Eczema

  • Overview
  • What it looks like
  • How it happens
  • Treatment & tips
  • Skin care solutions

Overview

Eczema is a word we tend to associate with a red, itchy rash seen with dry skin. It is a chronic (long-term) skin condition that appears in different ways at different times. 

Eczema affects about six million Canadians. About two thirds (60%) of those people develop eczema in the first year of their lives. 90% do by the age of five.

Understanding why eczema acts the way it does will help you or a loved one with eczema manage the disease and stay in control.

What it looks like

What it looks likeWhat it looks likeWhat it looks like

People with eczema have patches of red, dry, itchy skin. Scratching makes the condition worse and the skin becomes inflamed which further aggravates the itch. These patches of eczema may ooze become scaly, crusted or hardened. Symptoms can range from mild to severe. Eczema can occur anywhere on the skin and is commonly found on the bend of the arms, elbows, backs of the knees, cheeks, neck, and in children also in the diaper area. In fact, if there is no itch, you do not have eczema. The symptoms of eczema sometimes come and go.

Itchy and dry skin often happens before there are any visible signs of eczema on the skin. Other first signs include a tingling sensation, whitening, a tiny bump or a bit of redness. If scratching occurs at this stage, development of a flare is more likely.

How it happens

Skin is the body’s first line of defense. Healthy skin forms a protective barrier that seals in moisture and helps keep out irritants, allergens and bacteria. A healthy skin barrier is densely packed with lipids including ceramides, fatty acids and cholesterol. It is the ratio of these lipids that are critical in maintaining skin hydration. Another important component of the skin barrier is filaggrin, which helps regulate healthy moisture levels in the skin. Filaggrin is a matrix protein that gives a skin cell its strength, but also transitions into amino acids that eventually form the natural moisturizing factor.

There are many factors that can cause dry, itchy skin. External causes may include exposure to wind, heat and cold or irritating topical products with high pH levels. Internal causes may include overall health, genetics, family history, medical conditions such as asthma or allergies and sensitive skin conditions.

Irritants

This is a class of environmental triggers that do not cause an immune response. Examples of irritants include detergents and surfactants (such as soaps and shower gels). They can irritate the skin’s barrier by reducing the thickness of your skin and by diminishing the protective layer. Repeated use of surfactants makes the skin drier and more prone to irritation by other factors.

Allergens

These triggers differ from irritants because they do stimulate an immune response. Examples of allergens that can trigger eczema include certain foods (such as eggs, peanuts, soy and wheat) and inhaled allergens (such as house dust mites). Animal dander, climate, molds and cigarette smoke are also allergens that can trigger eczema. Most people with eczema have allergies like these, which lead to symptoms of their condition.

Flares of eczema may also be triggered by emotional turbulence, as well as by high heat/low humidity environments that cause water to evaporate from the skin.

Genetics

Genetic experts have discovered the gene responsible for dry skin. A genetic mutation that switches off the filaggrin gene effects the skin barrier, sometimes leading to severe or persistent forms of eczema. Skin with eczema has also been found to have lower levels of ceramide (lipids).

Treatment & tips

There is no cure for eczema, although sometimes children can outgrow it. Your doctor may prescribe one or more topical  medication(s) (applied to the skin) to treat the early signs and symptoms of eczema. Two commonly prescribed topical medications are:

  • Topical calcineurin inhibitors (TCIs)
  • Topical corticosteroids (TCSs)

It is important to use these products exactly as your doctor tells you, including how much and how long. Don’t be afraid to ask your doctor for clarification if you are not sure.

Hydrating the skin will also help to relieve the dryness and itching. A daily skin care regimen can keep skin hydrated, reduce flare-ups and keep your skin soft and moist.

  • Cleanse and moisturize with mild, pH-balanced and fragrance-free products formulated for dry, itchy skin 
  • Look for products containing skin-benefiting ingredients like ceramides and shea butter to replenish lipids allantoin to relieve itch and arginine or sodium PCA (filaggrin proteins) to improve skin barrier function 
  • Moisturize 2-3 times daily, especially after bath-time, or as often as needed to soothe the dry, itchy skin and restore their barrier lipids 

In addition, consider these tips::

  • Bath using emollient oil once every two or three days with warm not hot water
  • Keep children’s fingernails cut short to minimize damage from scratching
  • Avoid products with perfume, fragrance, colourants and high pH soap
  • Don’t expose your skin to very hot or very cold water
  • Avoid harsh fabrics/elastics in clothing, cool cotton lets the skin breathe.
  • Avoid chlorine or solvents, use mild laundry detergents; avoid bleach, and double-rinse clothing.

Skin care solutions

New Technologies in skin care have led to the development of therapeutic cleanser’s and moisturizers specifically formulated for dry, itchy skin. Some Cetaphil products were created specifically for dry, itchy skin. Find your perfect match then follow a daily regimen that includes cleansing, moisturizing and protecting your skin.