Skin Deep: Information on Eczema This Article Was Originally Written by Jan Speeden for Growing Today Magazine

Skin Deep: Information on Eczema This article was originally written by Jan Speeden for Growing Today Magazine Another sleepless night, fighting the urge to scratch – and losing. It’s enough to drive you crazy and if your eczema wasn’t aggravated by stress to start with, the stress of living with eczema certainly adds to the difficulty of finding relief. Sound familiar? Chances are you, or someone you know, suffers from eczema or dermatitis (the terms are interchangeable) as about one in five people are affected at some stage of their life. I’ve become more and more interested in eczema, it’s possible causes and the variety of remedies available. We get quite a number of visitors with eczema or more frequently bringing young children who are miserable with their itchy skin. I empathise strongly with anyone with this kind of skin problem, having developed it myself as a baby and only finding myself free of it at about 25 years old. My aim in this article is not to offer a cure – if only I could, but to make available a range of options from different healing disciplines, some self help ideas and hopefully a little insight and understanding into this very confusing and frustrating skin complaint. Before we look at the various types of eczema, let’s have a look at what happens to the skin. Our skin is made up of two layers; the thin, outer layer or epidermis – which is continually being replenished by new cells forming at its base. These travel to the surface changing their shape and structure on the way, until at the surface they compose a scaly layer which is mostly made of keratin – the same substance that forms our hair and nails. Below the epidermis is a thicker layer, the dermis which is tough and elastic, supplied with blood vessels, nerves, sweat and grease glands, hairs also grow from the dermis. Healthy skin performs a number of vital functions for the body including: • temperature control • excreting waste products • a sensory organ • providing a barrier against infection • protecting the body from the sun • manufacturing some of our Vitamin D requirements 1 In an eczema sufferer there is generally a higher than normal level of white blood cells in the epidermis and dermis – normally they are present mainly in the blood. These white cells release chemicals which irritate the skin and set up the “scratch-itch- scratch” cycle. In cases of allergic dermatitis a group of white blood cells known as T lymphocytes act as vigilantes and develop a specific memory for the contact substance. These cells multiply rapidly triggering a skin reaction, often forming small blisters. Scratching is the means by which eczema becomes visible, this can become extreme and damage the skin, creating more irritation, swelling and redness. Once the skin is broken there is also the risk of secondary infection. Any form of eczema can be: Acute: where the skin is red, inflamed, moist and swol- len, itchy and painful, often tiny blisters appear which burst and weep. This stage is uncomfortable but short lived. Or Chronic: this is a long term phase, dominated by itching – which in turn leads to thickening of the skin as a defence mechanism. On the positive side when the eczema does clear up it generally disappears without a trace. The following list is a guide to the various shapes and sizes eczema comes in and, of course, there are exceptions to the rules and some people may suffer from several different forms at different times or more miserably, at the same time. Types of Dermatitis or Eczema 1. Atopic Dermatitis – Childhood Eczema: Frequently linked with a family history of asthma, eczema or hayfever. It affects equal numbers of boys and girls, usually occurring in infancy and subsiding at puberty. Common Sites: Patches of dry irritable skin on the face, behind the ears, behind the knees and in the folds of the elbows. Child may alternate bouts of eczema with asthma, may well have brothers or sisters suffering from hayfever or asthma. 2. Seborrhoeic Eczema: Affects areas where the sebaceous glands are most numerous (around hair follicles). a) Infantile “cradle cap”, where baby has a greasy, scaly scalp and some redness and scaling in body folds. Generally occurs between 3 – 9 months and does not usually bother the child. b) Adult – tends to affect men more than women (and more often with fair hair and skin), pink scaly patches form on scalp, eyebrows, ears, face, front of chest and body folds. Frequently preceded by bouts of dandruff and itchy scalp. 2 3. Contact Irritant Dermatitis Pretty self explanatory – rash develops in response to exposing the skin to an irritant on first contact. Redness and itching appear on skin involved. Common triggers include: soap, detergents, shampoo, perfumes, washing powders which contain stain digesters, bleaches, caustics, paraffin. 