A.Vogel Talks Atopic Eczema

Atopic eczema is the most common variant of eczema and usually appears in children at a young age



Skin Health Advisor
@AVogelUK
Ask Felicity

An introduction to atopic eczema

Atopic eczema is the most common form of eczema and affects approximately 20% of children in the UK.1 

The chronic skin condition, otherwise known as atopic dermatitis, is not contagious but it can emerge in families or those who are sensitive to allergens such as pollen, dust mites or asthma. Atopic eczema is known to affect any area of the body but tends to favour the face, scalp and elbows.

There is no known cure for eczema and instead the condition appears to be recurring, characterised by pronounced episodes and then periods where symptoms are not as serious.

When children start to go through puberty, their eczema can fade away entirely although sometimes it lingers if flare-ups are particularly severe and symptoms persist. 

1http://www.bad.org.uk/shared/get-file.ashx?id=69&itemtype=document

The causes of atopic eczema

There is no definitive cause of eczema but there are a number of influential factors that have been identified in stimulating an episode of atopic eczema or exacerbating pre-existing symptoms.

It is important to recognise these triggers so that you can take preventative measures against causing any outbreaks or worsening your symptoms.

  • Genetics: The genes that you inherit from our parents can influence a variety of factors, including your susceptibility to atopic illnesses such as hayfever or eczema. A study by Division of Molecular Medicine, at the University of Dundee discussed the relationship between the filaggrin protein and your vulnerability to eczema.2  If you are born with a defective gene that inhibits your production of the filaggrin protein, then this can a profound impact on your chances of developing atopic eczema as filaggrin plays a vital role in strengthening your skin cells in the epidermal layer of skin. Filaggrin bonds with keratin and keeps our skin moist, supporting your immune system. When this protein is lost, your skin is weaker and allergens find it easier to permeate, stimulating an allergic reaction and having a knock-on effect on your immune system
  • Weak Immune system: Your immune system is the body’s first line of defence against invading germs and pathogens, protecting you from infections, viruses and disease. When your immune system is weakened or inherently defective, then this can have a drastic impact on the rest of your body, influencing how you respond to allergic reactions and invading pathogens. Some research suggests that atopic eczema is an autoimmune disease that occurs when immune proteins such as crytokines mistake skin tissues as harmful cells and attack them, stimulating eczema symptoms.3 Another explanation could be that your immune system, either through poor diet, or a genetic predisposition, produces too many IgE antibodies, that then overreact and cause too many inflammatory chemicals to be released, exaggerating eczema symptoms
  • Poor nutrition: Your diet can have a great influence on your eczema symptoms. The primary impact of your diet is its role in supporting your immune system. If your immune system is already weak or defective, then consuming vast amounts of foods rich in inflammatory chemicals such as histamine will only place it under further stress, exacerbating our symptoms and affecting our autoimmune responses. Around 70% of your immune cells are located in your digestive tract, meaning that your immune function can also be compromised by regularly eating foods that are difficult to digest or encourage the growth of unfriendly bacteria in your gut, If you suffer from food allergies, it is also important that you recognise possible triggers and do your best to avoid such allergens to inhibit a potential outbreak
  • Stress: Stress is a common fixture in any skin disease, especially if symptoms are visible and difficult to conceal. If you suffer from eczema, then it is likely there will be psychological repercussions such as anxiety, feelings of depression and social apprehension. However, these emotional reactions can influence your immune system, stimulating a flight or fight response that results in inflammatory chemicals being released into your body. When this happens, your eczema symptoms are increased and become more persistent, which in turn exacerbates our feelings of stress forming a destructive cycle. Stress can also have a number of negative repercussions for your digestive system as well, causing bouts of constipation and diarrhoea that may result in an increased levels of toxins lingering in your system
  • Skin infections: When you suffer from atopic eczema, you can become more vulnerable to secondary bacterial skin infections. A type of bacteria, known as staphylococcus aureus, grows on the surface of the skin and can reproduce rapidly during episodes of eczema, exaggerating your symptoms.4 This reproduction is often aided when you scratch the surface of our skin, allowing bacteria access to dead skin cells and the sensitive layer of skin under the epidermis, the dermis
  • Allergens: Allergies such as hayfever do not appear to be the definitive cause of atopic eczema, but they can cause symptoms to flare-up, triggering an eczema episode. This is because the skin in sufferers of atopic eczema tends to be more sensitive and easier for allergens to permeate. When your immune system recognises these allergens, it releases a wave of IgE antibodies which usually have inflammatory properties, aggravating the affected area and stimulating an outbreak of eczema. In food allergies, it is not always guaranteed that consuming a harmful food will trigger an outburst, but it can occasionally happen in small children and infants.5 It is therefore advisable to avoid inspiring this immune response by taking steps to avoid any potential allergens and to keep an eye on eczema symptoms to identify any potential allergic inhibitors
  • Irritants: Episodes of eczema can often be stimulated when you come into contact with irritants that aggravate your skin and trigger an immune response. These potential stimulants often include everyday household items from cleaning agents to bubble bath as they contain harmful toxins or harsh fragrances. When these come into contact with your skin, it can cause an outburst of eczema as a response to the chemical compounds or intensify your pre-existing symptoms.

