Eczema Prevention

Introduction

There are many skin disorders that vary significantly in symptoms and severity. Some of them are long-lasting, while some may improve with certain medications and treatments. There are many different causes for these infections, which may include environmental and lifestyle factors. A few of them are caused by autoimmune factors too. While some of the diseases are less severe, others may cause life-threatening conditions. 

In this article, we will look into one of the skin disorders, which is Eczema, and the most common form of this disease, Atopic dermatitis. 

What is eczema?

Atopic dermatitis (AD), commonly called eczema, is a skin condition due to inflammation which can lead to dehydrated and itchy skin. Eczema commonly affects infants and children; however, adults and the elderly population can be affected too.1

AD is a prolonged recurring disease that has affected 2.4% of the population globally. It has been ranked as the third most prevalent skin condition in the world in 2017.2 This condition is prevalent among children about 15-20% of children are affected, while only1-3% of adults have it.3

Symptoms

The symptoms of eczema vary greatly from one to another, depending on age and the contributing factors. The main symptoms of eczema include:

  • Dry and cracked skin
  • Itchiness, also called pruritus
  • Rashes or swollen skin
  • Oozing and crusting
  • Small bumps
  • Thickened skin.4

In babies and younger children, it causes itchy, red, scaly, and coated lesions on the arms, knees, cheeks, or scalp. In children aged 2-16, affected areas experience thickened and scratchy skin, with pus or blisters commonly present on the inner forearm, posterior leg, and neck. Since the disease is less common in adults, the face, arms and neck are the most affected areas.5

Eczema often begins before the age of five and may continue into adulthood. Some people may experience eczema flare-ups when exposed to environmental triggers or stressors. 

Can eczema be prevented?

Since eczema is a chronic condition and may lead to severe complications, the question becomes how can eczema be prevented. Many studies identified that eczema is one of the autoimmune diseases because autoreactive antibodies were commonly found in patients with eczema.6 However, recent studies suggest there is no association between autoimmunity and atopic dermatitis. According to National Eczema Association, AD is technically not an autoimmune disease, but have common characteristics like the symptoms may come and go, and there are periods of flare-ups and remissions, which is why it is considered to be an autoimmune disease.

Flares generally mean outbursts or sudden spreading of something. Eczema flare-ups indicate the return of symptoms and affect more than one part of the body. This can be the result of our immune system getting overwhelmed and can't function properly against infections. 

How to minimise eczema flare-ups

There are some measures we can take to prevent eczema flares, but the most important one is to avoid contact with the triggers. It is advised to try to identify the triggering factors for your eczema and stay away from them, which can include: 

  • Wool and Polyester
  • Perfumed soaps
  • Detergents used for laundry
  • Lotions (Aftershave)
  • Other household cleaning products. 

Let’s look into other preventive measures for the disease. 

Find a moisturiser your skin likes

Studies have identified the association between moisturizing and reduced risk of eczema flares. When skin gets dry, it becomes irritated, brittle, and tight, which can lead to an eczema flare-up. Moisturiser can help to improve skin hydration and assists the function of the epidermal layer against inflammation.7

It is vital to choose moisturisers very carefully. For example, moisturisers with no fragrance or artificial ingredients, creamy, and thick, are suitable for your skin, instead of thin, watery ones. 

Minimising alcohol intake and smoking

Smoking and alcohol intake have often been identified as risk factors for some inflammatory skin disorders. A study investigating the association between smoking and Atopic dermatitis suggested that both active and passive smoking in children and adults have a strong correlation with the disease, as tobacco has a detrimental effect on our immune system.8

Alcohol is considered harmful to the immune system as well. The breakdown of alcohol releases histamines which can cause redness, discolouration, and itching on the skin. Moreover, alcohol can break our skin barrier9 and lead to the loss of water from the skin, worsening the eczema symptoms. 

It is recommended to reduce the intake of alcohol and avoid smoking (active and passive) to minimize the risk of triggering eczema flares. 

