Dr Sarah H Wakelin

BSc | MB BS | FRCP

  Appointments  077 59 23 65 88  

Consultant Dermatologist

| Dr Wakelin Answers Your Questions

What is eczema?

Eczema (also known as dermatitis) is one of the commonest skin complaints. It can start at any age and on any part of the skin, though some places are affected more commonly, such as the face, hands and skin folds. The skin is itchy and turns red and bumpy (sometimes with tiny water blisters) then dry, cracked and flaky.

It usually takes at least a week to settle and sometimes comes and goes for many years.

What causes eczema?

There are several different kinds of eczema and they have different causes. In most people, eczema seems to happen due to an in-built tendency, for example atopic eczema which runs in families along with hay fever and asthma. Eczema can also be caused or made worse by chemicals that come into contact with the skin.

These include things like soap and washing up liquid, which irritate the skin (they are harsh chemicals) or substances that trigger an allergic reaction in certain people, such as perfume, lanolin and rubber.

Is my eczema caused by food allergy?

In babies and small children, there may be a link between eczema and food allergy – babies with severe eczema are more likely to have a food allergy than those without eczema, and sometimes, cutting the food out of their diet helps their skin.  This should only be done with the advice of a dietician to make sure that the baby does not miss out on essential nutrients.  

In older children, food allergy seems to be less important, and it is rarely of any importance in adults with eczema.

What can I do to get rid of eczema?

This depends on what kind of eczema you have and whether it is caused by anything coming into contact with the skin.  All kinds of eczema will benefit from gentle skin care  - which means using moisturisers and avoiding things that irritate the skin (soap, body washes, rough clothing).

Steroid creams or ointment may be needed to settle the eczema and take away the heat and redness. They help break any itch-scratch cycle and give the skin a chance to heal.

Are natural and organic skin care products safe?

Although it may seem best to use products that are labelled as ‘natural’, ‘organic’ and those containing botanicals/plant extracts, these are not necessarily a good choice for someone with eczema. Most fragrances and perfumes come from plants and these can can cause skin allergies.

Many people are unaware of the fact that they have a fragrance allergy.

How can I tell if I am allergic to something I’ve used on my skin?

Sometimes, you will be able to tell as you get the rash within hours or days of applying something to your skin and it clears up completely when you stop using this. More often though, it is difficult to tell as you may become allergic to something you have used for a long time (which you are unlikely to suspect).

Patch tests can help investigate contact allergies to a wide range of chemicals as well as your own cosmetics, skin care products and topical medication.

Are steroid creams safe?

Topical steroids (applied to the skin surface) have been used to treat rashes for over fifty years. They come in a range of strengths from mild to super-strong. When they were first developed, strong steroids were prescribed for long term use on delicate areas such as the face, and this caused problems such as redness and thinning of the skin (steroid atrophy).

Doctors now know how to use steroid creams much more safely and how to choose the right strength and length of treatment to minimise any chance of skin thinning.

QUESTIONS AND MY ANSWERS

Consultant Dermatologist Dr Sarah Wakelin answers questions