Eczema (or Atopic Dermatitis) is a common chronic, inflammatory skin condition, affecting nearly a third of Australians during some stage of their life. Although eczema often begins during the first two years of life, it is also highly prevalent in adults.
Eczema causes extreme itching and can be accompanied by crusting, scaling or blisters. Typically, the skin will be affected in the creases of the elbows, on the back of the knees or on the hands – but it can be located anywhere on the skin.
The affected skin appears dry, cracked, thickened and scaly. Scratching the skin will often make it worse, leading to further disruption and sometimes bleeding and infection.
Eczema is linked to an overactive response by the body’s immune system to a perceived irritant. This irritant can be internal such as a reaction to a food, or external such as a reaction to pollen, metals such as nickel or a skin care product.
Eczema is highly associated with food allergies, asthma and allergic rhinitis – which is fundamental to understanding the person’s immune response and how to help reverse the disease process.
Its pathogenesis is complex, with lipid imbalance being a contributing factor, along with some genetic risk factors such as filaggrin (FLG) mutations. Despite this genetic issue, emphasis should be placed upon the environment that the skin is subject to. Chemicals that contact the skin will further exacerbate the degradation of the skin barrier and contribute to eczema development or flare.
It is important to use extreme caution with all products applied topically to the skin. Some creams advertised as ‘gentle’ or ‘appropriate for sensitive skin’ are still laden with chemicals that can further disrupt the skin barrier, removing lipids and making the skin even drier. We advise avoiding exposure to a list of harmful substances; including soaps, sodium laurel sulphate, detergents, surfactants, emulsifiers and mineral oils, to name a few. Even natural products such as coconut oil or essential oils can further contribute to the problem.
The skin microbiome of eczema patients also shows some degree of dysbiosis.
Staphylococcus aureus frequently colonises the lesional skin of approximately 90% of eczema patients and is associated with disease flare.
The abundance of other skin organisms such as S. epidermidis, Malassezia, Candida species and Trichophyton rubrum have also shown correlation with eczema, and increase during skin flares.
Our team uses a multi-faceted approach when it comes to eczema. This includes removal of any irritating chemicals and swapping them with products that are truly congruent with skin. It also requires resolution of internal inflammation, addressing lipid levels and healing of the skin barrier.