Eczema – one of the most common medical problems in the world today affects millions of people globally. And it is on the rise with the number of people suffering from the condition doubling in the last 30 years.
Both adults and children are affected yet it is most commonly thought of as a childhood ailment.
The majority of people (especially children) suffering from eczema have what is known as Atopic eczema.
The Origin Of Atopy
The word Atopy originated in 1923 when two doctors – Dr Cooke and Dr Coca were classifying and categorising different rashes and skin conditions. The doctors had a group of patients who did not fit into Dr Coca’s classification system so they made up the word atopy to categorise the group. The word atopy literally means ‘without a place.’
The group of patients put into the atopy group all had sensitive skin and were susceptible to irritation and eczema. Most of them had family members with asthma, hayfever or allergies. Today the word atopy is considered to refer to an inherited allergic condition.
The reason atopic people have sensitive skin is not known. However most atopic people will develop eczema at an early age, usually before 2 years old, but rarely before 2 months old.
It is not the eczema that is inherited but rather the atopy. If a child has one atopic parent (i.e. having eczema, asthma, hayfever or allergies) there is a 20% chance the child will be atopic as well. If both parents are atopic the chances of the child being atopic rise to 60%.
Being atopic does not give you eczema , it simply makes you susceptible to develop the condition. The skin must be irritated by something for the eczema to develop. We know these irritations as eczema triggers.
Atopic Skin Is Different
Atopic skin does not function in the same way as normal skin. It does not have the ability to act as an effective barrier keeping water in and irritants out. Water evaporates easily leaving atopic skin very dry.
Atopic people are also more perceptive to the sensation of itch. A mild irritation to the skin that would normally be perceived as a gentle tickle or simply the sensation of touch will be perceived by the atopic skin as the sensation to itch. Hence atopic skin is typically very dry and itchy.
Skin sensitivity and skin barrier tend to improve over time with 50% of atopic children being less susceptible to skin irritation by the age of 5 years and 90% less susceptible by the age of 9 years. Eczema may reappear in adulthood but usually not before the age of 60.
Why Do Atopic People Get Eczema?
It is believed that the excessive itching of the atopic person leads to the rash of eczema developing. However it is not just the itching that will lead to the skin irritation. The protective skin barrier is not working properly so normal elements will irritate the skin resulting in eczema. Soaps, cleaners, rough woolen clothing or frequent bathing may all irritate atopic skin triggering eczema.
Other Atopic Features
Atopic people tend to have other lesser-known, seemingly unrelated characteristics. They will often have a small crease on the lower eyelid, near the nose or dark circles under the eyes. Small acne-like bumps may be present on the back of the arms.
Atopic skin is more prone to the wart virus or fungal growths like ringworm or athletes foot. These characteristics will be helpful in the diagnosis of an atopic person even if eczema or skin irritation is not present.
The itch and the classical red, scaly, crusted or blistered rash must be present for eczema to be diagnosed. The symptoms must also last for a long period of time or must reappear frequently. Having a close family member who is atopic will also aid in the diagnosis of atopic eczema.
The diagnosis also depends on the location of the rash which needs to be typical for the age. Infants will usually experience eczema on their scalp, cheeks, elbows and knees. Small infants don’t scratch so rubbing against other surfaces like their bedding will irritate the areas affected.
Toddlers most commonly develop eczema in skin folds like the elbows and behind the knees but can develop it anywhere, as they are now able to scratch. Atopic eczema in adults is rare as the other forms of allergy (asthma, or hayfever) are more common. If eczema does occur in adults it is most likely to appear on the hands or feet.
What To Do If You Are Atopic
The reason for atopic people having atopic skin is not known and similarly a cure for atopy is not known. Current treatments are aimed at relieving and controlling the symptoms.
A doctor’s preferred form of treatment for atopic eczema is generally steroid based creams. However new creams are always appearing on the market.
A safer and more popular choice of treatment is natural creams. There are many natural creams on the market. Most are good quality creams and very effective for some but not for everyone. Finding the best natural cream to treat your eczema will be a matter of trial and error.