Eczema affects one in five people, and its exact cause remains unknown. But as Angela Tufvesson finds, it usually improves with age, and in the meantime thereās plenty you can do to alleviate the symptoms.

Kazia Guy remembers watching her brother scratch his eczema-riddled skin with a knife when they were children. Yet she didnāt suffer from eczema and neither did her first child, so she was surprised when her second child, five-year-old Deandre, was diagnosed with eczema.Ā
āDeandre was born with very dry skin and I had to oil it a lot,ā she says. When Deandre was a few months old his skin worsened and the condition was diagnosed as eczema, which Kazia says became almost unbearable over the next few years. Deandre also struggled with asthma and food allergies.Ā
Unfortunately, Deandre isnāt alone, as New Zealand has one of the highest prevalence rates of eczema in the world. The troublesome skin condition, also known as atopic dermatitis, usually develops in childhood and affectsĀ 20 percent of New Zealanders beforeĀ the age of five. More than half of all eczema suffers display symptomsĀ in the first 12 months of life.
A family trait
Eczema is caused by inflammation of the skin and the skinās inability to retain adequate moisture. The result is red, scaly and very itchy skin. Sometimes tiny blisters form and the affected areas can weep, which is a sign the skin has become infected. Eczema is not contagious but there is no cure.Ā
The exact cause of eczema is unknown but most experts believe the condition has a genetic base and is linked to other atopic, or sensitivity, disorders including hayfever and asthma. āWhat weāve found recently is quite a number of people who have eczema have an abnormality of how the skin is made, and this is inherited,ā says paediatric dermatologist Diana Purvis of Auckland Dermatology.Ā
āThere are a whole lot of different proteins involved with skin barrier function, and one of the proteins that has been identified recently, filaggrin,
is low in many people who have eczema. If you have low levels of filaggrin in the outer layer of your skin, the cells arenāt structured as strongly and the normal amount of waterproofing of the skin isnāt there.ā
But even when there is no family history of eczema, a child still has a five to 15 percent chance of developing it. Scientists continue to probe the causes, with research suggesting antibiotics, coeliac disease and increased consumption of fast food may be linked to higher rates of eczema.
The role of diet
Once the skin barrier is disrupted, moisture leaves the skin and it becomes dry and scaly. Triggers such as wool, heat, soap, perfumes, synthetic fabrics, sweating and stress, along with allergens such as dust mites, pollen and mould can all cause eczema to flare. Kazia says Deandre is susceptible to a heap of environmental triggers, including pine, pollen, grass, stress, antibiotics and even playing in the sand pit.Ā
In most cases, diet doesnāt cause eczema flare-ups, but children with eczema are more likely to develop food allergies ā which in Deandreās case include soy, dairy and peanut. āPeople are often quick to say itās a food allergy thatās causing the eczema to flare up but when we look at the research, thereās very little that supports that taking foods out makes a difference to the severity of eczema,ā says Purvis. āIn children itās more useful to think of eczema as a predisposing factor for developing anaphylactic food allergies. Children who have eczema have a higher rate of those than the general population.ā

Effective treatment
Lots of parents are concerned about the safety of steroid creams, fearing that they are unnatural or cause āskin thinningā, but research shows steroid creams occur naturally in the body and are a safe option for children and adults. Whatās more, new Australian research shows corticosteroid creams produce excellent results.
āSteroid creams are the most effective treatment for inflamed skin,ā says Penny Jorgensen, allergy advisor for Allergy New Zealand. āThey are safe to use, even on scratched eczema skin, and studies in childrenĀ
show that side effects do not occur with regular use for months. If the inflammation of eczema is treated effectively this restores the natural barrier function of the skin and allows the skin to heal.ā
Even though eczema canāt be cured, the condition affects only two to three per cent of adults, so most children will grow out of it. Kazia says after a long search for solutions Deandreās eczema has improved significantly over the past couple of years. āHe still has scarring but it is no way near as bad as it used to be,ā she says. āNever give up because it does actually get better, even if it takes a while.ā
Purvis says that actively treating eczema throughout childhood to break the āitch, scratch, infectionā cycle can help to reduce the chance of the condition persisting into adulthood. Reducing exposure to triggers, choosing mild soaps and laundry detergents and wearing loose, cotton clothing can help to control and prevent symptoms.
And never underestimate the value of a good moisturiser. āThe main action to take is to moisturise, moisturise, and moisturise,ā says Jorgensen. āA suitable moisturiser should be applied to the skin all over the body at least twice a day, and donāt be afraid to use a lot!āĀ