About atopic eczema
Eczema (also known as ‘dermatitis’) is a non-contagious dry skin condition that can affect people of all ages, including 1 in 12 adults and 1 in 5 children in the UK. Atopic eczema is the most common form of eczema and tends to run in families. ‘Atopic’ is a term used to describe the tendency to develop eczema, asthma and hay fever. Some people may only have atopic eczema but others may also have asthma and/or hay fever. The chief characteristic of atopic eczema is the ‘itch’, which at times can become almost unbearable, leading to sleep loss, frustration, stress, and depression.
What causes it, and why is eczematous skin dry and itchy?
Atopic eczema is caused by a combination of environmental and genetic factors. In atopic eczema, dry skin is due to a genetically defective skin barrier. Skin without eczema provides an effective barrier that protects the body from infection and irritation. If you think of the skin as a brick wall, the outer cells are the bricks, while fats and oils are the mortar, holding everything together and acting like a seal. The cells attract and keep water inside, and the fats and oils also help to keep moisture in.
If you have eczema, your skin may not produce as many fats and oils and will be unable to retain water. Also, some everyday substances (e.g. soap, bubble bath and detergents) will dry out the skin. Gaps open up between the skin cells as they are not sufficiently plumped up by water. This means that the skin barrier is not as effective as it should be, and bacteria or irritants can more easily pass through. These then trigger an inflammatory response, which causes the redness in eczema flares. Although the exact cause of eczema is not known, an ‘over-reactive’ immune system is understood to be involved.
How is it treated?
There are a number of different topical treatments for atopic eczema – that is, treatments that can be applied to the skin: emollients (medical moisturisers), topical steroids and topical calcineurin inhibitors. For more severe eczema, treatments include phototherapy, oral steroids, oral immunosuppressant drugs, and a biologic drug.
Is there a cure for atopic eczema?
Although there is currently no known cure for atopic eczema, when it is well-managed it is possible to limit its impact on day-to-day life.
Will my child grow out of atopic eczema?
Children often ‘grow out of’ the symptoms of atopic eczema, but it can return at any time, unfortunately. If you have atopic eczema at an early age, your skin is likely to remain sensitive even if there is no recurrence of eczema.
For more information on atopic eczema, please see our Living with Eczema and Childhood Atopic Eczema booklets