2 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378480/

3 http://www.mountsinai.org/about-us/newsroom/press-releases/atopic-dermatitis-found-to-be-an-immune-driven-disease

4http://www.eczema.org/atopic-eczema

5http://www.everydayhealth.com/eczema/the-link-between-food-allergies-and-eczema-rash.aspx

The symptoms of atopic eczema

The symptoms of atopic eczema are commonplace in most variants of the skin condition and can be very uncomfortable and disheartening to experience.

If you notice that your symptoms are persisting or getting worse then you should speak to your doctor to avoid developing a secondary infection.

  • Itchiness: Arguably the most infamous symptom of eczema, itching normally occurs when our skin is dry or inflamed, making you want to scratch the area repeatedly. This urge can be so persistent that it can interrupt your sleep and affect your day to day activities
  • Inflammation: Inflammation can appear as a response to inflammatory chemicals such as histamine. These chemicals are usually released into your system as a reaction to contact with an irritant or pathogens. This can occur in atopic eczema when you come into contact with a substance that can aggravate your symptoms or if the immune system is responding to an allergen
  • Dry skin: In episodes of eczema your skin can become very dry and brittle, sometimes flaking due to persistent scratching, which then makes you more vulnerable to a secondary bacterial infection
  • Blistering: Blisters can appear when the skin is being persistently damaged, either through scratching or cell degeneration. When fluid collects in the layers of skin below the epidermis, it can form a blister, which should not be agitated or touched.   
  • Hair loss: If eczema occurs in the scalp it can damage the hair follicles and cause your hair to become frail and breakable, often falling out in patches around the affected area.
  • Disrupted sleep: The relentless itching that occurs alongside other uncomfortable physical symptoms is often the main culprit when it comes to sleep deprivation during atopic eczema. If you are lacking a good night’s sleep, it can then affect your day to day life, making you feel more irritable, disorientated and unable to cope with your other symptoms 
  • Stress: Stress is a persistent psychological symptom associated with atopic eczema, often putting pressure on your fatigued immune system and having a profound effect on your self-esteem and confidence. This emotional shift is often a response to the visibility and irritability of physical eczema symptoms, sometimes perpetuated by a lack of sleep and inability to relax.

Home remedies

There are a variety of home remedies available to relieve the symptoms of atopic eczema, some of which have been tried and tested for decades.

If you feel that your symptoms have changed though, and are concerned about secondary infections then you should speak to your doctor as soon as possible to avoid any further complications.

  • Relax: Stress is a major source of pressure for your immune system, often stimulating an overproduction of inflammatory chemicals and worsening your eczema symptoms. It is therefore advisable that you try to find ways of managing your stress and keeping yourself calm during this time. You should try to take time out from your day to day worries by indulging in some quiet time to yourself, either reading a book or indulging a bath. Meditation can also be beneficial for teaching you proper breathing techniques and how to take control of your stressful emotions
  • Good nutrition: If your diet is having a detrimental effect on your immune system and your digestive tract then this will only worsen your eczema symptoms and make you more prone to outbreaks of the condition. Instead of consuming vast quantities of inflammatory foods such as caffeine, processed sugars, salt and saturated fats, you should be trying to support your immune system and the production of friendly bacteria. A diet that is rich in vitamins that contain essential anti-oxidants would be most advisable, especially foods that contain plentiful amounts of vitamin C. Ginger and onions have natural anti-inflammatory properties, so you could try incorporating them into your meals. Your morning cup of coffee is probable a staple part of your everyday routine so you could try substituting this with a caffeine-free alternative like Bambu. If you have a food allergy, you should make yourself aware of potential allergens and cut them out of your diet in order to avoid an allergic reaction
  • Avoid irritants: It can often feel as though there are irritants lingering everywhere during an outbreak of eczema, from the chemicals in your household detergents to the cleansers we use to wash your faces. It is important to have an idea about what specifically can trigger your eczema symptoms and to try and take steps to avoid it whenever possible. For example, if you’ve noticed that your eczema is particularly bad after using a certain cosmetic product then try to switch to an organic and unscented alternative. If you suffer from hayfever then try to minimalise your contact with pollen by closing your windows and avoiding grassy, woodland areas
  • Turmeric: A popular spice with curry-enthusiasts, turmeric contains a number of beneficial properties when it comes to your skin. A natural anti-inflammatory agent, you can apply turmeric topically after diluting with a little water, or take it internally as a supplement to aid your digestion and circulation. If this option appeals to you, please check out Your Health Food Store as they offer a range of turmeric supplements
  • Oatmeal: A natural exfoliate, oatmeal can help to sooth the persistent itching that occurs with atopic eczema and can work as an anti-inflammatory agent to reduce the appearance of swelling and redness. Oatmeal can be mixed with a little water until it forms a paste or even added to your evening bath
  • Honey: There are many benefits attributed to raw, unprocessed honey. It is known to have anti-bacterial properties which may reduce the chances of developing a secondary bacterial infection as well as locking in moisture, relieving dry, itchy skin. You can apply honey to your skin topically – Manuka honey works best - just remember to wash off thoroughly afterwards to avoid any unpleasant stickiness. Your Health Food Store has a range of Manuka honey products if they remedy appeals to you.

