Referral To A Specialist
You may be referred to a hospital specialist for further tests. You might see a doctor or surgeon who specialises in conditions affecting blood vessels , or a doctor who specialises in skin conditions if:
- you have varicose veins and changes to your skin, such as varicose eczema, lipodermatosclerosis or a history of leg ulcers
- you have very poor blood flow in your legs
- your symptoms do not get better, despite treatment
- it’s possible you have contact dermatitis
Other Types Of Eczema
Eczema is the name for a group of skin conditions that cause dry, irritated skin.
Other types of eczema include:
- discoid eczema a type of eczema that occurs in circular or oval patches on the skin
- contact dermatitis a type of eczema that occurs when the body comes into contact with a particular substance
- varicose eczema a type of eczema that most often affects the lower legs and is caused by problems with the flow of blood through the leg veins
- seborrhoeic eczema a type of eczema where red, scaly patches develop on the sides of the nose, eyebrows, ears and scalp
- dyshidrotic eczema a type of eczema that causes tiny blisters to erupt across the palms of the hands
Page last reviewed: 05 December 2019 Next review due: 05 December 2022
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How To Prevent Eczema
Before you can prevent Eczema from flaring up, youll need to understand its triggers. Eczema flare ups can be caused by many things in the environment. Common environmental causes are pollen, dust mites, pet dander, and dandruff. Some food can also trigger Eczema flare ups so it is advisable that you do your research and seek professional assistance to find out what food is suitable for your condition. Try to stay away from triggers that will aggravate the Eczema.
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Eczema Research And Clinical Trials
We offer a number of clinical trials for patients with all types of eczema. We offer trials for topical treatments, pills, and injection medications in patients of all ages.
Some of these developments directly stem from research conducted in our Eczema Program. One such discovery is a treatment targeting a specific white blood cell called a T-helper 22 lymphocyte , which we found to be highly increased in eczema cases and associated with disease severity.
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How Is Eczema Treated
There is no cure for eczema. But treatments can help with symptoms. The doctor will recommend different treatments based on how severe the symptoms are, the childs age, and where the rash is. Some are topical and applied to the skin. Others are taken by mouth.
Topical moisturizers. Skin should be moisturized often . The best time to apply moisturizer is after a bath or shower, with the skin patted dry gently. Ointments and creams are best because they contain a lot of oil. Lotions have too much water to be helpful.
Topical corticosteroids, also called cortisone or steroid creams or ointments. These ease skin inflammation. Its important not to use a topical steroid prescribed for someone else. These creams and ointments vary in strength, and using the wrong strength in sensitive areas can damage the skin, especially in infants.
Other topical anti-inflammatory medicines. These include medicines that change the way the skins immune system reacts.
Medicine taken by mouth. These can include antihistamines to help itchy kids sleep better at night, antibiotics if a rash gets infected by bacteria, and corticosteroid pills or other medicines that suppress the immune system.
Other types of treatment can include:
- wet wraps: damp cloths placed on irritated areas of skin
- bleach baths: bathing in very diluted bleach solution
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When To Get Medical Advice
See a GP if you have symptoms of varicose eczema. Your doctor will often be able to make a diagnosis simply by looking at your skin.
A GP will also ask you questions to determine whether you have a problem with the flow of blood in your leg veins, as this is the main cause of varicose eczema.
To help make a diagnosis, a GP may want to know if you have ever had health conditions such as:
- varicose veins swollen and enlarged veins
- DVT a blood clot in the veins of your legs
- leg ulcers areas of damaged skin that take several weeks to heal
- cellulitis an infection of the deeper layers of the skin and underlying tissue
- surgery or injury to your legs
A GP may also check the pulse in your feet and may do an ankle brachial pressure index test to see if compression stockings are suitable for you.
The ABPI test involves comparing blood pressure readings taken from your ankles and upper arms. A significant difference in the readings suggests a problem with the flow of blood in your arteries in which case, compression stockings may not be safe to use.
What Is Varicose Eczema
This is the term used for skin changes that happen when the pressure in the veins of the legs increases. You may also hear it called gravitational eczema, stasis eczema or venous eczema.
This is a photo of varicose eczema in an elderly man. It’s an example of long-standing varicose eczema, as seen by the thickened, dark-stained skin:
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Home Remedies Can Help
The best way to manage eczema around the eyes is to keep the skin in the area highly moisturized.
- Avoid drying face washes. Choose leave-on emollient products that keep the skin moisturized while they cleanse it.
- Avoid fragrances. Many skincare products contain added fragrances. Choose products that are fragrance-free.
- Use gentle products. Ask your dermatologist for recommendations for gentle moisturizers. These will keep skin moist and free from irritation.
- Wear sunscreen and sunglasses. Sun exposure can make the skin on your eyes more sensitive and lead to eczema outbreaks. Aim to limit exposure.
- Avoid triggers. If you know certain allergens or products trigger an outbreak, steer clear of these. Stick to tried-and-true favorites that you know dont irritate your skin.
