A wide variety of products are available over the counter to treat dry skin. Emollients and moisturisers should be used regularly to moisten the skin adequately. Ointments are generally preferable to creams if the greasiness can be tolerated, as they are suitable for very dry
skin. Bath emollients and creams should be used in combination to maximise results.
Where dry skin is caused by an allergic reaction, it is best to avoid the irritant. Products that are dermatologically tested or labelled ‘hypoallergenic’ are also recommended.
Atopic eczema is the most common type of childhood eczema and is linked with hayfever and asthma. The tendency to develop atopic eczema is inherited but it is strongly inﬂuenced by environmental factors. Atopic means extra sensitivity to substances that cause an allergy (allergens). The most common allergens are house mites, pollen, cat/dog fur and sometimes foodstuffs. The areas commonly affected include skin creases such as the fronts of elbows and wrists and backs of knees. However, any area of the skin may be affected. Babies are more likely to develop eczema on their face which can be extremely uncomfortable.
Allergic contact dermatitis
This type of eczema develops when the body’s immune system reacts against a substance in contact with the skin. The allergic reaction often develops over a period of time through repeated contact with the substance. For example, an allergic reaction may occur to nickel, which is often found in earrings, belt buckles etc. In order to prevent repeated reactions it is best to avoid contact with anything that you know causes a rash.
Irritant contact dermatitis
In this type of eczema, it is the frequent contact with an everyday substance such as detergents or chemicals that are irritating the skin. It most commonly occurs on the hands of adults and can be prevented by avoiding the irritants and keeping the skin moisturised.
Treatment of eczema
There is currently no cure for atopic eczema, although there are many ways to minimise the discomfort and distress caused. The three main goals of treatment are healing the skin and keeping it healthy, preventing ﬂare-ups and treating symptoms as they occur. A wide range of treatments are available from your pharmacy. Treatment is based on the use of emollients (moisturisers) including soap substitutes, bath oils and general moisturisers and topical steroids for ﬂare-ups.
Emollients reduce water loss from the outer layer of the skin by covering it with a protective ﬁlm. This keeps the water in the skin where it is needed. They should be used regularly and are available in various forms: sprays, ointments for very dry skin, creams and lotions for moderate/dry skins.
Some are applied directly to the skin whilst others are used as a soap substitute or can be added to the bath. Sprays may be easier to use and more convenient. They help prevent skin damage as they avoid direct contact with the skin.
When eczema is under control, only emollients need to be used. However, in ﬂare-ups, when the skin becomes red and inﬂamed, a steroid cream may be needed. Topical steroids should be applied thinly to the affected area on unbroken skin, your pharmacist can advise you on how to use them safely.
Sedative antihistamines may sometimes help to reduce the itch of eczema at night and give a good night’s sleep. They can make you feel drowsy the next day so take care if you are driving or if you are treating a child going to school. Antihistamine creams must be avoided as the ingredients in them can make the eczema worse.