Facts about eczema
Facts about eczema
• Over two million children and adults in Canada
suffer from eczema, a common, chronic, life-
• Eczema (atopic dermatitis) is characterized by painful red, swollen, itch and flak
some cases, the itching and redness are so intense that sufferers scratch the selve
bleed, increasing the risk of secondary infection.
• Twelve to 25 per cent of children and 10 to 15 per cent of adults in Canada
. The majority of eczema cases are diagnosed in early childhoo
n may eventually outgrow eczema, about 80 per cent will have dry, irritable
• Since 1970, the prevalence of eczema has nearly tripled
. Studies show that the steady
increase of this chronic condition is generally attributed to allergens and irritant
• Eczema is the result of a complex relationship
of many known and yet-to-be-determined
causes, including heredity, environmental allergens, and skin irritants (i.e. wools, fragrances and certain detergents). The condition is associated with the immune system’s response to environmental irritants, as well as with respiratory allergies and asthma.
• Environmental triggers
are the most common elements that cause flare-ups; eczema sufferers
often find that hay fever or exposure to allergens—such as those released by cats and dogs—can make symptoms worse. In general, people with eczema often have hypersensitive skin that does not tolerate certain topical stimulants or environmental contaminants.
An inside look at eczema
1. Allergens penetrate the skin, interact with
2. Activated T-cells release cytokines, which initiate an immune response.
3. These events result in the itching and inflammatory
Normal skin has an outer layer that acts as a barrier and helps keep water and, hence, moisture, in the skin. In atopic dermatitis, this barrier is not well-formed. As a result, the skin loses moisture and becomes dry. A second abnormality is an imbalance in the immune system, which can make the immune system overactive in the skin, leading to redness and swelling. Itching is another major component of eczema. While scratching may be a natural reaction to an itch, it actually accelerates and aggravates the process, making the itch worse.
What patients and parents are saying about eczema
Children and eczema
“It was heart-wrenching to see my first son, Christopher, born with eczema. He
never slept through the night. No matter what we did he was badly affected with
dry, itchy and flaky skin. I tried everything - at one point I even covered him from
head to toe in petroleum jelly to keep the moisture in after a
imagine how uncomfortable that would be for a two-year-old?
dermatologist who was conducting a trial study on a new kind of treatment called "topical calcineurin inhibitors" or TCIs. Once Christopher used this ointment, his skin started to clear up. My shy little boy, who disliked having his arms or legs exposed, started to come out of his shell. Christopher was now able to do things
cil, riding a bike, playing video games and using the co
think of how far Christopher has come I cry with happiness, knowing full well the emotional scars he will not have
rry for the rest of his life. As a parent I believe that we need to explore all
A family perspective
“As a parent with a child with eczema, there are no words to express our
exact feelings; in fact, many feelings overwhel
exhaustion, guilt and discouragement all come to
about it is that it doesn’t only affect the child, it affects all family members. I remember when our daughter, Jesabel, was younger; we went as far as changing our diet, because we had noticed that certain foods triggered flare-ups. We also
fireplace or carpets, in order to eliminate as many triggers as possible. We also had
void any activity that would make Jesabel perspire,
such as going to the park or swimming in an indoor pool. My
daughters out and I would stay home with Jesabel, or come up with s
Élaine Bélisle St-Jean, mo er of thre
Adults and eczema
"I dread winter! The worst part for me is the increased frequency and severity of my
flare-ups. I find that the changes in humidity I experience between my home, the
outdoors and my workplace are terrible for my skin! I have to be very conscious of my
daily routine of moisturizing my skin an
minimize the effects of the drier air this season brings."
Sherry O'Connor, mother of two, lifelong sufferer of eczema, Hamilton
How is eczema treated?
• Eczema is difficult to treat because the condition is recurring and chroni
eczema has been treated with moisturizers to hydrate the skin, topical steroids (or cortisone creams) for inflammation, oral antihistamines for control of itch and antibiotics when there is infection.
• Since no treatment can cure the condition, and because of the periodi re
have to treat their condition for a prolonged period of time. This
situation may lead to concerns related to the side-effects of some current treatments. For
side-effects associated with topical steroids include skin discolouration
• Topical steroids:
Topical steroids appl
ied to th skin are treatments that are used primarily
to control inflammation. They should only be used under the supervision of a
essential to use the prescribed strength and quantity as prescribed by a
topical steroid can be bought from a pharmacist without a prescription. This is y
a mild steroid, which is sold as a cream or an ointment.
