struggling we're giving you some tips on how to avoid the most common triggers:
House dust mites
House dust mites live in warm, damp places, such as mattresses, carpets and soft furnishings. They live off skin cells that we shed and their droppings can often make eczema worse. While you can’t get rid of them completely, there are things you can do to reduce dust mites, such as:
- Vacuum your carpets, sofas and arm chairs, and mattresses at least once a week (preferably with a model that has a HEPA filter)
- Wash your child's bedding once a week at a high temperature - at least 60°C
- Fit barrier covers to mattresses, pillows and duvets
- Remove household clutter to make dusting easier – but do it thoroughly just a couple of times a week (dusting every day can increase dust in the air)
- Consider swapping carpets for laminate or stone flooring
Pets
Pets make us happy, so we're not suggesting for one minute that you get rid of yours, if you have one. But something called dander and the saliva of animals, can be a problem for some people. Reducing the amount of time that your spend with your pet and the type of contact you have with them can help, for example:
- Try to resist letting your pet lick you – and remember to wash your hands (and any other body part) if you have been licked, and after stroking or playing with them
- If you can, play with them outside, rather than inside the house
- Keep them off the furniture and out of bedrooms and wash their bedding regularly
Heat
When your skin gets warm it can become incredibly itchy and uncomfortable. When your skin is itchy it's hard not to scratch, but when you do it makes your skin more itchy and sore, so you want to scratch it even more; this is known as the itch-scratch cycle. The trouble is that scratching can damage your skin and make your eczema worse. If you can, you should try to resist the urge to scratch. You can help yourself by trying to keep your skin cool on hot days and at night, and when you are physically active. So why not:
- Buy cotton clothing (rather than clothes made from synthetic, man-made fibres)
- Wear layers so you can take one off if you get too hot
- Keep your bedroom temperature cool – around 10-16°C, open a window if necessary and use a fan in the summer
- Give thick duvets a miss and go for lighter bedding instead
Soaps and bubble baths
Soaps, shower gels, bubble baths and other cosmetic products used to wash and moisturise, may contain ingredients that aggravate sore skin. In some cases, the ingredients themselves can cause an allergic or irritant reaction. You can find out more about replacement emollient wash products in our How treatment works section.
Food
For some people, having a food allergy can trigger flare-ups. The most common culprits are: cow's milk and other dairy products, eggs, nuts (especially peanuts), wheat, soya, fish and shellfish.
You may suspect that a particular food is a trigger for you. Keep a diary of what you eat and the condition of your eczema at the time. You may find that certain foods seem to be causing a problem. If you think something you eat may be triggering your eczema talk to your doctor or nurse, they may ask you to exclude individual items of food so they can see if one of them is responsible. It's important that you don’t exclude any foods from your diet without medical supervision; you need to think about your long-term health after all.
How do I look out for signs of infection?
Skin with eczema cannot provide its natural protective barrier, which means that your skin is more likely to become infected. By looking out for the signs of infection you can make sure you get the right medical support when you need it. There are two main types of infection:
Bacterial infections
These are usually caused by the bacteria staphylococcus and/or streptococcus and are easily treated with antibiotics. You can take these by mouth or as a medicated cream.
- Weepy
- Scabby
- Spots containing or discharging pus
- It's unlikely to respond to your current treatment
- It may get rapidly worse
- Yes, you may feel:
- Feverish
- Generally unwell
Contact your GP surgery to make an appointment
Tell them you suspect you have a bacterial infection
Viral infections
Like bacteria, there are many different viruses that can cause an infection. The most important one to look out for is called eczema herpeticum, which is caused by the herpes virus, the virus that also causes cold sores. It needs to be treated very quickly so the infection does not spread.
- Clusters of blisters like early cold sores
- Circular ulcers: these can be small (1-3mm across) or large if a few join together to form a crusty ulcer
- It will be rapidly getting worse and painful
- Yes, you will feel:
- Feverish
- Lethargic (tired)
- Very unwell
Contact your GP surgery immediately and request an urgent appointment
Tell them that you suspect that you have Eczema herpeticum
If you are using an open container of emollient, like a tub, this can become contaminated. If your eczema has been infected, you should throw away any open containers and buy new ones. Look for an emollient that comes in a pump dispenser, as this is unlikely to become contaminated.
