Eczema

Stephen Shumack, OAM, MB BS, FACD


What is Eczema?

Eczema (also known as Dermatitis) is a common skin condition that affects 10-20% of the population. This skin condition produces dry, red, scaly, and itchy patches on the skin, usually starting during the childhood years.

It is often associated with other conditions such as Asthma and Hay Fever. These three conditions form the Atopic Group of Conditions. In fact the common type of Eczema is often called "Atopic Eczema" or "Atopic Dermatitis".

 

What Causes Eczema?

Eczema is caused by a genetic defect that produces an abnormality in a filagrin protein in the skin. Filagrin allows skin cells to adhere together tightly; forming a barrier against irritants, allergens, and bacteria. In eczema sufferers the filagrin protein does not work properly causing a reduction in the barrier function of the skin; which allows irritants and allergens to penetrate into the skin. This penetration leads to inflammation, which results in red, scaly, itchy plaques that we recognize as eczema.

Eczema can be exacerbated by irritating agents on the skin such as long hot showers, the overuse of soaps or detergents, over-washing of the skin, and contact with irritating materials (i.e. wool or sand).

 

Genetics of Eczema

There are a number of genetic abnormalities that can result in defective filagrin protein in the basal (bottom) layer of the skin. These abnormalities are present in approximately 25-30% of the population; however, these abnormalities lead to the development of eczema in only 25-50% of this group.

Patients with eczema are more likely to have family members with eczema, asthma, or hay fever.

Condition Triggers

Triggers for eczema include contact with irritating chemicals or substances such as hot water, soaps, detergents, sand, chlorine in swimming pools, or wool. These agents irritate the skin, which can flare or precipitate eczema in the areas that are contacted with these agents.

Eczema and the Immune System

The abnormality in the barrier function of the skin, caused by the defective filagrin protein, results in the activation of the immune system through exposure to irritants, allergens, and other proteins. This may then cause inflammation in those areas, resulting in the clinical presentation of eczema: dry, red, itchy, and irritable skin.

 

What Happens if I Don't Do Anything?

Eczema can be very uncomfortable and unsightly with red, scaly plaques that sometimes lead to bleeding and scratch marks on the skin. Individuals with eczema are often itchy, particularly at night. The itchiness may affect sleep and the ability to relax. It is important to remember that eczema is not contagious. You cannot catch it from someone or give it to someone else.

 

What Are My Options?

We now understand that the main characteristic of eczema is a defect in the barrier function of the skin. Attempts to restore the barrier function with emollients and moisturizers are important in patients with eczema. Similarly, avoiding contact with irritating chemicals or substances is important to reduce the amount of irritation to the skin.

Topical steroid creams are useful to reduce the amount of inflammation. Patients will sometimes require other treatments, such as ultraviolet light or tablets. These treatments reduce the amount of inflammation and, thus, treat eczema.


Dr. Stephen Shumack has been practicing dermatology for over 20 years at 2 large private practices located in Sydney and Kogarah, Australia. At St. George Dermatology and Skin Cancer Centre in Kogarah, Dr. Shumack has participated in numerous clinical research studies for dermatological conditions including psoriasis, tinea, acne and skin cancers. For more information about Dr. Shumack's research and ongoing studies visit: ResearchTrials.org - St. George Dermatology and Skin Cancer Centre

 

For more information on eczema please visit:

ResearchTrials.org: Eczema

Active Studies

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