Eczema is the itchy and inflamed rash that not only 1 in 5 children under the age of two years old currently have, but us adults suffer from, too.
So, what is it exactly? Well, eczema is a result of a faulty skin barrier (the protective, uppermost layer of the skin) allowing irritants – think certain chemicals and substances – to penetrate through the layers of the skin. The irritants don’t belong on the skin, so the body instantly triggers an immune response, releasing inflammation as well as an itchy chemical called histamine, hence, the intolerable itch!
Unfortunately, adult eczema doesn’t have a cure, which means there are many eczema sufferers itching (sorry) for answers on treating, preventing and managing the skin condition.
So, to sort the fact from the fiction we asked Australasian College of Dermatologists’ fellow Dr Karen Koh to answer the questions you have about adult eczema – from what foods to avoid, to how to treat it.
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Before diving deep into the world of eczema, it’s important to understand the different types of eczema. There are eight different types of this skin condition, although, atopic eczema and contact eczema are the most common forms of the dermatitis.
“Most cases of eczema are atopic, meaning it’s genetically inherited and often includes being prone to allergic conditions such as asthma and hayfever,” says Dr Koh.
Contact eczema, however, occurs as a reaction to substances that come into direct contact with the skin.
From changes in temperature to feeling stressed, Dr Koh says there are numerous factors that can cause an eczema breakout.
“Changes in temperature, such as extreme heat or cold, and low or high humidity could worsen eczema. This may be due to the seasons, but also might be influenced by work environments, such as moving from a hot day outside to a cold air-conditioned office and vice versa,” explains Dr Koh.
“Being unwell or rundown with viral or bacterial infections, or stressful life situations can also cause eczema to worsen,” she adds.
“External factors might affect eczema as well. For example, substances that come into contact with the skin, along with oral substances like medications and supplements can also cause irritation or allergy.”
And while many people may believe foods can trigger an eczema flare-up, Dr Koh says it’s less common than we think.
“Certain foods might cause eczema to worsen, but this is probably only a factor in about 10 per cent of people with eczema.”
As Dr Koh identified above, it’s not very common for diet to be linked to eczema.
“No foods should be avoided unless there is an obvious relationship between the food being eaten and development of a rash,” Dr Koh asserts.
“It’s common to cut out dairy or gluten, but more often than not these are not an issue. In children with obvious eczema, sometimes certain foods irritate the skin because they’re acidic (think citrus, pineapple, strawberries) and often get on to the face and hands when eating them.”
“Cutting out important food groups without allergy testing is not recommended,” she adds. “It’s important to consult a GP, or to undergo testing with a dermatologist or immunologist before restricting foods.”
Eczema sufferers often claim their rash itch intensifies at nighttime. Dr Koh says “this is most likely due to overheating with heavy bedding, quilts and blankets”.
Certain fabrics, such as non-breathable polyesters and synthetic materials, could make itching at night worse. Dr Koh recommends sleeping in light, breathable fabrics like cotton and linen.
Sure, eczema is more common in children and babies, but adults can be diagnosed with it, too.
“Our skin can definitely change over time,” Dr Koh explains. “Often as we age, our skin becomes dry. Atopic eczema often develops in infancy or early childhood, but can also develop for the first time in adulthood.”
If eczema flares up and you haven’t had it before, Dr Koh advises seeking help from a doctor to determine the cause of the rash.
“If eczema is a new problem, it is worthwhile also making sure that a contact eczema is investigated; for example, if you work in a kitchen, it could be an irritation from excessive handwashing. Even new parents washing their hands after changing nappies may develop contact eczema because they’re not used to washing their hands so often.”
Other irritants that could cause contact eczema include allergies to a new perfume, make-up or cleanser, or the skin reacting to new jewellery or a watch band.
“Yes, the actual rash is the same thing, but if it occurs in different locations it might be a clue to the cause,” says Dr Koh.
“Hand and eyelid eczema can be due to contact reactions, but also can occur in atopic eczema. If one location seems to be affected in isolation, for example eyelids, it’s important to rule out substances that are applied to that skin such as eyeshadow, mascara and eye creams.”
Dr Koh adds that airborne sprays, such as spray antiperspirants, hairsprays and household sprays, as well as insecticides or garden sprays, might also get on the eyelids and cause a reaction.
“Atopic eczema is genetically inherited, and is, unfortunately, reasonably common,” says Dr Koh.
“There are some dry skin conditions that might predispose some people to developing eczema,” she adds.
“Definitely NOT,” assured Dr Koh.
“However, if the eczema gets secondarily infected with bacteria or viruses, those infections, if untreated, could be spread to another person,” she adds.
People commonly confuse eczema for psoriasis and vice versa. Dr Koh says despite their similar appearance and treatment, they are not the same issue.
“They are different types of skin inflammation with different genetic and immune reactions. However, in some locations on the skin they can look quite similar. And, in some situations, the treatment is very similar.”
“Yes. This is probably due to the immune reactions that occur with stress,” Dr Koh tells us.
“People with eczema often notice their skin might flare up with stressful situations, despite their treatment. These stresses can be physical and psychological.”
PSA: you can and should use sunscreen, says Dr Koh.
“People with eczema should probably use products that are formulated for sensitive skin. Modern sunscreens usually contain a mixture of physical blockers (such as zinc or titanium oxide) that reflect ultra-violet radiation, and chemical blockers that absorb ultra-violet radiation,” she explains.
“Keeping to a sunscreen just with a physical blocker is likely to be safer and better tolerated.”
“Any cream, make-up or sunscreen can contain fragrance or preservatives (which prevent your creams going off) that might cause eczema to react,” says Dr Koh, who suggests researching hypoallergenic products as they are often fragrance free.
If you have skin that is likely to react to new products, simply test on an area of skin, like the inner arm, before putting on more obvious areas. And don’t forget to clean those beauty tools!
“Make sure any make-up applicators, sponges and brushes are cleaned regularly to prevent contaminants or infections,” she adds.
Text: Bauer