Understanding eczema and the available treatments

What Is eczema? 

Eczema is a chronic skin condition marked by itching, dryness, rashes, scales, blisters, and infections. It can occur in all ages, ranging from mild to severe. Babies can develop eczema shortly after birth. Children may experience dry, itchy patches that worsen due to scratching. Adult eczema is common, especially among those in their twenties or over 50. 

"Flare-up" is a term used by many with eczema to describe acute symptoms resulting from persistent irritation. Severe cases can lead to lingering flare-ups. Treatment includes moisturisers, antihistamines, topical steroids, and corticosteroids prescribed by doctors and dermatologists. 

Proper diagnosis is crucial as eczema can be mistaken for other skin conditions like psoriasis. Dermatologists aid in creating a symptom management plan and preventing future flare-ups. 

What causes eczema? 

The main eczema type is atopic dermatitis, triggered by an overactive immune system that dries and irritates the skin barrier. It can affect any body area, causing various symptoms due to inflammation. 

Eczema arises from environmental and genetic factors. When irritants activate the immune system, skin inflammation occurs. Symptoms stem from this. Skin folds, like behind knees and elbows, are prone to irritation. Genetics also play a role; lacking the "filaggrin" protein can lead to drier, itchier skin. Risk increases if atopic dermatitis or related types run in the family. 

What is eczema caused by? 

In addition to having an eczema family history, many common household objects are possible environmental irritants and can induce allergic reactions, leading to an eczema flare. Other common eczema triggers may include: 

• Long periods of exposure to dry air, high heat or cold. 
• Certain soaps, dandruff-causing shampoos, bubble bath products, body wash, and facial cleansers. 
• Isothiasolinone, an antimicrobial used in personal care items such as baby wipes. 
• Cocamidopropyl betaine, a thickening agent found in shampoos and lotions. 
• Dust mites. 
• To avoid being triggered by a home product, look for the National Eczema Association Seal of Acceptance. 
• Chemically laced laundry detergents and fabric softeners. 
• Surface cleansers and disinfectants for certain textiles, such as wool or polyester in clothing and sheets. 
• Natural liquids such as fruit, vegetable, and meat juice perfumes in candles metals, particularly nickel, in jewellery or utensils formaldehyde, which is found in home disinfectants, certain vaccines, glues, and adhesives. 
• Emotional stress can sometimes cause an eczema flare-up, but it's unclear why. Some people's eczema symptoms and flare-ups worsen when they are "stressed." Others may become worried simply by knowing they have eczema, which can cause their skin to flare up. 

What are the different types of eczema? 

Eczema refers to a set of skin disorders characterised by dry, inflamed skin. Eczema can be classified into seven types: atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis, and stasis dermatitis. 

Eczema might also manifest as: 

• Discoid eczema - Eczema that appears in round or oval spots on the skin. 
• Contact dermatitis - A kind of eczema that happens when the body is exposed to a certain chemical. 
• Varicose eczema - A type of dermatitis that primarily affects the lower legs and is caused by issues with blood flow through the leg veins. 
• Seborrheic eczema - characterised by red, scaly spots on the sides of the nose, brows, ears, and scalp. 
• Dyshidrotic eczema (pompholyx) - a type of eczema in which small blisters appear on the palms of the hands and the bottoms (soles) of the feet. 

What does eczema look like? 

Eczema transforms the skin's look and feel. Rashes can be bumpy, red, or elevated, depending on skin tone. Inflammation can puff up areas like eyelids. Skin turns dry, rough, and prone to cracks, blisters, and scabs, causing pain and discomfort, and hindering focus. 

Where do eczema symptoms appear on my body? 

Eczema symptoms might appear anywhere on your skin. The most likely sites where you'll find eczema symptoms are on your: 

• Hands 
• Feet 
• Face, particularly the cheeks 
• Elbows 
• Ankles 
• Knees 
• Within and around the ears 
• Neck 
• Lips 

While it is less prevalent, eczema can appear on your: 

• Breasts 
• Skin folds near your vagina (vulva) 
• Nipples 
• Penis 

How to cure eczema permanently? 