Unfortunately, eczema is a persistent skin condition that is tricky to treat. For some people, eczema subsides over time as they get older. Other people, however, may have to deal with the condition throughout their lifetime.
As more information is gained on the condition, more effective treatment and symptom management options are becoming available. A combination of the above treatment options and preventative measures works best for most people.
How Can I Help My Child Live With Atopic Dermatitis
Atopic dermatitis has no cure. But it will usually get better or go away as your child gets older. There may be times when your child has few or no symptoms. And he or she may have times when symptoms get worse. This is called a flare-up. To help prevent flare-ups, make sure your child:
Stays away from triggers. Common triggers include irritants such as wool, soap, or chemicals. Other triggers include allergens such as eggs, dust mites, or pet dander. Stress is also a trigger.
Doesnt scratch the skin. Try to keep your child from scratching. It can cause symptoms to get worse. It can also cause infection.
Always has short fingernails. Trim or file your childs nails to keep them short and prevent scratching.
Takes baths or showers with warm, not hot, water. Air dry or gently dry the skin afterward.
Uses moisturizers. Put creams or ointments on after bathing.
Wears soft clothing. Dont dress your child in wool or other rough fabric.
Keeps cool. Try to keep your child as cool as possible. Getting hot and sweating can make him or her more uncomfortable.
Doesnt get the smallpox vaccine. Its not a common vaccine, but people with atopic dermatitis should not get the smallpox vaccine.
Talk with your childs healthcare provider about other ways to help your childs skin condition.
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What Questions Might My Healthcare Provider Ask To Diagnose Eczema
The conversation with your healthcare provider will need to cover a lot of information. Be sure to be specific about your symptoms.
- Where is your eczema located?
- What have you used to try to treat your eczema?
- What medical conditions do you have? Allergies? Asthma?
- Is there a history of eczema in your family?
- How long have you had symptoms of eczema?
- Do you take hot showers?
- Is there anything that makes your symptoms worse?
- Have you noticed that something triggers or worsens your eczema? Soaps? Detergents? Cigarette smoke?
- Is there so much itchiness that you have trouble sleeping? Working? Living your normal life?
Gentle Soaps And Detergents
Laundry detergent can contain harsh chemicals that aggravate eczema.
Many body washes and cleansers contain detergents, which help provide a soapy lather. Detergents and other lathering agents can dry out the skin, especially in people with eczema.
Bar soaps can also be harsh on the skin because of their alkalinity.
Try using a gentle, no-lather, fragrance-free cleanser. Avoid products with rough particles for scrubbing or exfoliating, as these can further irritate the skin.
Many people with eczema also find that switching to a more gentle, fragrance- or color-free laundry detergent can help improve symptoms.
Additionally, try skipping fabric softener, which lingers on clothes and often contains fragrances and chemicals that can irritate the skin.
Sitting next to a fireplace or near a furnace may feel good, but it can worsen eczema symptoms. The hot, dry air can dehydrate the skin and aggravate the itchiness of eczema.
Use a humidifier during the dry winter months and avoid getting too close to heaters and fireplaces.
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Causes Triggers And Risk Factors
Researchers are still unsure of the exact cause of pediatric eczema. However, the American Academy of Allergy, Asthma, & Immunology suggests that it may result from the leakiness of the skin barrier. This can lead to the skin drying out, making it more prone to irritation and inflammation. Factors that can contribute to the development of eczema in children include :
- Genetics: Children with a family history of eczema, allergies, or asthma are more susceptible to developing eczema. Mutations in certain genes, such as CARD11 and FLG, also have associations with eczema.
- The immune system: A person may experience a flare of eczema when their immune system overreacts and causes an exaggerated response to a trigger.
- The environment: The envirome refers to potential triggers an individual may have exposure to, including pollutants, such as tobacco smoke, climate factors, such as temperature, and social factors, such as stress.
Evidence also highlights a link between allergies and eczema in younger children. Many experts refer to the progression of allergic conditions as the . It typically begins with atopic dermatitis and food allergies in infancy, then develops into allergic asthma and allergic rhinitis in childhood.
People with eczema are
When diagnosing eczema, doctors will likely ask about:
Currently, there is no cure for eczema, but the condition is manageable. Treatments typically involve keeping the skin moist and reducing inflammation. A treatment plan may include:
What Can I Expect If Ive Been Diagnosed With Eczema
Nearly half of children with eczema will outgrow the condition or experience great improvement by the time they reach puberty. Others will continue to have some form of the disease. For adults with eczema, the disease can be generally well-managed with good skin care and treatment, although flare-ups of symptoms can occur throughout life.
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Eczema Coping Tips Reducing Skin Irritation
People with eczema have sensitive skin. Irritants such as heat or detergents can easily trigger a bout of eczema.Suggestions for reducing skin irritation include:
- Avoid overheating your skin. Wear several layers of clothing that you can remove, as required, instead of one heavy layer. Dont put too many blankets on your bed and avoid doonas.
- Dont use perfumed bubble bath or bath products labelled medicated.
- Wear soft, smooth materials next to your skin, preferably 100% cotton. Avoid scratchy materials, such as pure wool, polyester or acrylic. You could try a cotton and synthetic mix material this is fine for some people with eczema. Remove labels from clothing.
