How to alleviate eczema?

The atopic eczema (or atopic dermatitis) is a chronic inflammatory skin disease that progresses in flare-ups. This dermatosis usually develops in early childhood and persists into adulthood in over 50% of cases.

Eczema affects 2 million adults in France, which is nearly 4% of the population. It is the second most common skin disease, just after acne.

Atopic eczema occurs in individuals with a specific genetic predisposition that favours allergies, referred to as an atopic predisposition. The term 'atopy' refers to a person's tendency to develop an allergic reaction to normal environmental elements (animal hair, dust, pollen...), which do not cause problems for the rest of the population. This atopy is caused by a dysfunction of the skin barrier due to a lack of sebum, lipid and cell adhesion molecule production, which then can no longer fulfil its protective role.

When a person suffers fromeczema, their skin is constantly very dry. During flare-ups, itchy red patches appear. The itching causes a thickening of the skin (lichenification) and scratch marks (excoriations).Appropriate management of eczema can reduce the frequency and intensity of flare-ups.

When suffering from atopic skin, two things are necessary.

• Restore the skin barrier.

  Atopic skin is characterised by a disruption of the hydrolipidic barrier, which no longer fulfils its protective role: the skin allows water to evaporate in large quantities, which dries it out. Moreover, it allows allergens and irritants to penetrate, thus triggering an inflammatory response. Therefore, strengthening the skin barrier is necessary to alleviate eczema.

  For this, the application of a emollient balm several times a day (at least twice), particularly between bouts of atopic eczema, is essential in order to restore the skin barrier by compensating for the lack of lipids. This helps to prevent the evaporation of water and the entry of allergens that cause the inflammatory reaction. The emollient balm nourishes, softens and soothes the skin. It provides a feeling of hydration and comfort. These benefits help to limit the frequency and intensity of flare-ups.

• Reducing inflammation:

  Although the application of an emollient balm can restore the skin barrier, it alone is not sufficient to soothe eczema: it needs to be combined with topical corticosteroids . Indeed, the emollient balm helps to strengthen the hydrolipidic barrier, but during eczema flare-ups, topical corticosteroids, through their anti-inflammatory action, help to alleviate redness and itching by reducing the inflammatory response.

  Please note : the use of dermocorticoids should be done under the supervision of a doctor. To avoid adverse effects, dermocorticoids are often used in treatment courses.

Dermatologist Dr. B. LEVY GAREL explains that there is an unjustified fear of corticosteroids, known as corticophobia: "The treatment of eczema relies on the use of topical corticosteroids. However, many patients are afraid to use them. It's important to know that untreated eczema can lead to a risk of secondary infection. Thus, the benefit/risk balance is in favour of treatment with topical corticosteroids.Of course, if your eczema requires the application of topical corticosteroids every day, it means that this treatment is not sufficient. In this case, you should consult a dermatologist. The reasoned application of topical corticosteroids, following the treatment prescribed by your doctor, aims to treat eczema without causing adverse effects through the absorption of corticosteroids into the bloodstream."