Eczema: Symptoms, Treatments, And Causes

This content is for information purposes only and is not provided with the intention of diagnosing a condition or illness. You should speak to a medical professional for diagnosis.

Atopic dermatitis (commonly known as eczema) is a recurring, non-infectious, inflammatory skin condition affecting one in three Australasians at some point in their lives¹. People with eczema find it hard to keep the moisture in their skin, so it becomes dry and easily irritated².

No one knows exactly what causes eczema, but it can run in families². Many people who suffer from eczema also have other allergic conditions such as hay fever and asthma.

Eczema can vary in severity and symptoms may flare up and subside from day to day. There is usually no single trigger for an eczema flare³.

What causes eczema?

Eczema is caused by a person’s inability to repair damage to the skin barrier due to a mutation in the gene called filaggrin⁴. Normally, every cell in the skin has two copies of the filaggrin gene; people who are susceptible to eczema only have one copy of this gene.

If a person’s skin is exposed to irritants and their skin barrier is affected, a person with only one copy of the filaggrin gene may have difficulty repairing their skin barrier.

Once the skin barrier is broken, moisture leaves the skin and the skin will become dry and scaly. Environmental allergens can also enter the skin and activate your immune system, producing inflammation that makes the skin red and itchy⁴.

Although eczema affects people of all ages, it usually appears in babies between two and six months of age and generally disappears at around six years of age¹.

What are the symptoms of eczema?

People with eczema have areas of red, dry, itchy skin, most often in the creases of their elbows, wrists, neck, and behind the knees. They might experience watery fluid weeping from the affected skin, and lesions (sores) that may become infected by bacteria or viruses².

How common is eczema?

One in three Australasians will be affected by eczema during their lives¹. The condition is most common in people with a family history of eczema or allergies⁴.

• Infantile eczema occurs in around one in five children under 2 years old and usually improves by 5 years of age.
• Childhood eczema may follow infantile eczema or start from 2 to 4 years of age.
• Adult eczema symptoms include rashes and dryness in elbow creases, behind the knees, or on your face, ears, and neck.

What triggers eczema?

Triggers vary from person to person, however, the following things are generally regarded to make eczema symptoms worse²:

• Dry skin
• Scratching the affected area
• Viral or bacterial infections
• Swimming pool chemicals
• Artificial colours and preservatives
• Sand, especially from sandpits
• Some types of carpet or grass
• Allergens that you can breathe in, such as pollen
• Woollen or synthetic fabrics
• Hot weather and hot showers

How is eczema diagnosed?

Eczema can be diagnosed by a doctor or skin specialist (usually a dermatologist). Itching is an important clue to diagnosing eczema – if an itch is not present, it’s unlikely that the problem is eczema¹.

How do you treat eczema?

Treatment options for eczema include⁴:

• Moisturisers (emollients): it’s recommended to apply moisturiser every day, especially after showering and if you live or work in an air-conditioned or heated environment.
• Anti-inflammatory creams: topical steroids (corticosteroids) are usually available by prescription from your doctor and come in various strengths. It’s generally better to use the lowest strength cream that’s effective in treating your eczema.
• Phototherapy: exposure to ultraviolet (UV) radiation can help reduce the symptoms of chronic eczema. It’s important that your exposure is carefully monitored by a doctor as UV therapy can cause faster ageing of the skin and greater risk of skin cancer, similar to sunbathing.
• Oral anti-inflammatory medication: most people affected by eczema can manage the condition with creams alone. Oral anti-inflammatory treatment is only considered in severe cases of eczema that are resistant to other treatment. The side effects can include high blood pressure, increased susceptibility to infections, and mood and behavioural changes.

Can eczema be cured?

No. There is no known cure for eczema; it can be a lifelong condition. In most cases, eczema tends to improve with age⁵.

Is eczema contagious?

No, eczema is not contagious⁴.

How can I manage my eczema?

Both children and adults can follow these steps to manage and minimise the severity of their eczema⁶:

• Keep your fingernails short to prevent scratching from breaking your skin
• Wear cotton mitts or gloves at night
• Wear 100% cotton whenever possible
• Have lukewarm baths and showers
• Use hypoallergenic products and avoid perfumed products
• Pat skin dry with a soft towel after showering
• Apply moisturiser within three minutes of showering
• Use washing powders and detergents for sensitive skin

Are there any complications associated with eczema?

As skin affected by eczema is often broken, the sufferer can be at risk of contracting bacterial and viral infections including¹:

• Staphylococcus aureus (golden staph)
• Herpes simplex virus (cold sores)
• Warts

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Sources:
1. https://www.eczema.org.au/eczema-facts/
2. https://www.healthdirect.gov.au/eczema
3. https://www.allergy.org.au/patients/fast-facts/eczema-atopic-dermatitis
4. https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/eczema-atopic-dermatitis
5. https://healthywa.wa.gov.au/Articles/A_E/Eczema-atopic-dermatitis
6. https://www.eczema.org.au/managing-eczema/