- Always wear protective gloves when using any type of chemical or detergent. You may want to wear cotton gloves inside rubber or PVC gloves.
- Avoid chlorinated pools. If you have to swim in a chlorinated pool, moisturise your skin well when you get out.
Getting Diagnosed With Dermatitis
If you have dry, itchy or scaly skin on your legs, make an appointment at your GP practice. You may be given an appointment to see the nurse rather than the doctor as nurses are often responsible for caring for patients with leg problems.
Alternatively, there might be a Leg Club or specialist leg clinic in your area. You dont need to be referred by your GP to attend one of these.
When you see the nurse or doctor, they should:
- Ask about your symptoms and how long you have had problems
- Examine your lower legs
If it looks like you have varicose eczema, you may be offered a simple test called a Doppler ultrasound. This test compares blood flow in your ankle with that in your arm to find out if there are blood flow problems in your lower leg. You might have to come back to have your Doppler test on another day or at another clinic but you should have this test within a few weeks of your first appointment.
You may also wish to visit your local pharmacy in the first instance and speak to a pharmacist who may be able to assist.
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What Are Common Triggers
Atopic eczema is aggravated by different factors depending on the individual, but common triggers include cold, dry weather, stress, hot water and harsh soaps, says Anderson. In the winter, cold outdoor temperatures and indoor heating make for an irritating combination. Most people with eczema get better in the summer as the temperature and humidity levels tend to be higher, leaving the skin more moist, says Anderson.
As for contact eczema, Anderson says skin will flare up whenever its touched by an irritating substance, regardless of the season.
Why Is It So Important To Moisturize After A Bath Or Shower
Water is an effective way to put moisture back into the skin, but only if you use lukewarm water, avoid scrubbing and apply a moisturizer within three minutes after bathing or showering. This last step very important if you dont moisturize immediately afterward, the moisture your skin needs will evaporate and may cause a rebound effect making the skin even more dry.
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How Is Eczema Diagnosed
There is no specific test used to diagnose eczema. The doctor will look at the rash and ask about symptoms, the child’s past health, and the family’s health. If family members have any atopic conditions, that’s an important clue.
The doctor will rule out other conditions that can cause skin inflammation, and might recommend that your child see a dermatologist or an allergist.
The doctor may ask you to ban some foods from your child’s diet, switch detergents or soaps, or make other changes for a time to see if your child is reacting to something.
Wear Gloves To Protect The Skin On Your Hands
Wear vinyl or plastic gloves for work that requires you to have your hands in water. Also, wear gloves when your hands are exposed to anything that can irritate your skin. Wear cotton gloves under plastic gloves to soak up sweat from your hands. Take occasional breaks and remove your gloves. This will prevent a buildup of sweat inside your gloves.
Wear gloves when you go outside during the winter. Cold air and low humidity can dry your skin. Dryness can make your eczema worse. Wear clothes made of cotton or a cotton blend. Wool and some synthetic fabrics can irritate your skin.
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How Is Atopic Dermatitis Diagnosed In A Child
The healthcare provider will ask about your childs symptoms and health history. He or she may also ask if you or other family members have atopic dermatitis, asthma, or nasal allergies such as hay fever or allergic rhinitis. He or she will also ask about allergy symptoms in your child. The healthcare provider will examine your child, looking for signs of atopic dermatitis. There is no specific test for atopic dermatitis. Testing is usually not needed, but it may be done. Tests may include:
Blood tests. Your childs blood may be checked for levels of immunoglobulin E . IgE is released by the bodys immune system. Its high in most children with allergies and with atopic dermatitis. Other blood tests may also be done.
Skin tests. Skin tests may be done to check for allergies or other skin conditions.
Do Not Scratch Your Legs
Discomfort and itching can lead you to scratch your legs. You must never scratch areas affected by eczema. No matter how much you feel like scratching, you should resist the temptation. Scratching will make your skin bleed. If you scratch your legs, you may develop another infection because the disease will cause microorganisms.
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Are There Home Remedies For Weeping Eczema
Because weeping eczema is infection-related, the only thing that will clear it up completely is prescription medication. However, there are some things you can do at home to ease your symptoms. Weeping eczema home remedies include:
- Probiotics: Research suggests that topical probiotics may help reduce the severity of eczema symptoms.
- Natural oils: Coconut oil, olive oil and sunflower seed oil all protect and restore the skin. They also help reduce inflammation.
- Vitamins and supplements: Fatty acids such as black currant seed and evening primrose are known for their anti-inflammatory properties. Vitamin D and Vitamin B12 can also help improve common eczema symptoms.
- Colloidal oatmeal bath: This remedy helps soothe and relieve dry, itchy skin caused by eczema.
- Diluted bleach bath: Adding a very small amount of bleach to your bathwater can help kill bacteria on your skin. In turn, this can reduce redness, itching and scaling. When properly diluted and used sparingly, bleach baths are safe. Talk to your healthcare provider before incorporating bleach baths into your regimen.