Myths about eczema

Eczema seems to becoming one of the most common reasons why persons come to their pharmacist. Is it becoming more prevalent? Or is the condition not treated by the sufferer.

When speaking to concerned parents, it is becoming apparent that many are at their wits end, and the majority rely only on their doctors prescription to provide relief, not realizing the connection between their child’s condition and the environment. What is the child eating, drinking, touching or in contact with?

As usual I will not go into a detailed explanation on eczema, which can be found on the Net, what I will do is to look at the medicines and treatments used and show that with the correct use, the full benefit of each treatment can be realised.

There are a lot of misconceptions about eczema. It’s important that we understand the condition so you can help others understand it as well. Here are a few common myths about eczema and the truth about each one.

Myth: Eczema is just like acne.

Fact: No. Eczema is not like acne — they are completely different conditions. However, it is true that some medications may cause acne and complicate eczema. Talk to your doctor, there are different medications that may help.

Myth: Eczema is caused by an emotional disorder.

Fact: Although at one time doctors did believe that eczema was caused by an emotional disorder, we now know that emotional factors, like stress, can make eczema worse. There are techniques that can help you manage the stress, anxiety, anger, or frustration that can lead to increased instances of eczema “flare ups”.

Myth: You can “catch” eczema from someone who has the disease.

Fact: Eczema is absolutely not contagious. This means that you can’t “catch” the disease from another person and you can’t give it to someone by touching him or her.

Myth: You can’t go swimming if you have eczema.

Fact: Most people with eczema can go swimming. However, some people who have severe eczema find that the chemicals used in swimming pools or the salt in sea water makes their eczema worse, so they choose not to go in. Make sure that before and after you go swimming, you rinse your skin and put on a moisturiser.

Myth: People who have eczema do not wash properly.

Fact: Of course this is not true. Having eczema has nothing to do with personal hygiene; the disease is believed to be caused by a combination of environmental, genetic and immune system factors. In reality, many eczema sufferers bathe much more frequently than non-eczema sufferers to help hydrate the skin!

Myth: Eczema will leave permanent scars.

Fact: Generally, no. Although your eczema can be very uncomfortable and unpleasant, it is very unusual for it to leave any permanent marks on your skin. However, some conventional treatments such as steroidal creams can cause skin discolouration, striae (white, shiny stretch marks), and skin thinning. Talk to your doctor if you are concerned about any unusual side effects from your current treatment

Myth: Eczema can be cured with steroids.

Fact: Unfortunately, there is no cure for eczema. Although steroids have been used for a long time to treat eczema, they are not a cure and they do have limitations for treatment.

Understanding that eczema is a skin disease, helps to understand what treatments will work, and which ones may damage.

The skin is a barrier designed to protect and cover. The cells that make up our skin retain moisture, this allows our skin to stretch and be flexible enough in normal conditions. The eczema patient though does not boast this elasticity and their skin easily dries out and becomes stiff, inflamed and will eventually split or tear.

A new way of thinking is leading to an understanding of the role of the skin barrier. The skin barrier appears to play a significant role in how effectively the skin functions, and why certain people get eczema while others do not. In healthy skin with a resilient skin barrier, allergens cannot penetrate deeper into the skin.

Instead, bacteria and irritants are prevented from entering; the skin barrier, as previously mentioned also helps to protect proper levels of hydration in the skin. Research into the skin barrier has shown that there is a genetic predisposition to a weakened, defective skin barrier. This allows allergens to penetrate the skin.

In addition, the defective skin barrier allows for increased interaction with environmental factors such as soap and detergent, house dust mites, hard water, infection and some topical pharmaceutical and cosmetic products. This can result in a worsening of eczema symptoms, and a further breakdown of the skin barrier.

It stands to reason that any treatment that can protect or enhance this skin barrier will be useful treatments for eczema. Obviously moisturising the skin will be the most important thing to do.

Certain soaps or emollients will help, emulsifying ointment or bars, when used as a soap substitute works just as well as the popular Cetaphil and for a fraction of the price. A teaspoon mixed in warm bath water (not hot) will do the trick.

After bathing, dabbing the skin and applying your moisturising cream locks in the moisture of the bath. The moisturising cream should be applied in small amounts and rubbed in until it disappears into the skin. Moisturising creams such as Aveeno, Cetaphil, and 10 per cent glycerin, 10 per cent urea mixed with aqueous cream will work equally well.

You will find on the Internet statements that suggest that aqueous cream is counterproductive in the treatment of eczema.

Aqueous cream is made from sodium lauryl sulphate; a detergent in the cream which could affect the thin layer of fats lying on top of the skin. Because of this ingredient, aqueous cream should be determined to be a detergent, more so than a moisturiser. Similarly coating the skin with petroleum based products can be problematic if overdone.

The secret to relief of eczema is to keep the skin hydrated, it will not cure eczema, but once the skin is moist, itching or scratching should not occur.

Topical steroids are used regularly and the patient or parent of a sufferer would be familiar with the brands of steroidal creams used (Advantan, Betnovate, Dermovate, Cutivate).

Topical steroids are anti-inflammatory treatments to bring the itch of eczema under control and to remove the redness. They should only be used under the supervision of a doctor and it is essential to use the appropriate strength and quantity as prescribed by your doctor. Hydrocortisone cream or ointment is also a topical steroid that can be bought from a pharmacist without a prescription. It can be used to treat mild eczema.

Antihistamines can also be prescribed to improve the itching associated with eczema.

Watching the diet of an eczema sufferer is important, certain foods, even fruits can make eczema worse. It is important that those irritants are known and eliminated.

* Bandele Serrano, is the President of the Barbados Pharmaceutical Society and the owner of Avis Pharmacy Ltd.

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