What is Atopic Eczema?

Atopic Eczema is a common chronic but eventually self-limiting itchy inflammatory skin disorder, mainly of childhood, but sometimes persisting into adult life.  It occurs in all races, punctuated by relapses and remissions; it is usually genetically determined and associated with other atopic conditions.  Atopic Eczema affects both sexes equally and usually starts in the first few weeks or months of life.  It is most common in children, affecting at least 10% of infants at some stage.  Atopic eczema may develop for the first time in adulthood.

Atopic is the term used to describe conditions such as eczema, asthma, seasonal rhinitis, hay fever and urticaria.  Eczema is the term used to describe changes in the upper layer of the skin that include redness, blistering, oozing, crusting, scaling,

thickening and sometimes pigmentation.  The words eczema and dermatitis are interchangeable and mean the same thing: therefore atopic eczema and atopic dermatitis mean the same thing.

What causes Atopic Eczema?

This is not fully understood. A tendency to atopic conditions often runs in families and is part of your genetic makeup. In patients with atopic eczema, the function of their skin as a barrier to the outside world does not work well, so that irritant and allergy-inducing substance enter their skin, and may cause dryness and irritation.  Atopic Eczema is not contagious.

What are the symptoms of atopic eczema?

The main symptom is itch. Scratching in response to the itch may be the cause for many changes seen on the skin. Itching can be bad enough to interfere with sleep, causing tiredness and irritability. If the condition doesn’t itch it is not eczema.

What does Atopic Eczema look like?

Atopic eczema can start on the face in infants, but the areas most commonly affected are the flexures for example at the front of the elbows or the backs of the knees or around the neck or wrists.  The skin looks red and dry and scratch marks with bleeding can be visible. If the skin is consistently rubbed or scratched the skin may thicken up.  Affected areas may be moist or weepy and water blisters can occur.  Other common appearances of atopic eczema include discrete coin-sized areas of inflammation and numerous small bumps that coincide with the hair follicles.

How is Atopic Eczema diagnosed?

It is usually easy for your Doctor to diagnose eczema by looking at the skin. Blood tests and skin tests are usually not needed.

Can Atopic Eczema be cured?

No it cannot be cured but it can be very well controlled.  Usually your General Practitioner can give you a treatment regime to manage the condition very effectively but occasionally the help of  a doctor with a special interest in dermatology or a Dermatologist will be necessary.

How can Atopic Eczema be treated?

Moisturisers (Emollients):  These should be applied daily to help the outer layer of skin function as a barrier to the environment.

Topical steroid creams or ointments: These are anti-inflammatories that will settle the redness and itching of the eczema. Used incorrectly (too strong or for too long), topical steroids may cause side effects, but they are very safe as long as they are used correctly.

Antibiotics and/or antiseptics:  If eczema becomes wet or weeping it may be infected. Antibiotics and/or antiseptics may be required.

Topical immunosuppressants:  Tacrolimus ointment (Protopic) is sometimes required to improve skin eczema.  This would need to be used in conjunction with the appropriate skin care regime.

Antihistamines:  You may be recommend an anti-histamine.  These can be very helpful at night to alleviate the itch of atopic eczema, although they are less effective if used long term.

Bandaging (dressings):  The use of medicated paste bandages can sometimes be very helpful, as they are soothing and provide a physical barrier to scratching.  When skin is infected other treatments are more appropriate.

Ultraviolet light:  Some patients with chronic eczema benefit from ultraviolet light treatment which is given through the hospital.  One of the side effects of this would be the long term risk of skin cancer but the number and the duration of sessions would be regulated strictly through the hospital.

Stronger treatments:  People with severe or widespread atopic eczema sometimes need stronger treatments, which dampen down the immune system, and these will usually be given under close supervision of a health care professional. These include oral steroids, azathioprine, and ciclosporin.

How much does a Dermatology consultation cost?

A Dermatology consultation with Adare Cosmetics Clinic is €80.  During the consultation she will examine the patient’s skin, make a diagnosis and discuss a treatment regime, then arrange a follow up visit for a few weeks afterwards.  After that hopefully you can be discharged to the care of your own General Practitioner and would only need to see Dr. Mackle again if the condition deteriorates.

Contact us for further information on Atopic Eczema and the treatments available.

 

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