FAQ: Eczema

What is Eczema?

Eczema is one of the most common skin conditions seen by community doctors. It is a condition that causes the skin to become dry, cracked, and itchy.

It is usually a long term condition that first appears during childhood, though it can also develop in adults. It is more common in people with asthma or hayfever, or if they have a family history of these conditions.

Why do I have eczema?

We don’t know why people get eczema, but it is unlikely to have one single cause. People with asthma, hayfever or allergies are more likely to get eczema. These conditions are known as atopic conditions.

Sometimes eczema can be triggered by certain things, such as soaps, detergents, stress and weather. This has been an issue during the pandemic as people have been washing their hands more regularly resulting in dry cracked skin.

What symptoms would I have?

In eczema the skin is usually dry and cracked, with itching around the area. These can be in small, well marked patches, or they can be large swathes of skin. They often occur on the hands, the inside of elbows and knees, on the face and scalp.

These patches of dry skin can be missed if regular moisturiser is used, though some people will have flare-ups when the eczema is difficult to manage, and the skin becomes inflamed. If the skin remains cracked it makes it easer to become infected, which can appear red, hot to touch with discharge from the area.

How should I treat eczema?

There is currently no cure for eczema. Some people have the condition lifelong, in others the eczema reduces in intensity or even disappears.

The main treatment for eczema is moisturising. Keeping the skin well moisturised prevents cracks that can lead to itching, further inflammation and infection. This moisturiser needs to be applied regularly. The thicker and greasier the moisturiser the better it works on dry, thickened skin.

Steroids should only be used for eczema flare ups, when moisturisers are not enough to manage the skin. They dampen down the inflammation but have lots of side effects. They can thin the skin causing easy damage or bruising, worsen skin infections, and if used excessively steroids can cause systemic problems.

Do you have any other questions about eczema? Ask them below in the comments section:

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FAQ: Acne

What is acne?

Acne is a common skin condition that affects most people, usually during their teenage years. It causes spots to appear, oily skin, and can be disfiguring if not managed properly.

It commonly appears on the face, back and chest.
Acne appears in many different forms:
Blackheads – small black or yellow bumps on the skin. The black colour comes from the lining of the hair follicle.
Whiteheads – these are also small but white, hard and do not pop when squeezed.
Papules – small red bumps
Pustules – small bumps with a white tip in the centre filled with pus
Nodules – large hard lumps underneath the skin.
Cysts – large pus filled lumps, look similar to boils. These can scar permanently

Why do I have acne?

The most common reason for acne to appear is puberty. Hormone changes can cause grease producing glands next to hair follicles to produce more grease. This causes normally harmless bacteria on the skin to grow aggressively, causing inflammation and pus. The hormones also cause blockages of the hair follicles and the grease pores. This is not solved by cleaning the skin.

In women changes in hormones can cause acne to form at certain times. This can include flare ups just before the period, during the first few months of pregnancy or in patients with polycystic ovary syndrome (causes acne, weight gain and cysts in the ovaries).

Acne can run in families. If one or both of your parents have adult acne, you are more likely to have acne.

Poor diet, poor hygiene and sexual activities do not play a role in acne. The infection and inflammation occurs underneath the skin, not on the skin. Washing your face excessively can cause acne to become more iflammed.

How should my acne be treated?

Treatment of acne depends on the severity of the acne. It is best to start off with simple, topical treatment and move onto stronger, systemic treatment if this does not work.

Benzoyl peroxide is an antiseptic that reduces the number of bacteria on the skin. It also has an anti-inflammatory effect. You should apply it 20 minutes after washing your face, but it should not be applied excessively.

Topical retinoids work by removing dead skin cells from the surface of the skin. This prevents their build-up in hair follicles. They usually come as gel or cream form and are applied before going to bed. They cannot be used during pregnancy as they can cause birth defects.

Topical antibiotics help kill bacteria on the skin, as a lotion or gel used once or twice a day. A 6 to 8-week course is usually recommended. Similarly, long term oral antibiotics can be used to treat more severe acne. The total course can last 4 to 6 months.

If your acne is worse during your periods or due to polycystic ovarian disease, then hormonal therapy may be required. You might be started on the combined oral contraceptive pill, though its effects can in some people take months to occur.

Do you have any other questions about eczema? Ask them below in the comments section:

Dr Rajan Choudhary

MBBS , UK

Chief Product Officer

www.secondmedic.com

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