Heidi Darcy, a former wound resource nurse, and now the Intellectual Property and Science Communication Manager at Comvita, offers parents an insight into the different symptoms of common eczema complaints
Big I, little i...
Icabod is itchy. So am I.
- Dr Seuss
Itch is a very small word to describe a very distressing symptom of eczema. Broken sleep, scratched, raw skin and a crying baby drive parents to desperately seek a ‘cure’ for eczema. Naturally, parents want to make the problem go away so that these little ones are comfortable in their skin. Eczema can often be well managed, although it cannot be cured. It is important to understand what is happening in the skin when eczema symptoms are visible. A knowledge of eczema symptoms helps parents know why they should apply products and what they expect to see as a result.
People with eczema do not have enough of the oily substance that normally surrounds skin cells. This allows gaps to form around the cells. Large amounts of water pass out of the skin, causing it to become very dry. Deep cracks can form in the skin. Germs, allergens and irritants can get in through these cracks, causing the body to react or become inflamed. People with eczema need regular application of moisturisers to rehydrate the skin.
Red skin means inflamed skin. Immune cells in the second layer of our skin, the dermis, are always on the lookout for germs. When they detect an invader, the cells signal the rest of the immune system. Blood vessels in the skin open up wide to let disease-fighting white blood cells out through the gaps. The colour of the blood vessels so close to the surface of the skin makes the skin look red and angry. Well moisturised skin will have less gaps and will be less prone to becoming inflamed. Once inflammation has developed, special creams are needed to help reduce the redness and skin damage.
Called lichenification, thickened skin develops from repeated scratching. To relieve itchy skin, young children may rub their skin on sheets or furniture. This constant friction causes the top layer of skin, the epidermis, to become thickened. The skin’s natural grooves appear more pronounced and the skin takes on a leathery appearance. Reducing the scratching and rubbing will encourage a more normal skin texture to develop.
Pigment cells in the dermis, called melanocytes, help give skin its colour. Inflammation and scratching damages these melanocytes. They are not able to produce pigment normally , causing uneven skin tone. This damage is reversible and normal skin tone will return when eczema is under control.
Lifestyle changes may help to reduce the effects of eczema. The majority of eczema symptoms though, are managed with a variety of creams and ointments. Parents can find it confusing to know which product to apply, where to apply it and why to apply it. An awareness of what is happening in the skin can help parents to understand the reason for applying different products and what the products are trying to achieve. Talk to your pharmacist or doctor for further information.
Heidi Darcy is a former wound resource nurse and is currently the clinical advisor at Comvita.