Herbal remedies

If conventional medicines have failed you, then worry not.

There are plenty of different herbal remedies out there to internally and topically combat the symptoms of eczema, reducing any irritation and preventing any persisting afflictions.

However, if you notice any negative changes to your symptoms then you should consult your GP at your earliest convenience.

  • Neem cream: Made from extracts of neem leaves, Neem Cream is a soothing treatment for dry, irritated skin, alleviating itchiness and discomfort. If your eczema symptoms have spread to your scalp, you could also try Neem Shampoo, which is gentle on damaged skin and can aid the repair of hair follicles. It is worth noting however, that neither neem cream nor shampoo is suitable for pregnant women or those who suffer from nut allergies
  • Vitamin C: If you want to support your immune system and increase your intake of vitamin C then why not try Nature-C? Made using fruit extracts, Nature-C can be taken by anyone over the age of 6 and will provide you with an essential dose of vitamin C, an essential anti-oxidant when it comes to the health of your skin and immune cells
  • Molkosan®: Molkosan® is a lactose free prebiotic that works to aid the absorption of calcium and other essential nutrients in the digestive tract. It also works to improve the population of friendly bacteria in your gut, having a positive impact on the immune cells that are found there and preventing digestive complications
  • Viola tricolor: Viola tricolor is a natural remedy that is often recommended for the treatment of eczema symptoms. The formula is made using extracts of wild pansy, and contains a number of flavonoids that can support the health of the capillary membranes, nourishing your skin cells and maintaining their integrity. Viola tricolor can also work as an anti-inflammatory agent, relieving swelling any associated irritation. This solution is suitable for children over the age of 2 but should not be taken by breastfeeding or pregnant women
  • Dormeasan®: Dormeasan® is a natural herbal sleep remedy that gently works to restore a normal sleep cycle. The tincture is made from extracts of Valerian and Hops can be of comfort to an eczema sufferer who is finding their sleep constantly disrupted by their symptoms. Non-drowsy and organic, Dormeasan may not be suitable for those who are taking medication that is affected by alcohol consumption or women who are pregnant
  • Stress relief daytime: A natural stress remedy, Stress Relief Daytime is made using extracts of Valerian and works to support your mood, helping you cope in difficult situations and enabling you to take back some of the confidence that your eczema symptoms may have stolen from you.

Conventional medicine

If you are suffering from atopic eczema then it is likely that your doctor will prescribe you a range of conventional medication to ease any uncomfortable or distressing symptoms.

These medicines may vary in strength depending on the severity of your symptoms and might induce a variety of unpleasant side-effects.

You should always take any prescribed medicines exactly as specified by your doctor and immediately contact your local surgery if you feel that your symptoms are being exacerbated by your medication.

  • Steroid creams: If you are suffering from atopic eczema, then your doctor might prescribe you a topical steroid cream to apply to the affected area. However, medication containing steroids should not be taken persistently as they can trigger unpleasant side-effects such as acne. If you feel as though this medicine is not suited for you, then you should speak to your doctor
  • Emollients: The first line of defence against eczema symptoms, emollients or moisturisers, are applied directly to the affected area to treat dryness and irritation. There are many different subtypes, some of which may be aimed at specific symptoms, but some emollients may not agree with your skin type. If this happens, then you should consult your GP to prevent an allergic reaction or the appearance of a rash
  • Anti-depressants: Your doctor might prescribe you an anti-depressant if he feels that your symptoms are having a serious impact on your psychological health. Anti-depressants come in many different types, not all of which will be compatible with you, leading to unpleasant side-effects that may only worsen your feelings of anxiety and stress
  • Anti-histamines: Anti-histamines might be suggested to you to relieve any inflammation and itching. These can be bought over the counter at your local pharmacy but can cause drowsiness, making them unsuitable to take if you are planning on driving or operating heavy machinery.

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