Eczema

What is Eczema?

Eczema is an endogenic chronic, recurring itching skin condition with genetic predisposition. This means that the disease is always present, even though flares may come and go. The symptoms of eczema include dry, inflamed skin and intense itching. Chromosome 11 and 5 predicts the tendency and is part of the atopic syndrome of atopic eczema, hay fever, sinusitis, asthma, keratosis pilarus and allergies of ear, nose and throat. Eczema flares happen because the immune cells in an eczema sufferer's skin overreact to certain triggers. Therefore it is very helpful to identify and avoid exposure to those triggers.

Many people think of eczema as "just a rash" but for millions it is a frustrating, persistent condition that can make their lives miserable. At times, eczema can be so mild that it may not even be noticeable and Often it can be severe enough to keep a person awake. Eczema is not contagious; it cannot be passed from person to person.

These children are frequently staphylococcus aureus carriers and potent super antigenic endotoxin stimulates Th2 cells with interleukin 3, 4 and 5 produced. The Th1 cells also produce interleukin 2 and interferon gamma. Not controlling these staphs prevents healing and resistant eczema is then seen. Triclosan kills these bacteria (Créme Classique soap and Créme Classique cream.)

More prone to: Warts, mollusca, herpes simplex, vaccinia, alopecia areata.

Environmental aggravating factors:

Scratching, excessive water contact, detergents and bubble bath may dry the skin in an already dry skin. A dry climate ,solvents, tension, heat, sweat, playing on grass and wearing wool and nylon as well as playing on nylon carpets, skin friction, animal hair irritates the super sensitive skin.

Avoid: house dust- mites, cockroaches and environmental allergens especially on carpets and floors.

Prolonged breast feeding may prevent or suppress attacks.

Prognosis

60% Of children will outgrow the condition before 5-15 years of age and 85% before 15-20 years of age. In adults a chronic hand and foot eczema may develop in later years after outgrowing the childhood phase and careers exposed to irritants and clamminess like hairdressing, mechanics, labworkers, builders may severely be affected.

Treatment of eczema

Wash: Wash with a neutral non irritating soap like Créme Classique soap containing Triclosan for the staph super infection. Moisturizing cream like Créme Classique may be used. Pat dry after wash, but do not rub. Use a soft cotton towel. Water should be body temperature. Try to prevent prolonged exposure to water. 3 Minutes maximum daily bath/shower, avoid excessive swimming. Avoid bubble baths and detergents.

Moisturize: The top epidermis in atopic skin is dehydrated due to a reduced lipid barrier function of the stratum corneum. Excessive evaporation takes place during drying, minute cracks appear in the epidermis, allowing allergens and bacteria to penetrate. Weeping and oozing is noticed due to spongiosis and leaking of tissue fluid through the epidermis. Excessive water contact like swimming absorbs excessive water and reduces the barrier function and evaporation takes place, AGGREVATING THE CONDITION. Using Créme Classsique Ointment before any water contact improves the barrier function on skin.

Non-cortisone anti-inflammatory creams and ointment: Créme Classique cream or ointment contains Cetomagrocol Chlorocresol as preservative. Parabens as preservative may trigger allergic contact dermatitis if used frequently.

Diluted cortisone cream or hydro-cortisone: 10-20% Dilution of cortisone cream in Cetomagrocol 3 x /day penetrates better than cortisone by itself and with the anti-inflammatory affect may be more effective, less damaging and cheaper than full strength ointments. A dilution may be applied for long periods with minimal cortisone detrimental effect.

Alternative to cortisone creams: Coal tar cream is prescribed and may help if cortisone treatment failed.

Anti-itch: The older oral sedating H1 anti-histaminics like Phenergan and Aterax are very affective, especially at night.

Narrow Band Ultra Violet (311 nm): This treatment is very effective and remissions for months are noticed with no side effects.

Deka Excilite - µ (308 nm): Deka Exicile-µ is a Monochromatic Excimer Light (MEL@ 308 nm) which offers a revolutionary way of treating eczema. MEL@308nm for targeted Phototherapy marks a decisive breakthrough on traditional treatments and methods.

Extreme cases: Cyclosporin treatment by a dermatologist or pediatrician on a 6 weeks course or shorter.

Special Diets

Remember that breast feeding may prevent attacks. Soy may cause allergies in atopic patients. Children with eczema are more likely to have or develop allergies to certain foods (milk, wheat, peanuts) and airborne allergens (dust mites, molds, pet hair). Make sure to pay attention to any allergens that you may have that triggers eczema or make it worse. Consult a Specialist to determine what you are allergic to.

Noticeable symptoms of Eczema?

An itchy red rash that keeps recurring
Dry patchy, bumpy, or scaly areas on the skin
A family history of hay fever, asthma and or eczema

There is no cure for Eczema but there are many products available to provide relief, reduce the redness and help control your Eczema to minimize its impact
Make sure your room is not too warm to avoid sweating while sleeping and don't let your skin dry out.


For a definite diagnosis of Eczema contact Dr H A De Beer on 012 343 5592 who will recommend an appropriate treatment programme. Contact Advanced Dermatology on 012 809 6090 to discuss your Eczema

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