Find out what helps you manage stress

Stress has been directly associated with our immune system and skin conditions. In order to understand the association, it can be referred to as the body's fight and flight response. During stressful situations, the body releases a hormone called cortisol, which can suppress the immune system and upsurges inflammation in the body when released in greater amounts. This unusual increase in inflammation can trigger symptoms of eczema, eventually leading to flare-ups.10

It is highly recommended to identify stressful situations and manage them effectively. Some techniques like deep breathing, meditation, and distraction can help in releasing stress. 

Stay hydrated

It is commonly known that hydration is important, especially for skin function. Water in our skin acts as a barrier and supplies moisture to prevent external infections.11 NHS recommends taking at least 1.5 to 2.5 litres of water per day, which is equal to six to eight cups a day.12

Conclusion

In conclusion, eczema is one of the most prevalent inflammatory skin diseases among children and adults. It has similar characteristics to autoimmune diseases and thus can't be prevented. However, there are numerous ways to prevent the disease from getting worse. Avoiding contact with triggering agents, minimising the intake of alcohol and smoke, managing stress and staying hydrated can help us combat this condition. 

References

  1. Atopic eczema [Internet]. nhs.uk. 2017 [cited 2022 Nov 3]. Available from: https://www.nhs.uk/conditions/atopic-eczema/
  2. Urban K, Chu S, Giesey RL, Mehrmal S, Uppal P, Nedley N, et al. The global, regional, and national burden of atopic dermatitis in 195 countries and territories: An ecological study from the Global Burden of Disease Study 2017. JAAD International [Internet]. 2021 Mar 1 [cited 2022 Nov 3];2:12–8. Available from:https://www.sciencedirect.com/science/article/pii/S2666328720300559
  3. Nutten S. Atopic dermatitis: global epidemiology and risk factors. ANM [Internet]. 2015 [cited 2022 Nov 3];66(Suppl. 1):8–16. Available from: https://www.karger.com/Article/FullText/370220
  4. Atopic dermatitis (Eczema) - Symptoms and causes [Internet]. Mayo Clinic. [cited 2022 Nov 3]. Available from: https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273
  5. Hadi HA, Tarmizi AI, Khalid KA, Gajdács M, Aslam A, Jamshed S. The epidemiology and global burden of atopic dermatitis: a narrative review. Life (Basel) [Internet]. 2021 Sep 9 [cited 2022 Nov 3];11(9):936. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470589/
  6. Boehncke WH, Brembilla NC. Autoreactive t-lymphocytes in inflammatory skin diseases. Frontiers in Immunology [Internet]. 2019 [cited 2022 Nov 3];10. Available from:https://www.frontiersin.org/articles/10.3389/fimmu.2019.01198
  7. Girolomoni G, Busà VM. Flare management in atopic dermatitis: from definition to treatment. Ther Adv Chronic Dis [Internet]. 2022 Jan 13 [cited 2022 Nov 3];13:20406223211066730. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771745/
  8. Kantor R, Kim A, Thyssen J, Silverberg JI. Association of atopic dermatitis with smoking: A systematic review and meta-analysis. J Am Acad Dermatol [Internet]. 2016 Dec [cited 2022 Nov 3];75(6):1119-1125.e1. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216172/
  9. Svanström C, Lonne-Rahm SB, Nordlind K. Psoriasis and alcohol. Psoriasis (Auckl) [Internet]. 2019 Aug 21 [cited 2022 Nov 3];9:75–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709030/
  10. Eczema and stress: what’s the link? | pfizer [Internet]. [cited 2022 Nov 3]. Available from: https://www.pfizer.com/news/articles/eczema_and_stress_what_s_the_link
  11. Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary water affects human skin hydration and biomechanics. Clin Cosmet Investig Dermatol [Internet]. 2015 Aug 3 [cited 2022 Nov 3];8:413–21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529263/12.Healthy hydration [Internet]. Kent Community Health NHS Foundation Trust. [cited 2022 Oct 27]. Available from: https://www.kentcht.nhs.uk/leaflet/healthy-hydration/

Amira Samnani

Bachelor of Science in Nursing- The Aga Khan University Hospital, Pakistan

Amira is a Registered Nurse with demonstrated clinical experience of working in health care industry. She has a 4 years of experience as a practicing nurse in Internal Medicine-Adult care unit. She is proficient in her knowledge about health education and promotion. Currently, she is seeking roles in her field while continuing her education to become health and wellness expert.

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