Dermatitis & Eczema

Dermatitis and eczema are more or less interchangable terms for the same condition. When we speak about dermatitis or eczema we are talking about a condition involving irritation and inflammation of the skin. The rash may be localised to a small area of the body ( as seen above, involving the palms of the hands ) or it can involve large areas of skin and even the whole body. Often the involved skin becomes dry and easily irritated further.

• People may be born with a tendency to allergy and eczema. This allergic tendency manifests itself as eczema often associated with other allergic conditions such as asthma and hayfever.
• Eczema may be caused by contact with substances such as chemicals, solvents, soaps, shampoos or cosmetics. Other sources of irritation to the skin may be biological such as contact with animals or plants.
• Eczema can be caused or aggravated by foods we eat.
• Almost all medicines can cause rashes in susceptible individuals.
• Viral illnesses like the flu can cause patients to develop rashes.
• Rashes can occasionally develop in association with severe internal disease

This patient thought she had eczema, however, she had an infection that responded to a short course of antibiotics.

This patient thought she had eczema, however, she had a skin condition that responded to an antifungal shampoo.

This patient thought he had eczema, however, he had a fungal infection that required a course of anti-fungal tablets to clear up.

This patient thought he had eczema and he was right. The eczema was being caused by leather shoes and was being made worse by bacterial and fungal infections.

This patient thought he had eczema and he was right. His eczema was being caused by untreated varicose veins. His eczema improved with wearing of compression stockings and treatment of his varicose veins.

• Apply a cheap moisturiser such as Sorboline or Cetaphil. You can get these products from your local chemist or supermarket.
• Apply the moisturiser frequently during the day.
• In particular apply the moisturiser to the rash before any contact with water such as hand washing, showering, bathing or swimming.
• Contact with water will make your skin dry and easily irritated. You should therefore avoid long showers, baths and swims.
• Soap will also irritate the skin and should be avoided on inflamed skin.
• Resist the temptation to scratch. If the itch becomes intense you can slap the area to alleviate the itch.

If the rash does not settle quickly, please make an appointment for medical review. Remember that the quicker you start treatment, the quicker your rash is likely to get better.

What are my therapeutic options?

• Stress management -- Exacerbations of eczema are often associated with periods of stress. Making lifestyle choices that minimise stress will be helpful in controlling the condition. A relaxed lifestyle will help to keep your skin healthy. Activities that help you to relax such as exercise, yoga, hypnosis, acupuncture will all help.
• Food chemical sensitivity --  A lot of patients suspect that some foods in their diet cause or aggravate their eczema. Some patients have successfully cleared or diminished their eczema by altering some component of their diet. The essential message is to avoid following excessively restrictive diets that can make you malnurished. If you suspect that a food is aggravating your eczema, go off it for two weeks. At the end of the two weeks you must reintroduce the food to see if it aggravates the eczema. Only test one food at any one time. If you continue to suspect a food or group of foods, consider seeking the advise of an allergist or food allergy unit.
• Cortisone Creams -- There are many cortisone containing creams available. Some of the weaker creams are available over the counter, at the local chemist, whilst the stronger creams are only available with a doctor's prescription. All cortisone creams have anti-inflammatory effects. Patients need to try a number of creams to determine which is most suitable for their eczema. Cortisone creams should ideally only be used for periods of time not exceeding one week. After one week of cortisone treatment, the cream should be stopped for one week to allow the skin to recover.
• Moisturisers --  These are an essential part of the treatment of eczema. Moisturisers should be used frequently and in particular before contact with water.  
• Oral cortisone -- Cortisone tablets are used very rarely for eczema. Only when there has been an extensive exacerbation of the condition which can not be controlled with other therapies.

What should I be mindful of?
If your eczema shows signs of being out of control, present for assessment.

What do I do next?
Make an appointment for review of your eczema.