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Eczema is an intensely itchy, inflammatory disease of the skin. The skin is thick, dry and often overgrown by bacteria such as staphylococcus aureus.

The different types of Eczema have different distinguishing markings but most share general features.

Eczema is most often classified into two main types:

Contact Eczema - is often the result of an external allergen. It is also referred to as contact dermatitis. Contact Eczema occurs when one or more external substances provoke a reaction on the skin. It may be described as irritant contact Eczema or allergic contact Eczema depending on the reaction. Common contact allergens and irritants include: cosmetics, perfumes and hair dyes, shampoos, toothpastes, deodorants and soaps, insecticides, aerosol sprays and detergents, epoxy resins (also resins in nasal sprays), nickel (present in jewellery, jean studs, bra clips and zippers), wool-derived alcohol (lanolin, cosmetics and creams), rubber chemicals (clothing, shoes and tyres), solvents, abrasive dusts, acids and alkalis, lead, copper, cadmium and mercury.

Atopic Eczema - is thought to be provoked by an internal cause. Atopic Eczema commonly occurs during infancy. It is usually found on the face, wrists and inside the elbows and knees. It is a hereditary condition and is often associated with asthma, hay fever, hives and food allergies.

Eczema can also be classified as Acute or Chronic.

Acute Eczema has a sudden onset with intense symptoms, which usually subside after a period of time. It is recognized by redness and swelling, usually with an ill-defined border and small blisters. In severe cases these blisters can become large, weepy and crusted in the affected areas of skin.

Chronic Eczema refers to a long-term skin condition. The symptoms of a chronic Eczema are persistent and recur frequently. Chronic Eczema may show all of the above symptoms but usually presents with less weeping and blistering of the skin. It has a more scaly, highly colored and thickened area of skin, dry and leathery patches of skin (often due to scratching or rubbing) and a more painful cracking and splitting of the skin.

Most cases of Eczema are thought to be caused by an abnormal functioning of the body's inflammatory process. People with Eczema may have immune system defects. This leads to an inability to control inflammation and decreases the ability to kill bacteria and viruses. Other possible causes include hot and humid conditions, cold, dry conditions caused by the weather or air-conditioning, stress and emotions, contact with irritants (discussed previously in this topic), poor dietary habits, family history of Eczema, asthma, food allergies, allergies to medication, low stomach acid (hypochlorhydria), chlorinated water and nutritional deficiencies.

As with all conditions your Doctor should be consulted. Your Doctor will diagnose and treat your skin condition. Eczema can be difficult to diagnose as it presents in many different forms and may be confused with a fungal infection. Endogenous types of Eczema are usually treated with corticosteroid and/or tar ointments and antihistamines. Drugs, which work to suppress the immune system, may also be prescribed in some cases. The management of exogenous types of Eczema is based upon discovering and avoiding the substance, which is causing the irritation or allergic reaction. This may involve wearing protective clothing if contact is unavoidable e.g., the person is being exposed to the substance at work. Prevention is a major part of the management programme for all types of Eczema.

• Investigate the possibility of food allergies. Seek advice from a Dietician. Possible allergens include cow's milk, wheat, gluten, eggs, peanuts and citrus fruits.
• Eczema sufferers with known sensitivities to nickel may find their condition improves if they reduce the amount of nickel in their diets. Foods rich in nickel include rolled oats porridge, dried beans and peas, nuts, and chocolate. Nickel-sensitive Eczema sufferers should consult their Dietician for advice.
• Essential fatty acids are important for maintaining healthy skin and to reduce inflammation. The best sources include; fish, especially tuna, salmon, halibut and sardines; nuts and seeds; and vegetable oils.
• Try to include pumpkin seeds and sunflower seeds daily. These contain zinc and vitamin B6, which are needed for the immune system and for the metabolism of essential fatty acids.
• Mangos, carrots and apricots are thought to be good for skin conditions because of their high amounts of Vitamin A and beta-carotene.

• Vitamin A supplementation may be beneficial as it promotes skin healing.
• B group vitamins may assist in alleviating symptoms of dermatitis.
• Fish oil can reduce inflammation and dryness.
• Zinc is thought to aid healing of the skin and enhance immune function.
• Chickweed herb can prevent itching and stop hardening of the skin.
• Calendula can reduce inflammation and redness.

The listed oils are suggested for the temporary relief of the symptoms of Eczema. The most specific oils are shown in capitals.

1. Avoid using soap or detergents where possible and use other products. Moisturising creams or ointments to combat dry skin might be suggested. Avoid using products containing lanolin, as some people are allergic to this substance.
2. A bath with lubricating oils added may help to relieve dry skin.
3. Ask your Pharmacist for advice about protective clothing, including cotton gloves, which may be needed if contact with irritating or allergic substances cannot be avoided.
4. A mild cortisone cream is sometimes used. If you have any queries regarding your prescribed medication, ask your Pharmacist for advice.
5. Avoid exposing the affected areas of skin to excessive sunlight as this may aggravate the condition.
6. If the diet is considered inadequate, some nutritional supplements might be considered.

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