Eczema (Atopic Eczema)
What is atopic eczema?
eczema is an inflammatory condition of the skin. Atopic is the term
used to describe conditions such as eczema, asthma, seasonal rhinitis
and hay fever, which often have a genetic basis. Eczema is the term used
to describe changes in the upper layer of the skin that include
redness, blistering, oozing, crusting, scaling, thickening and sometimes
pigmentation (although not all of these changes will necessarily occur
together). The words eczema and dermatitis are interchangeable and mean
the same thing: thus atopic eczema is the same as atopic dermatitis. For
simplicity we shall use atopic eczema in this leaflet.
eczema affects both sexes equally and usually starts in the first weeks
or months of life. It is most common in children, affecting at least
10% of infants at some stage. It usually disappears during childhood,
although it can carry on into adult life or come back in the teenage or
early adult years. It may occasionally develop for the first time in
What causes atopic eczema?
is still not fully understood. A tendency to atopic conditions often
runs in families (see below) and is part of your genetic make-up. In
people with atopic eczema, the function of their skin as a barrier to
the outside world does not work well, so that irritant and
allergy-inducing substance enter their skin, and may cause dryness and
inflammation. Atopic eczema is not catching.
Is atopic eczema hereditary?
Atopic eczema (as well as asthma and hay fever) tends to run in
families. If one or both parents suffer from eczema, asthma or hay
fever, it is more likely that their children will suffer from them too.
In addition, there is a tendency for these conditions to run true to
type within each family: in other words, in some families most of the
affected members will have eczema, and, in others, asthma or hay fever
What are the symptoms of atopic eczema?
main symptom is itch. Scratching in response to itch may be the cause
for many of the changes seen on the skin. Itching can be bad enough to
interfere with sleep, causing tiredness and irritability.
What does atopic eczema look like?
eczema can affect any part of the skin, including the face, but the
areas most commonly affected are the bends of the elbows and knees, and
around the wrists and neck (a flexural pattern). Other common
appearances of atopic eczema include discrete coin-sized areas of
inflammation (a discoid pattern), and numerous small bumps that coincide
with the hair follicles (a follicular pattern).
you have eczema, it is likely your skin will be red and dry, and
scratch marks (and bleeding) are common. When the eczema is very active
(during a ‘flare-up’) you may develop small water blisters on the hands
and feet, or the affected areas of your skin may become moist and weepy.
In areas that are repeatedly scratched, the skin may thicken up (a
process known as lichenification), and become even more itchy.
What makes atopic eczema flare up?
Many factors in a person’s environment can make eczema worse. These include;
- Heat, dust and contact with irritants such as soap or detergents
- Being unwell: for example having a common cold can make eczema flare
with bacteria or viruses can make eczema worse. Bacterial infection
(usually with a bug called Staphylococcus) makes the affected skin
yellow, crusty and inflamed, and may need treatment with antibiotics. An
infection with the virus that causes cold sores (herpes simplex virus)
can cause a painful widespread (and occasionally dangerous) flare of
eczema, and may need treatment with antiviral tablets
- Dryness of the skin
- Perhaps stress