4. Contact Allergic Dermatitis Reactions may occur after many years of handling a substance. Does not develop on first contact, reaction arises after repeated contact. There may be a delay of up to a week before the skin reacts and possibly the reaction will not appear on the area that was originally in contact with a substance. More commonly occurring in women. Common allergens include: nickel found in jewellery, animal hair, colophony found in sticking plasters, some plants including Primula obconica, Rue, Angelica and Giant Hogweed. 5. Stasis or Varicose Eczema This form of eczema is common in middle aged and elderly persons suffering from varicose vein problems. The sluggish blood supply to the lower legs deprives the skin and tissues of nutrients – leading to thin, reddened skin, often blotchy with a scaly rash. If skin is damaged in this area it is important not to scratch as this may easily lead to varicose ulcers which are very difficult to heal. 6. Neurodermatitis (Lichen Simplex Chronicus) Often a small area of skin is affected, frequently on the arms, lower legs or back of the neck. This area is extremely itchy and uncomfortable and the habit of scratching is formed. This is aggravated by tiredness and stress. Most commonly found in middle aged people. 7. Nummular or Discoid Eczema Presents as round, red areas, frequently found in young adults, on the lower arms or lower legs. Looks like ring worm and is very itchy – they frequently become secondar- ily infected. Related to seborrhoeic eczema. 8. Asteatotic Eczema Elderly people may develop this eczema, the lower legs become dry and cracked and look like crazy paving. It responds well to the use of emollients, moisture retaining preparations and the addition of some dietary supplements. Ok, we’ve looked at the various forms eczema takes and a little at what happens under the skin. Now, let’s take a look at some different healing disciplines, how the source of eczema is perceived and each disciplines approach to its remedy. In writing this I am trying to remain objective, make sense of what I have been told or have read and regurgitate it for you, so that you can look at some of the options and make an informed choice of where to go from here, although as you will realise there are a lot of other choices available. 3 Sifting through the screeds of information I have, there are some common themes, and these seem to me, common sense care for those suffering from eczema, or with skin prone to eczema. • Wear cotton clothing especially next to the skin; this also includes cotton gloves under rubber gloves for cleaning etc if your hands are sensitive. • Keep fingernails short and clean. • Avoid extremes of temperature, this includes baths and showers and exercise that increases the body temperature – going from hot to cold or cold to hot triggers the itching mechanism. • Don’t use soap on your skin, there are soap free preparations. A couple of tablespoons of cider vinegar in the bath will act as a deodorant and soothe skin. Oatmeal bags or flax seed brew will soften and soothe skin. Pat skin dry and don’t rub. • Avoid alcohol. • Check out possible allergy producing substances both contact and internal; some possible food substances are dairy products, citrus, spices, fish and seafood, eggs and wheat products. Salicylates can be a trigger for eczema (this is a broad topic and would take many pages). If you think food allergies are contributing to your problem you can check them out in more detail online, or even at the library! • Avoid exposing yourself to people with coldsores, herpes simplex. • Lanolin plugs the oil glands and vaseline and other greasy ointments aggravate eczema by preventing the evaporation of sweat, so it’s best to avoid these and products including them. • Stress, tension, tiredness and anxiety can trigger a flare up of eczema or exacerbate an existing condition. • Application of emollients, moisturisers, bath oils etc help skin to retain moisture and lessen irritation, & are most effective applied to damp skin, straight out of the shower. • As for asthma sufferers, dust, animal hair and feathers can be serious irritants. Use synthetic bedding materials and keep drapes and floor coverings to a minimum especially in the sufferer’s bedroom. • If your families have a history of asthma, hayfever or eczema try to prolong breast feeding and wean onto goat’s milk products. Orthodox Medicine: Tends to focus on external remedies, emollients, topical steroids and preparations con- taining tar. These are supplemented when necessary with antibiotics and antihistamines internally. There is much concern over the use of steroid creams and the side effects include thinning of the skin, development of small visible blood vessels on the skin and stretch marks, like those of pregnancy, in the skin folds.

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