Learn more about eczema.

Eczema is a chronic inflammatory disease of the skin that progresses in flare-ups. It is very common, making it the second most frequent skin disease, following acne. Children are particularly affected by eczema, and it is estimated that around 17% of 6 - 11 year olds are afflicted. Depending on the case, eczema can either disappear or persist into adulthood.

Several forms of eczema are recognised. One of the most common is atopic eczema. Also known as atopic dermatitis, it is caused by an atopic genetic predisposition. Studies have shown that atopic eczema is often associated with mutations on the genes coding for filaggrin and other proteins essential to the integrity of the stratum corneum. This results in an ineffective skin barrier that allows water to evaporate easily and allergens to penetrate. Moreover, individuals with atopic dermatitis typically secrete large amounts of immunoglobulin E (IgE) in response to environmental antigens, causing disproportionate immune reactions when the skin comes into contact with a common allergen (animal hair, dust...).

Eczema can also be acquired and result from an allergic reaction, in which case it is referred to ascontact eczema. The reaction is due to a specific substance that the skin cannot tolerate. Another form of eczema is thenummular eczema, characterised by well-defined round erythematous patches. The etiology of this type of eczema is poorly understood. There is also thedyshidrotic eczema, affecting the hands and feet, and thedeficiency eczema, which manifests following a zinc deficiency in the body.

Although regarded as a mild condition, eczema is associated with numerous troublesome symptoms and impacts the daily lives of those who suffer from it.

• Lesions.

  Red and inflammatory, eczema lesions appear during flare-ups. Generally, they affect the face, neck, and also the body's folds. Initially red and warm, they are accompanied by a sensation of itching. A few hours later, small vesicles filled with clear fluid appear at the site of the red lesions while the itching continues. Following the scratching of these vesicles, they become weepy and the skin thickens (lichenification) before healing with or without scars.

• Itching.

  During its flare-up periods, eczema causes significant itching that impacts the life of the affected individual. Irritability, sleep disturbances, fatigue... are all consequences of the itchiness.

• Skin dryness.

  An atopic skin is perpetually very dry, due to its inability to retain water: this is referred to as xerosis. The skin feels tight and uncomfortable, even outside of flare-ups. Certain external factors such as prolonged contact with water or the use of unsuitable products exacerbate xerosis.

The solutions to soothe eczema largely depend on its origin. Indeed, allergic eczema will be relatively easy to target and the elimination of the irritating substances responsible will be enough to make the reaction disappear. If the eczema is genetic, it is impossible to predict if the flare-ups will manifest again one day. However, it is recommended to use emollients daily. In the form of creams, milks or balms, these rich treatments help to restore the skin barrier and re-lipidise the epidermis.

To soothe the skin and alleviate itching during eczema flare-ups, dermatologists often prescribe topical corticosteroids. These cortisone-based products should be applied at the onset of a flare-up to mitigate it as quickly as possible. Sessions of phototherapy are also sometimes suggested. This method utilises UV rays to relieve red lesions and itching.

Other tips exist to soothe itching. Certain natural ingredients such as honey, the aloe vera gel or essential oils of tea tree or true lavender are recognised to be anti-inflammatories, thus reducing itching. The application of cold compresses is also recommended, for fifteen minutes three to four times a day. Cold is an excellent soothing agent and anti-scratch ally.

• ROGUEDAS A. M. et MISERY L. Atopie et stress. Annales de dermatologie et de vénéréologie (2004).

• GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).

• YEUNG J. & al. Diagnosis and treatment of pruritus. The College of Family Physicians of Canada (2017).