When the word eczema is used on its own, it usually refers to atopic eczema or dermatitis. The word atopic means a genetic predisposition to eczema, hayfever, and asthma.
Atopic eczema is a condition that affects up to 20% of children in the Western world and there has been a marked increase in this skin condition over the last few years.
In the past, it was thought that atopic eczema was primarily an allergic disease but now we know that it is mainly due to a disturbed epidermal barrier function. Because of this disturbed epidermal barrier, the body’s immune system becomes exposed to various allergens (e.g. house dust mite, food) and builds up an abnormal allergic response to these antigens i.e. the allergies are secondary to the abnormal epidermal barrier function.
Therefore, people with a family history of asthma, hayfever, and eczema need to use the correct skincare products literally from birth. A study has shown that the daily use of a moisturizer during the first 32 weeks of life reduces the risk of atopic eczema/dermatitis.
It is recommended that you cleanse the affected person’s skin with a gentle cleanser that is as close to pH 5.5 as possible, one that does not disturb the skin’s natural microbiome and does not strip the skin of its natural lipids and fats. People with atopic eczema are prone to secondary bacterial infections so the moisturiser should ideally be preservative-free, in an airless pump, and not in a tub where you risk bacterial contamination if correct ‘pot-care’ is not used.
I always recommend that my patients use products that have been specifically formulated for this condition – this is important, as using the wrong ingredients can cause a flare-up. The Avène XeraCalm A.D Lipid-Replenishing Cleansing Oil, together with the Avène XeraCalm A.D Lipid-Replenishing Balm, both contain a microflora unique to Avène Thermal Spring Water called Aqua Dolmiae, which has been clinically proven to reduce the usual symptoms of atopic dermatitis of itching and dryness and to restore the skin barrier function.
It is important that the moisturiser contains ingredients similar to natural skin lipids. I usually tell my patients with atopic eczema to “take less fat out of the skin with cleansing and put more back into the skin with a good moisturiser”.
There are other prescription topical treatments that would include topical corticosteroid cream/ointments and topical calcineurin inhibitors which are often needed to break the ‘scratch, itch, scratch’ cycle.
However, it has been shown that if people with atopic eczema regularly use the correct cleanser and moisturiser then the need for topical corticosteroids is reduced. Therefore, one of the most important treatments for atopic eczema is to use the correct cleanser and moisturizer specially formulated for this skin type.