Eczema is a general term for a group of conditions in which the skin becomes inflamed or irritated.

There are many forms, but the most common and prone to flare-ups are atopic dermatitis or atopic eczema, which are associated with other allergic conditions like asthma or hay fever. It usually starts in children and in babies but can continue into adulthood. Although rare, it can also start in adulthood.

Patches of skin become red, scaly and itchy. Small blisters containing fluid can also form, and start to weep. Eczema causes include an abnormal response to the body’s immune system, an inability to repair damage to the skin barrier, allergies and sensitivity to chemicals and clothing. It also occurs in people who are prone to allergies like hay fever, and is often hereditary. It can be mild, moderate or severe.

What are its symptoms?

Eczema symptoms can vary in severity and most people are only mildly affected. Severe symptoms include cracked, sore and bleeding skin. There can be periods when symptoms are less noticeable, and periods of flare-ups when they become more severe.

Eczema symptoms include:

  • Skin dryness
  • Red and scaly areas on the front of the elbows and the back of the knees
  • Watery fluid weeping from affected skin
  • Itchiness
  • Lesions that may become infected by bacteria or viruses.

Eczema progresses through three stages in the course of a flare-up:

  1. Acute: The rash has just started with blisters, red skin and intense itchiness.
  2. Subacute: A transition between the acute and chronic stages, which includes flaky skin, cracks in the skin, an itching which not as intense but the skin can burn and sting.
  3. Chronic: The rash has been present for a long time. There is thickened skin, or lichenification, with accentuated skin lines, cracks in the skin and areas of skin breakdown called excoriations, and intense itching resumes.

How is it diagnosed?

A doctor will begin an eczema diagnosis by examining your skin and question you about your symptoms and medical history. It is recommended that you first consult a dermatologist, as other skin conditions can resemble eczema and it takes experience to accurately diagnose the condition.

The doctor may also use patch testing or other tests to rule out other skin diseases or identify conditions that accompany your eczema.

What are your treatment options?

There is no cure for eczema, but it can be managed with certain treatments, including medication and home remedies.

The usual treatment consists of three parts:

  1. Avoiding skin irritants and other triggers.
  2. Emollients (moisturisers): These are used daily to help prevent inflammation developing.
  3. Topical steroids (steroid creams and ointments): These are mainly used when inflammation flares up.

Can it be prevented?

You can’t stop flare-ups from occurring but you can minimise their severity by controlling or avoiding certain triggers in aspects of your environment. Triggers include hormonal changes in women, stress, exercise, skin irritants, changing seasons, and environmental factors such as tobacco smoke or water that contains lots of minerals.

Some of the things you can do to prevent or reduce eczema flare-ups include:

  • Avoid exposure to extreme temperatures, dry air, harsh soaps and perfumed products.
  • Use blankets and clothing made of cotton. Avoid irritating fabrics and stiff synthetics.
  • Pat rather than rub yourself dry after bathing and swimming. Then apply a moisturising lotion to trap moisture in the skin.
  • Use a humidifier to add moisture to indoor air during the winter heating season.

For more info
Allergy Society of South Africa

The accuracy of this information was checked and approved by physician Dr Thomas Blake in January 2015