The prevalence of eczema, in particular atopic eczema, has increased significantly over the past few decades and Australia is one of the worst afflicted countries. Estimates are that one in four children under the age of two develop the condition, compared to just 50 years ago when the figure was one in 10. Among the adult population between 10 and 15 per cent are affected, so what is this burgeoning skin pandemic we have on our hands?
Eczema is a group of skin conditions that cause the skin to become dry, red, itchy and inflamed. The terms eczema and dermatitis are often used interchangeably; however, eczema is actually a type of dermatitis. Dermatitis means inflammation of the skin, and it’s a broader term that encompasses more than eczema rashes.
Atopic eczema (AE) is the most common and can be the most severe type of eczema. It is a chronic inflammatory skin condition caused by a combination of genetics, environmental factors, immune dysregulation and an impaired skin barrier function, which increases skin permeability and the risk of allergic sensitisation and inflammation. This results in an overactive immune system that causes the skin to become dry, inflamed, itchy and irritated. The term “atopic” means you have a disposition to develop allergic diseases. A family history of eczema, asthma or allergic rhinitis is a strong predictor that you could also develop AE. If both parents have eczema, there is up to an 80 per cent chance that their child will also develop eczema.
AE affects people of all ages and has a substantial psychosocial impact on individuals and their families. AE is associated with an increased risk of other health conditions including food allergies, asthma, allergic rhinitis, insomnia and mental health issues such as anxiety and depression.
AE is the most common inflammatory disease in childhood, affecting 20 to 30 per cent of infants and 15 to 25 per cent of children. Most children with AE will grow out of the disease when their skin matures; however, a recent Australian study has found that AE persists into adulthood in around 25 per cent of patients.
There are several other different types of eczema, including:
• contact dermatitis, when the skin comes into contact with an irritant or allergen
• dyshidrotic eczema, characterised by small, itchy blisters on the hands and feet • seborrheic dermatitis, characterised by scaly, red and itchy patches on the scalp and face, caused by an overproduction of oil by the sebaceous glands
• varicose eczema, caused by poor circulation in the legs
• perioral dermatitis, characterised by small, red and itchy bumps around the mouth
It is possible to have more than one type of eczema on your body at the same time.
Causes and triggers
An important step in managing eczema is minimising triggers and irritants in your environment. The most common triggers that can irritate the skin and cause eczema flare-ups include:
• stress• extremes in temperature — hot and humid, hot tubs and saunas, cold and dry conditions, air conditioning or overheating• certain foods, particularly dairy, wheat, citrus fruits, eggs, nuts, soy• gluten intolerance• food chemicals and additives like preservatives and colourings• tobacco smoke• infections• hormonal changes such as fluctuations in oestrogen before and during menstruation, during pregnancy and menopause• allergens like house dust mites, moulds, grasses, plant pollens or animal dander• chemicals in fragrances and beauty care products such as perfumes, moisturisers, body washes, soaps, shampoos and bubble bath• cleaners and disinfectants, laundry detergents and fabric softeners• abrasive clothing of wool or other artificial fabrics