• Topical calcineurin inhibitors (TCIs):
The newest class of eczema
Canada, TCIs, interrupts the process that causes eczema rather than only treating the symptoms. Steroid-free TCIs, which are applied directly to the skin, prevent cells in the immune system from “switching on” and releasing chemicals that cause the itching and other symptoms associated with eczema.
Sunlight has been known to have a benefic
Ultraviolet light waves found in sunlight were discovered to be the so
effect. Phototherapy uses these ultraviolet light waves for the treatment
short-course phototherapies like ultraviolet A (UVA), ultraviolet B (UVB) and psoralen plus UVA (PUVA) have been shown to be beneficial for adults with severe atopic dermatitis. Narrow band and PUVA appear to be the most effective.
Antibiotics are used to treat the secondary skin infections that often accompany
eczema. Bacterial infections like staphylococcus and streptococcus are common in the skin of people suffering from eczema.
These are sometimes prescribed to aid sleep and relieve itching. However,
histamine does not appear to play a major role in the itching caused by eczema. A doctor should always be consulted before giving antihistamines to children.
Common myths and facts about eczema
• Eczema is just like acne.
nt causes and treatments. However, it is true that some
medications may trigger acne and co plicate e
czema. It is important to talk to a doctor, as there
are different medications that may help.
• Eczema is caused by an emotional disorder.
Eczema is not caused by an emotional disorder, although doctors did at one me believe
claim. However, it is clear that emotional factors, such as stress, can make eczema symptoms worse. There are techniques that can help manage the stress, anxiety, anger or frustration associated with eczema, which may ultimately help to reduce the number or th
• You can ‘catch’ eczema from someone who has the condition.
Eczema is not contagious. This means that you can’t ‘catch’ it from another person and you can’t give it to someone by touching them.
• You can't go swimming if you have eczema.
Most people with eczema can go swimming. However, swimming in saltwater or chlorine may irritate the skin of some eczema sufferers. It is recommended that people with
after swimming to rinse salt or chlorine re
swimming and after showering can also help.
• People who have eczema do not wash properly.
Eczema flare-ups are not triggered by a lack of proper hygiene, but by exposure to environmental antigens, as well as an imbalance in the immune system.
• Eczema will leave permanent scars.
Although eczema can be very uncomfortable and unpleasant, it is very unusual for it to leave any permanent marks on the skin. However, some conventional treatments (such as topical steroids) can cause skin discolouration, stretch marks and thinning of the skin.
• Eczema can be cured with topical steroids.
There is no cure for eczema. Although topical steroids have been used for a long time to treat eczema, they are not a cure and there are limitations on their use for treatment.
• Topical steroids are the only way to treat eczema.
Topical steroids have been the mainstay of eczema treatment for many years. However, significant medical advances have resulted in the development of topical calcineurin inhibitors (TCIs), the newest class of eczema therapy available in Canada. Steroid-free TCIs interrupt the process that causes eczema, rather than only treating the symptoms. Tacrolimus ointment (marketed under the brand name Protopic®1) was the first TCI to be approved in Canada for moderate-to-severe eczema. It was tested in clinical studies on more than 16,000 patients worldwide. Pimecrolimus cream (marketed as Elidel®2) has also been approved for the treatment of mild-to-moderate eczema. 1 Protopic is a registered trademark of Astellas Pharma Canada, Inc.
2 Elidel is a registered trademark of Novartis Canada
The EASE Program
• The Eczema Awareness, Support and Education (EASE®) Program is a national and fully
• The goal of the EASE Program is to foster greater understanding of, and to
• This EASE Program has been developed with the assistance
dermatologists to provide access to useful and accurate information
• The EASE Program has been recognized with four Public Education A ards
rmatology Association (2003, 2004, 2005, 2007). The award is granted annually
by the CDA for excellence in furthering the understanding of dermatologic issues and encouraging healthy behaviour in the medical, surgical and cosmetic care of skin, hair and nails.1
• The EASE Program has been developed as a community service through an educational
grant from Astellas Pharma Canada, Inc., a leader in the field of dermatology.
• The EASE Program has also developed Penny’s World – a fun, child-friendly website that
aims to help children understand eczema. Penny’s World features interactive learning activities and games, as well as
a fre colourful storybook, Penny’s EGGS-im-ah
, which can
• You can obtain free literature on eczema by visiting www.eczemacanada.ca or by writing to:
The EASE Program
CP 964 Succ. Place-d’Armes
Montreal, Quebec H2Y 9Z9
1 Canadian Dermatology Association website - www.dermatology.ca
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