Eczema causes itching, redness and dryness as well as weeping and bleeding in severe cases.  Not only can eczema cause considerable physical discomfort, but it can also have a profound psychological impact.

What causes eczema?

A number of factors contribute to causing inflammation in patients with eczema.  Genetics play a part with that maintain the integrity of the skin barrier.  Patients with eczema have a leaky skin barrier that allows irritants and allergens in, and water out, and this situation is often compounded by colonisation with bacteria such as staphylococcus aureus.

What are the different types of eczema?

Atopic eczema: this is the most common type of eczema and often starts in childhood.  There is often a genetic predisposition and it is linked to other allergic conditions such as asthma, hay fever and food allergy.

Dyshidrotic eczema: also known as pompholyx eczema, this presents on the hands or feet in the form of intensely itchy blisters which clear up leaving dry and cracked skin.

Asteatotic eczema: or eczema craquele is the result of very dry skin and often affects the elderly, as skin oil production decreases.

Discoid eczema: also known as nummular dermatitis.  This type of eczema is characterised by disc-shaped red and dry patches and typically appears on the legs, torso and arms.

Contact dermatitis: allergens including metals, fragrances, preservatives and adhesives can cause contact dermatitis which can be either irritant or allergic.  Dr Williams can arrange patch testing to investigate this possibility.

Seborrheic dermatitis: is caused by a yeast and causes a flaky, itchy, red rash that affects the scalp, eyebrow, nose, chin and sometimes chest area in adults.  In young children, it can affect the nappy area.

Do I need allergy testing?

Eczema is usually caused primarily by defects in the skin barrier rather than allergies but patients with moderate to severe atopic eczema are more likely to develop food and other immediate type allergies.  Dr Williams has a special interest in allergy and after taking an allergy focussed clinical history can advise whether or not allergy testing; either skin prick testing or specific IgE blood tests are indicated.

When eczema occurs at a particular site such as the hands, or face it can be caused by an allergic contact dermatitis.  Dr Williams can arrange patch testing at Ashtead Hospital to investigate this.

What are my treatment options for eczema?

The first step of eczema treatment is to avoid irritants such as detergents and fragrance.  Regular moisturising is important in the treatment of all types of eczema and Dr Williams can advise on the most suitable emollient for you.

In the majority of cases, eczema can be controlled with a reducing treatment plan of the correct strength of topical cortico-steroids and calcineurin inhibitors.  Dr Wiliams can provide a personalised written treatment plan that explains where, when and how to use each cream.  Some severe cases of eczema require treatment with phototherapy or systematic medication.