We tend to think as eczema as something that occurs in childhood, but the inflammatory skin disease is increasingly being seen as an adult-onset condition.
It is estimated that around 15 million people in the UK are currently living with eczema, but while the condition is still primarily associated with children, one in 12 sufferers are actually adults. And according to various studies, it also affects more women than men.
What’s more, atopic eczema, the most common kind of eczema, has increased two- to threefold in industrialised nations since the 1970s, studies say.
Mild cases can be an itchy, occasional annoyance, but in severe cases the condition can be debilitating.
An Allergy UK survey of adults with eczema revealed that 88% say it has an impact on their daily lives, 58% say it affects personal relationships and 73% claim their social life suffers.
But despite the scale of the problem, adult eczema is often under-recognised and therefore under-treated.
So in honour of National Eczema Week (14–22 September 2019) here’s everything you need to know about the condition.
What is eczema?
Eczema (also known as dermatitis) is a dry skin condition, according to the National Eczema Society.
“It is a highly individual condition which varies from person to person and comes in many different forms,” the site explains.
“It is not contagious so you cannot catch it from someone else.”
In mild cases of eczema, the skin is dry, scaly, red and itchy, but in more severe cases there may be weeping, crusting and bleeding.
Constant scratching causes the skin to split and bleed and also leaves it open to infection.
What causes eczema?
The National Ezcema Society says there are many different types of eczema.
Although it is still not known exactly why atopic eczema develops, research has shown that a combination of genetic and environmental factors could play a part.
“The term ‘atopic’ refers to a personal and family tendency to develop eczema, asthma and/or hay fever,” the site says.
What is more, eczema is also one of a few dermatological conditions that can be exacerbated by emotion, with two of the most commonly reported triggers being stress and anxiety.
Why are cases of adult eczema on the increase?
Dr Mervyn Patterson, cosmetic doctor at Woodford Medical, says there may be several reasons for the higher incidences of eczema, especially in women.
“Females are more likely to encounter a whole variety of cosmetic products, perfumes, cleaning agents, detergents and common household materials that can cause irritation,” he says.
“A very high percentage of the population now identifies themselves as having sensitive skin and when this occurs on the face, the most likely triggers are ingredients within the multiple skincare products that are constantly being experimented with.”
Dr Patterson says women may also be less likely to tolerate the appearance of dermatitis and therefore more likely to present themselves for treatment.
“Females are also more likely by nature of their occupation to come into contact with known potent sensitisers such as hair colouring agents used in the hair industry, solvents and glues used by nail technicians, peeling materials used by beauty therapists and general cleaning materials,” he says.
“Healthcare professionals are also at much greater risk of sensitisation from materials used to sterilise the skin and frequent use of latex gloves.”
It’s also possible that changing hormone levels in women, particularly during pregnancy and at difference stages of their menstrual cycle, could be playing a role in the gender disparity of eczema sufferers.
Is there anything you can do to avoid eczema?
Although it’s unlikely you can avoid eczema developing as an adult, it is probably a good idea to try to identify possible triggers as early as possible.
“This is easier said than done because sometimes finding the actual allergen be it airborne or dietary can be extremely difficult if not impossible,” Dr Patterson explains.
“Trying to treat the condition early with the best emollients, barrier repair products and steroids may help to reduce the incidences.”
Treatments for eczema
At the moment there is no known cure for the condition. What’s more, because there are so many factors at play for sufferers, including genetics, allergies and emotional triggers, those living with the condition can find it hard to find effective treatments.
According to Dr Patterson, eczema can often best be controlled by addressing the root cause.
“Repair the skin barrier and dampen inflammation which in turn helps to reduce the desire to scratch,” he says.
“Repairing the barrier helps make the skin healthier and reduces the penetration of environmental factors such as soaps, detergents and surface bacteria.
“Better barrier function also helps to reduce water loss from the deeper layers helping to prevent dryness and in turn itch.”
Dr Patterson says dampening chronic inflammation helps to reduce the excitability of the immune system, which in turn lowers histamine production and therefore the desire to scratch.
The NHS offers many different treatments to help control symptoms and manage eczema, including:
self-care techniques, such as reducing scratching and avoiding triggers
emollients (moisturising treatments) – used on a daily basis for dry skin
topical corticosteroids – used to reduce swelling, redness and itching during flare-ups
Though it is rarely thought to be diet alone that triggers eczema, some sufferers report that changes in diet can reduce flare-ups, so considering food intake could also be an option.
The National Eczema Society recommends keeping an accurate food diary and recording the condition of the eczema to see if you can identify potential triggers. But always see a doctor or dietitian before you make any changes to your diet.
In terms of specific products, Dr Patterson recommends Epionce Renewal Calming Cream, which he says reduces the itch by rapidly repairing the surface lipids in the external skin barrier and calming down pathways of inflammation in the skin.
“Eczema sufferers and parents of children with the condition dislike using too much topical steroids and struggle with the greasy emollient preparations that are prescribed on the NHS,” he says.
“Renewal Calming Cream in contrast is really pleasant to use as it is absorbed quickly and doesn't leave a greasy residue. As it directly addresses the underlying skin condition it helps to rapidly reduce symptoms and some of the dependency on steroid creams.”