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Eczema - Across the Generations

Eczema is a skin condition characterised by itchiness and red scaly areas of skin. It is an atopic condition, which means that there is a tendency for the body to over-react to substances which most people are not sensitive to. Other atopic conditions include asthma, hayfever and rhinitis. The tendency often runs in families.

I have had eczema since before I can remember. I cannot remember a time in my childhood when I was not itchy and spotty. Eczema is horrible, waking up with bloody sheets because you scratch in your sleep, itching all the time. My elder son was also diagnosed with eczema at 6 months old and to my delight I found out that the approach to eczema had changed radically since I was a child.

The modern approach is focused on management. Emollients are used to keep the skin moisturised, only natural fibres should be worn near the skin, house dust should be minimised. This is so different from my experience.

My GP had one answer for eczema in the late 1960's; Betnovate. For years and years from a very young age I used steroid cream every night. I do not remember what strength of Betnovate I was prescribed but it is now described as 'moderately potent' or 'potent' by the National Eczema Society, depending on the formulation. Every night by mother carefully dabbed it on my spots. I then went to bed and scratched it straight back off again.

There was no advice about managing the condition; in fact it was regarded as a rather annoying intrusion to the discussions about my asthma. So I never used an emollient, bathed in Radox bath salts, and my mother washed my sheets in biological washing powder - good for getting blood stains out.

My eczema gradually improved as I got older, but then at the age of 13 or 14 my GP refused to prescribe any more steroid creams, telling me that my skin would become too thin. He did however give me a tiny tub of emollient, but with no instructions, so I just put it on my face, that being the only place I had heard of putting moisturiser.

When my eldest son was diagnosed as having eczema I was fortunate that not only did I have two friends who had children with eczema to give me advice, I also had a wonderful health visitor, herself a sufferer who was able to advise me on both treatment and management.

My son was prescribed a mild steroid ointment, emollient cream and bath oil which keeps his skin almost eczema-free now, though a slight deviation into using baby bath for a shower brought an instant flare-up. We were given a lot of advice on how to reduce skin irritation, by correct choice of clothing, using non-biological washing powder and by minimising exposure to dust mites.

It was also helpful to join the National Eczema Society, whose joining pack is invaluable and they have further factsheets which can be sent on request. They also have an information line, which is useful for basic information, but not for more specialist advice. Since having children my eczema has recurred sadly, but at least I know how to manage it, and I can make informed decisions about treatment for both myself and my son. As a bonus the measures taken to reduce dust in the house have improved everyone in the family's asthma.

Here are some basic suggestions for the management of eczema. The dust reduction will also be useful for asthma sufferers. If you suspect eczema you should always visit your GP for correct diagnosis and treatment. Everyone's eczema is different and you will need a bit of trial and error to find out what works for you.

  1. Moisturise Moisturise Moisturise! Eczema sufferers have very dry skin and the itchiness will be reduced by moisturising. If you are not prescribed an emollient you can buy a big tub of Aqueous Cream for around £3 at most pharmacies. This is quite a thin cream and you can also ask for Emulsifying Ointment which costs about the same which is a thick, solid substance.
  2. Don't use soap or bubble bath; only use oily bath products which will not dry out your skin.
  3. Choose 100% cotton clothing and bedding. This is the least irritating fabric you can wear. Some eczema sufferers can wear silk, linen, and some man-made fibres. I don't know any who can wear wool! Also don't use feather pillows or duvets, always choose man-made ones.
  4. Reduce the levels of dust in your house. Dust attracts dust mites, which feed on the dead skin cells. They then excrete, and it is their faeces which eczema sufferers (and asthmatics) are allergic to. Vacuum carpets daily (sorry!) with a bagless vacuum cleaner and consider getting one with a HEPA filter as well. Damp dust surfaces regularly. Reduce the amount of soft furnishings such as cushions, swags, rugs and throws as these all harbour dust. Wash curtains regularly, air the house often and vacuum sofas, mattresses and chairs. Finally, when it is time to replace carpets choose hard floorings such as wood, laminate or vinyl. Carpets contain around 80% of the dust in the average house and also hold onto toxins carried in on shoes, pushchair wheels and animal feet. Leather or vinyl sofas will also trap much less dust than fabric covered ones.
  5. Pet dander and hairs can also trigger the allergic reaction causing eczema so if you cannot bear to get rid of your loved pet, regular vacuuming will again help.

Much more detailed advice can be found from the National Eczema Society and Eczema Voice, a support group for eczema sufferers.

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