No single cause of eczema has been identified, but it is thought to be caused by a mixture of inherited and environmental factors.

Genetics – atopic eczema is principally an inherited condition. A child is 60 per cent more likely to have the condition if one of their parents has atopic eczema which rises to 80 per cent if both parents have the condition.

Environmental – the most common allergens are house dust mites, pet dander pollen and food. Other non-allergic factors can be changes in weather, particularly cold, dampness, use of fragranced soaps and bathing too often (which dries out the skin) or in water that is too hot. Symptoms are often triggered or flare-ups made worse by irritants. The trigger will differ from person to person, some of the most common irritants are:

• soaps and detergents
• certain types of clothing e.g. wool
• temperature extremes e.g. too hot or cold
• changes in weather and/or temperature
• house dust mites
• animal dander (skin, fur or feathers)
• perfume or fragranced products
• environmental factors e.g. tobacco smoke or
pollution
• stress
• hormonal changes

Treating atopic eczema

There is no cure for atopic eczema but most children normally find their symptoms improve as they get older. There are OTC treatments available to help manage everyday symptoms and flare-ups:

Emollients – product ranges such E45, Oilatum and Eucerin are moisturising treatments applied to the skin. Patients should be encouraged to keep their children’s skin moist with regular use of emollients, as keeping the skin moist, soft and supple will help to reduce the incidence of flare ups. It is recommended to try a wide range of emollients to find the one that best suits the sufferer including creams, ointments, lotions and bathing products. They should be applied liberally and regularly – up to four or five times a day for severe symptoms. Emollients should be used continuously to try and prevent flare-ups occurring. There are no severe side effects from using emollients. It is no longer recommended to use aqueous cream to treat dry skin as it can irritate and damage the skin rather than protect it.

Topical corticosteroids – treatments such as hydrocortisone (Numark Hydrocortisone cream 1%) for mild symptoms and clobetasone creams (Eumovate Eczema and Dermatitis 0.05% Cream) for severe symptoms are applied directly to the skin. They are used to reduce redness and inflammation during flare-ups.

When sold OTC, steroid creams must:

• not be sold for use on the face or anogenital regions
• not be used on broken skin
• not be sold for use in children under 10 years for hydrocortisone or 12 years for clobetasone
• not be sold for use by pregnant or breastfeeding women
• only be used for a maximum of seven days.

Some people find oral antihistamines help to relieve the itchiness which can be useful if the person’s sleep is being disturbed. Oral antihistamines will not treat the condition only relieve the symptoms. Patients requesting oral antihistamines for a skin condition should be referred to the pharmacist. There are other treatments that can be prescribed by a GP to manage severe cases such as other creams, ointments, oral corticosteroids and antibiotics. Eczema tends to be a childhood condition, most children will grow out of it and often the eczema becomes less severe as they get older, although the skin will always be prone to drying out and a good moisturising routine is recommended. Symptoms can be managed by using the right treatment. It is important that you encourage the customer to try new treatments if they feel the current one is not working, as there is a suitable treatment for everyone it is just a matter of finding it. In addition, sensitivity to products that are being used long-term can develop, if flare-ups are becoming regular then an alternative emollient should be tried.