Dr Clare Bailey: An itch you must never scratch

Anyone who has had eczema will know just how irritating the itchiness can be. Also known as atopic dermatitis, this distressing condition affects one in five children and one in 12 adults, causing persistent inflammation of the skin – commonly on the face, arms and legs – and an almost overwhelming urge to scratch. Some find it keeps them up at night; others scratch their skin raw in their sleep.

eczema
Maite Franchi

Patients are advised not to rub or pick their eczema, especially if they want to avoid the ‘itch-scratch cycle’ – where excessive scratching makes the itching worse. But the brief relief of scratching can be all too tempting.

We know there is a genetic factor to eczema and that it happens when an overactive immune system causes the skin to become more sensitive and inflamed. The condition may also be partly due to defects in the skin barrier, allowing it to dry out and let germs in, as well as being triggered by environmental irritants.

So how can you get on top of eczema? As it requires a long-term approach, you need to catch flare-ups early and establish a daily regime of protectively moisturising the skin (even when it has settled). Here are a few things you can do to keep symptoms at bay:

  • Avoid long baths and showers as they can weaken the skin barrier and dry it out. Wash with an emollient soap substitute – ask your pharmacist for advice on which to use.
  • Moisturise with ointments and creams instead of lotions, as these are too watery. The greasier the better, to form a barrier and trap moisture in. Gently smooth it on, don’t rub.
  • Keep fingernails short to reduce the chance of breaking the skin.
  • Wear smooth cotton or silk next to the skin. Avoid wool, especially in cold weather (which already exacerbates eczema), as the rougher fibres can set off an itch.
  • Try to identify contact irritants including cosmetics and cleaning products that can cause sensitivity. If you suspect a culprit, test it by applying a small amount to your inner arm twice daily for five days and look for a reaction.
  • Be aware of allergens. Everyday triggers such as pollen, animal hair or dust can worsen symptoms – your GP may be able to arrange testing.

Despite these preventive measures, if you are still affected there are many treatment options:

  • Steroids ease inflammation and itching to speed healing – always use these as instructed by your doctor. Topical creams are used on active eczema and should be reduced or stopped when it has cleared. In severe cases, steroids are taken orally.
  • Anti-inflammatory creams, such as Elidel, can be used on delicate skin and for extended periods.
  • Antibiotics are sometimes needed because the cracked skin can allow germs in, causing infection.
  • Phototherapy is a targeted light treatment used for more severe cases.
  • Immunosuppressants may be used for severe cases, but they have more significant side effects.

If your skin becomes painful, blistered or develops pustules and weeping, contact your GP promptly, particularly if you have a fever.

Find out more at eczema.org

Bad mood? Check your food


I’m reading a fascinating book on the impact that food has on our mood. Brain Changer by Professor Felice Jacka, president of the International Society for Nutritional Psychiatry Research, draws on her extensive work examining the role that diet and gut health play in our mental health. It also looks at her own experiences of handling depression and anxiety.

The book presents scientific evidence that a diet of highly processed junk food puts you at a much higher risk of depression, while a healthy, balanced diet improves both brain performance and mood (for instance, traditional Norwegian, Mediterranean and Japanese diets are associated with better mental health).

Simply put: eat whole food, not too much and mainly plants, while avoiding processed foods.

If you have a question you would like answered, email drclarebailey@you.co.uk