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According to the Irish Skin Foundation, eczema affects about one in five children and one in 10 adults in Ireland. Now, in many instances, the disease is mild. However, often flare ups can occur maybe a few times a month, leading to leading to a severe impact on quality of life. Now, dermatology nurse specialist Danny is on the line saying good morning and welcome.
Now, just to get definitions in play, what exactly is eczema? How does it manifest itself?
So eczema is a chronic skin condition when we don't have a cure for it and it causes skin to become itchy, dry, cracked, saw and read. And I suppose that's a really important point about eczema we don't have a cure for. So we don't have a pin repulsion or a lotion or a moisturizer. If you go on social media, you sometimes see claims that this single moisturizer can read. You have eczema forevermore. That's not true. So we don't have a cure for it.
We can control it quite well. The other second really important point about eczema is that when you have eczema, you have an impaired skin barrier. So what does that mean? So I don't have eggs. In the past, my skin acts like a suit of armor, so keeps all the normal things the environment out. And I say normal dog, hair, dander, fluff, fragrance, preservatives, it keeps all those things out and it keeps all my nice always within my skin cells, which makes my skin function very normally.
However, when you have eczema, you have an impaired skin barrier, meaning it acts like a sieve. It takes all the normal things in the environment, like the dog hair, the floss that preserves the fragrance into the skin, causing inflammation. And because the skin is acting like a sieve, it lets all your nice natural oils out of your skin. Therefore, the skin is unstable. You've got inflammation, you start at your skin becomes red and inflamed.
You start to scratch and itch and then you get infected. And then you get into this itch scratch cycle, which is connected with eczema. So it's a chronic skin condition, meaning there's no cure for it. It's very common, particularly among children and parents. About one in five have eczema. Now, typically, many people listening will have had eczema as a child or a baby and would have basically grown out of it. However, we are seeing more children getting their eggs in the back in their late teens.
And we do have adults who had eczema as a baby, for example, and now have they hand eczema or contact eczema.
Now, the question is, since we don't have a cure, we'll talk about how you can mitigate the symptoms in a moment or two.
But what causes it?
I mean, is it an autoimmune condition or what is genetic effectively? So typically when somebody comes into a clinic with eczema, we'll ask the parent if they're a baby, any history of asthma, eczema, he fever or allergic rhinitis in the household. And they will always say, yes, you have something. So, for example, in my household, I have hay fever and my daughter has eczema. So if you have any of these eight topic conditions, they're almost first cousins of each other.
You can pass that genetic code down to your children and then they may develop eczema. So it's known as the topic disorder or any type of disease. And effectively, it's where we have a lack of a protein called Phenergan are less of a protein called collagen in our skin, which makes your skin acts like the suit of armor. You don't have enough Villagran. And then you get this impaired skin barrier and then you have triggers like dog hair, dander, fragrance that trigger off an eczema flare and you have less oils in your skin.
So you have dry skin and that's effectively what eczema is across the board.
Now, we mentioned earlier talking about migraine, that the stress, the anxiety can lead to surges in outbreaks of migraine. It does stress have any impact on eczema?
It can. Now, typically, studies show in dermatology that eczema has this waxing and waning or flare and kind of a down period. So typically in the summertime when we're talking about children again and the kids are out there playing outdoors, it's nice and warm outside. Once school comes back into this time of year, the heat goes on inside and it's cold and damp outside. Eczema would always flare. If you're feeling unwell, you've got a virus in this cough, cold or flu and guarantee the school's been back for one week.
Every kid in the country would have a sniffle or a sore throat or a little cough. And that with your eczema to any vaccination change in like even just starting school, the stress of starting school or school that can flare eczema as well. XML will flare. And again, I always tell parents, look, we're not, but we can control the eczema, but it will flare from time to time, particularly around this time of year.
Now it turns out that people with eczema, they have a poorer overall general health as well.
They do. And we've looked at studies for many years looking at eczema. And it tells me that in a large city in the US of six hundred and two adults showed that again. And people who have been there listening will know all about this, the worst symptoms the people have with eczema, which is is terrible, and we spoke about it before on the show as well. So when your skin is itchy, you don't sleep at nighttime, you're embarrassed or itching and scratching your constipated infections in your skin.
You're embarrassed for how your skin appears as well. And it's incredibly uncomfortable and the fact it is worse than pain. So people with who are surveyed that have chronic or terrible itch said they would rather be in pain than have itch. And also if the joints in the skins, the skin and hypersensitive people feel they have a worse overall health and people who have chronic heart disease or diabetes as well. And the study in the U.K. conducted in 2014, looking at people with skin conditions such as rosacea, psoriasis, skin cancer, when survey people with eczema, they found they had a poorer quality of life than people of various of the skin diseases.
Something that were bad in health looking at is actually how much it costs to have eczema. So, again, another good study in Europe of adults who have eczema found they spend nine hundred euros just under eczema per per year. And that's on buying moisturisers, attending doctor's appointments and petrol or transport for attending consultants appointments. If you're traveling across the country to do so, and we do forget that unlike the NHS in Ireland, our patients have to buy their moisturizes or whatever medical card or not, you have to buy your moisturizer some 20 years apart.
So that does bring us to the recommended treatments to keep your itch at bay. So what is the therapy, first of all?
So I have three. First of all, is not to use any Thorpes bubble baths, showers, nor normal washes whatsoever. Nothing a neighbor recommends and not just water by itself. So if you have had dermatitis, for example, or hand eczema and just use water to wash with, you will actually flare up your eczema. You need to emulsifier water and use something in it. So use a good soap free wash to wash your skin with. Second of all, you can't moisturize enough.
Moisturize, moisturize, moisturize, but use something without preservative parabens perfumes, go into your pharmacy, go to your GP or your dermatologist or your traumatology or specialist and ask for a recommendation on what moisturizer is good for you or your baby. Second or third of all, if you have eczema, please go to your GP. Don't go on Google and start Googling what to do. You won't find any good information there. Go to your GP, get your skin assessed.
You possibly will need a prescription for topical steroids. Now, topical steroids have a bad rap. Yes, they do have side effects, but we do need to use them when we're controlling eczema, particularly the ointment basis, because they have to bring down that inflammation. And if you have moderate to severe eczema, you need to be seen by a consultant dermatologist, a hospital based consultant dermatologist who can possibly do patch testing if they need to, for example, in adults.
But to give you a proper prescription and the regime and again, in dermatology, where there's a hospital with the dermatology unit, you will have dermatology, your specialist dermatology nurses who can actually come up with a plan on how to plan your care, what moisturized use, how to avoid triggers went use steroids. Also, we recommend people with moderate severe eczema do use therapeutic clothing. Basically, these are tops and bottoms. There are bandages made into clothing and you can use them at night time to cover over your moisturizer and that can help the skin to heal.
Get some good information that can see that enough. If you Google X may get the most horrendous rubbish that comes up. Really a lot of misinformation. So the Irish King Foundation website, there's a free helpline there. You can ring a dermatology nurse to get some good advice next about or any other skin condition. I always recommend my patients to go on YouTube, not to see anything, but to go on YouTube. Ah, Dr Alan Irvine, XMA.
There's a twenty minute talk. It was three years ago and that in Irvine is a lead in the world, not just in Ireland. Europe on XMA I think is a fantastic twenty minute talk about XMA, about the treatments, why we have it, and it's just so easy to understand to make yourself a cup of tea, sit down in front of You Tube and put in ulnar vines, talk there. It's really excellent.
Brilliant. What a mine of information. Dermatology nurse specialist Saleen Daily, thank you very much for joining us at Velho Coffee.
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