Unfortunately, there is no cure for eczema. There are therapies available, however, no treatment can completely erase your symptoms. Eczema is a chronic disorder, which means it can go away and reappear at any time. Treatments are very efficient in alleviating itchy, dry skin symptoms. 

How to treat eczema? 

Although no permanent cure for eczema exists, several lifestyle modifications and therapies can help relieve itching and prevent new eruptions. 

Healthy and Clean Habits 

A steady home routine can help if you have a history of eczema flare-ups. Do any or all the following actions: 

1. Clean your home on a regular basis to remove allergens such as pollen, mould, and tobacco smoke.  
2. Use unscented, soap-free, and oil-free hair and body products. 
3. Keep your skin moisturised by drinking plenty of water. 
4. By including exercise, meditation, or counselling in your daily and weekly plan, you can avoid the stress that might contribute to flare-ups. 
5. Remove everything that may irritate your skin from your environment, such as certain lotions, soaps, and fabrics. If you are allergic to certain foods or animal fur, avoid them as well. 

Eczema treatments 

Medication (Oral and Topical) 

At Oxford Online Pharmacy we stock a huge range of eczema treatments, from over-the-counter tablets to prescription strength creams we should have the treatment you are looking for.  

Eczema patients can choose from a variety of over-the-counter (OTC) and prescription therapies. You can consult with your doctor and test several drugs to find the most suitable for your skin.  

A medical expert may suggest one or more of the following: 

Antihistamines: These medications inhibit histamines, which induce allergy symptoms such as redness and itching. They are effective, but they may make you weary.  

You can get Fexofenadine 180mg tablets for the treatment of symptoms related to eczema at Oxford Online Pharmacy from £13.95 for a pack of 30. * 

Antibiotics: Scratching your skin might introduce bacteria and lead to skin infections.  Types of antibiotic treatments include: 

• Fucidin H cream 
• Fucibet cream which contains an antibiotic and steroid. 
• Trimovate cream which contains an antibiotic, steroid and antifungal. 

Antifungal drugs: Fungal infections require the use of antifungal creams or medications. A steroid cream may also assist with a fungal-infected eczema rash. 

Fungal infections and eczema are two skin conditions that can seem quite similar, with symptoms such as dry, itchy, irritated skin. Fungal infections are characterised by a red, scaly, itchy rash with occasional pustules. If you have pus-filled blisters, yellow or orange-coloured crusts, large red pimples, or red streaks moving across your skin, you may have an infection. 

Types of antifungal treatments include: 

• Nizoral cream  
• Daktacort which contains a steroid and antifungal. 
• Lotriderm cream which contains a steroid and antifungal.

Topical Steroid Creams: A cream or ointment that is administered directly to the affected area to reduce inflammation and swelling. Steroid creams are available in a variety of strengths. Excessive use might cause skin discolouration and thinning. 

Types of topical steroids include: 

• Elocon
• Eumovate  
• Audavate RD cream
• Betnovate 
• Dermovate 
• Betnovate RD (RD stands for 'Ready Diluted', it is one-quarter strength of Betnovate).
• Canesten HC  
• Daktacort Cream 

OTC Emollients: Most emollients can be bought over the counter (OTC) without a prescription required. Emollients are quickly absorbed by the skin. They work by locking in moisture and creating a protective barrier over the skin's surface to decrease oil and fluid loss and reduce the risk of infections. 

Types of emollients include: 

• Epaderm  
• Zeroveen 
• E45 Cream
• Doublebase 
• Diprobase 
• Zeroderm 
• CeraVe 
• Oilatum 
• Balnuem 
• Cetraben 
• Aveeno

When to use ointment vs. cream? 

Most of the treatments above come in a cream and ointment form, so how to know which one to use? Well, creams are second to ointments in terms of oil content and are also excellent at sealing in moisture. Relief creams are less oily to the touch since they contain less oil. Read labels carefully because creams can contain stabilisers or preservatives that can hurt your skin. 

Creams have a thicker consistency than lotions and are good for people who have dry skin on their face or body, or for use during the colder winter months. Ointments are the thickest type of moisturiser. These products are normally reserved for usage on extremely dry body skin since they function as an occlusive. 

*Prices are as of 24.08.23 and subject to change.