Skin Conditions

An interview with Dr Robert Rosen
Dermatologist, Sydney

Eczema (dermatitis)

A photograph of someone with Eczema

What is eczema?

One of the commonest skin conditions is eczema. It is also called dermatitis and simply means inflamed skin. Eczema can occur at any time although it is very common in children and babies. Childhood eczema frequently occurs in the body creases and is called "atopic dermatitis". Adults often develop eczema on the face around the nose, ears and eyebrows and this may be "seborrhoeic dermatitis". Eczema is not contagious. The condition can be managed well by minimising the exposure to trigger factors, using a suitable cleanser and moisturiser, and medication if necessary.

What are the types of eczema?

Apart from atopic and seborrhoeic dermatitis some people develop rings on their body known as discoid eczema. Allergic contact dermatitis occurs in some people, when their skin makes contact with substances such as rubber, nickel in jewellery or some fragrances, and becomes inflamed.

What does eczema look like?

Look for red dry scaly areas that are usually very itchy. Scratching the itch makes the rash appear, and in some people the eczema can ooze or weep. Eczema can flare-up when triggered by certain factors.

What makes eczema flare-up?

Common aggravating factors are:

  1. the use of soaps, detergents, solvents,
  2. long periods in water (especially baths and chlorinated swimming pools),
  3. antiseptics and perfumed products such as bubble baths,
  4. sand (beach and sand pits),
  5. wool and nylon,
  6. fragrances in cleansers, moisturisers, perfume sprays,
  7. substances causing allergic contact dermatitis (eg plants, rubber and nickel).

How can eczema be prevented?

Avoid any aggravating factor and moisturise frequently.

What are some handy hints when washing if you have eczema?

Soap:

  • use a non-soap cleanser (eg Cetaphil® Gentle Skin Cleanser / Cetaphil® Cleansing Bar),
  • refrain from scrubbing or using products that lather on the skin,
  • use a mild shampoo avoiding skin contact where possible,

Water:

  • shower less than 5 minutes in cool or luke warm water,
  • refrain from hot or steamy water (eg hot showers, spas, saunas),
  • avoid chlorinated swimming pools.

Antiseptics and perfumed products:

  • do not add antiseptics to the bath and avoid bubble baths,
  • avoid fragrances in cleansers, moisturisers, perfume sprays.

What is a suitable moisturiser for eczema sufferers?

Moisturisers should hydrate the skin by preventing excessive loss of water through the epidermis (the top layer of the skin), which occurs with eczema. A moisturiser should also help smooth and soften skin. Avoid those that contain perfumes or fragrances, alcohol, lanolin, and are greasy and oily. Importantly, a moisturiser should feel pleasant to use.

What about Cetaphil®?

Cetaphil® Gentle Skin Cleanser is a good soap-substitute for people with eczema. It is non-drying, with less irritation than many other cleansers. It does so without foaming and lathering. Cetaphil® Gentle Cleansing Bar is also available for those who prefer a bar. Cetaphil® Moisturising Lotion and cream are ideal for those with particularly dry sensitive skin who need greater moisturising.

When should I see my GP or a dermatologist?

If your eczema is troubling you or your child, or if it is severe enough to need prescription medication (eg a topical corticosteroid).

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