As beauty topics go it’s not the sexiest, we admit, but for those suffering from a skin condition such as eczema it’s something that can influence every aspect of day to day life, not to mention the impact it can have on self-esteem.
It’s estimated around 6 million people in the UK suffer from the condition, with one in nine having been diagnosed with it at some point in their lives. We’ve enlisted the help of Dr Stefanie Williams MD, Medical Director at European Dermatology London and Jasmina Vico, Skin expert and facialist extraordinaire who both see eczema cases on a daily basis.
What is it?
‘Eczema is a common chronic inflammatory skin disorder that can be caused by many factors’ says Jasmina. ‘It appears as a dry rash, often with red and scaly skin however it may present with a variety of symptoms such as skin swelling, itching, crusting, blistering, cracking or bleeding.’ So far so bad… Dr Stefanie goes on to add that the clinical appearance of eczema often depends on your age; ‘In babies the cheeks are often the first place to be affected, older children tend to have more of the flexural pattern with patches on inner elbows and behind the knees, whilst adults may present in various ways including persistent eczema on hands, eyelids, flexures and nipples.’
What causes it?
‘Atopic eczema is generally caused by a genetic tendency for this condition,’ says Dr Stefanie. ‘Environmental factors (eg the overuse of soap or other cleansers, cold dry winter air, friction from harsh fabrics, certain foods etc) can trigger and/or aggravate flare-ups.’ Interestingly she also adds that people who also suffer from or have a family history of hayfever, asthma and other allergies tend to be more prone to the condition. ‘Eczema is characterised by an impaired barrier function of the skin (ie too much water loss) and inflammation and in some patients there might be an overgrowth of certain bacteria.’
How to treat it?
‘It’s near on impossible to get rid of eczema completely, however it is possible to manage it with a combination of calming botanicals and lasers,’ says Jasmina.
‘Treatment of eczema definitely has to be a multi-pronged approach,’ confirms Dr Stefanie. ‘The best combination I’ve found that seems to work for my patients is:
1. Regular (at least twice daily but up to five times a day) application of a lipid-rich (oil-rich) moisturizer, particularly after bathing and when skin is still wet. This also has to be done in between flare-ups even if the skin appears fine, in order to lower the risk of another flare-up.
2. Steer clear of irritants such as harsh cleansers and detergents and use shower gels/soap only in ‘important’ body areas (armpits, skin folds, genitals, hands & feet). Instead, use emollients (eg aqueous cream) or bath oils to wash with and specialist cleansers for dry skin on the face making sure that the water is not too hot. Avoid environmental triggers such as spending too much time outside in cold, windy weather.
3. During a flare-up, a prescription anti-inflammatory treatment is required, eg a topical steroid cream or a steroid-free anti-inflammatory cream such as Elidel or Protopic.
4. Some patients react to certain fruits such as citrus fruits in which case intake should be limited. Other patients might have an actual allergy to certain foods such as dairy which can be determined with a blood or skin test. It’s a myth that drinking lots of water will improve dry skin, as the main problem is not the body content of water, but the increased water evaporation from the skin (because of an impaired barrier function). The skin simply can’t hold its water, no matter how much you drink – it’s like trying to fill a bucket with water which has a huge hole in the bottom.
5. Supplements can be helpful especially Omega-3 fatty acids (although make sure they’re from fish oils and not plant-based Omega-3’s which the body can’t utilize as well).
6. In severe cases, tablets to modulate the immune system and/or light treatment to strengthen the skin in between flare ups is needed.
Are steroids bad?
‘I get a lot of questions about 'steroid-phobia',’ says Dr Stefanie. ‘Steroid creams are absolutely fine, if used intermittently, and not constantly! Effective anti-inflammatory treatment should not be delayed, as a late start will lead to a longer overall treatment period needed so in general it’s better to treat with a slightly stronger steroid cream for a shorter period of time than prolonged periods with a too weak product.’
Best products for Eczema:
‘There are a large variety of ingredients at our disposal to improve the hydration of the skin,’ says Dr Stefanie. 'These are roughly divided into three groups':
1. Humectants (hold water in the skin, e.g. Urea, Hyaluronic acid, Lactic acid and Glycerin),
2. Occlusive agents (form a protective layer on the skin surface, thus reducing water evaporation from the epidermis, e.g. oils and waxes)
3. Emollients (soften the skin surface and smooth flaky skin)
‘Most good moisturisers for dry skin will contain all three to work synergistically but try and look for products that don’t contain fragrance,’ she adds.
Voya Palmrosa Balm Facial Serum, £53
The essential oil of organic Palmrosa not only helps to retain moisture in the skin, it also works to maintain it’s moisture balance in order to comfort even the most sensitive of complexions.
Westlab Pure Dead Sea Salt, £2.99
Known for their therapeutic benefits since ancient times, these essential mineral bath salts taken from the Dead Sea are high in magnesium and calcium to help soften and heal skin prone to eczema and Psoriasis
Avene XeraCalm A.D Cream £16.50
Soothing, nourishing and designed to relive itching by 97%, this cream is perfect for people with very, very dry skin and those prone to eczema. With the minimum number of ingredients, the cream also contains a patented formula to help stimulate the skin’s defences.
Skinfix Eczema Balm, £11.99
Working fast to create a barrier on the skins surface to lock in moisture and keep out irritants, this balm is the perfect on-the-go solution to managing eczema-prone skin.
La Roche Posay Lipikar Baume AP+, £12.50
Heard of your skin’s microbiome? Well you should have as new research has found that keeping the tiny community of microorganisms on our skin in balance is the key to a healthy complexion and that’s exactly what this paraben and fragrance-free cream does.
SkinCeuticals Phyto Corrective Masque, £55
One of Jasmina’s favourites for her eczema-prone clients, this lightweight, ultra-hyrdating gel mask is proven to result in a 47% reduction in discomfort and 20% decrease in visual redness.
Weleda White mallow Body Lotion, £9.95
With 95% organic ingredients, this lightweight body lotion soothes, cools and relieves itchiness for even the most sensitive skin. Well if it’s good enough for baby…..
Cetraben Emollient Cream, £3.99
Remember what Dr Stefanie taught us about emollients and humectants? This cream is the perfect combination of the two, containing skin-softening paraffin as well as glycerine to prevent moisture-loss.
Cetaphil Gentle Skin cleanser, £8.99
Softly softly is the best approach when cleansing eczema-prone skin and this ultra-mild cleanser doesn’t strip the skin of precious moisture or disturb the pH balance.
Eucerin Intensive Lotion 10% w/w Cutaneous Emulsion Urea, £13.50 Yes you may have heard of Urea in relation to wee (ew) but it’s also a major moisturising component in your skin and this richly soothing lotion works to replenish it (as well as Lactate) for long-lasting hydration and a reduction in redness and itching.
Sanex Dermo Repair Shower Cream – Sensitive Skin,
This bargainous shower cream not only moisturises sensitive skin using a completely natural chemical compound called Allantoin, it also helps to balance the skin’s natural pH.