Posted on 2nd July, 2021
Eczema (also known as atopic dermatitis) is the most common inflammatory skin condition worldwide, leading to two main symptoms - dryness and inflamed skin. This occurs because the water contained in the top layer of the skin can actually escape and evaporate through gaps, leaving the skin dehydrated and exposed. Then any external irritants from the outside can make their way through these gaps, because there isn’t enough ‘oily stuff’ there to block them out. Eczema sufferers typically have an issue with restoring that oily layer as fast as other people.
A good example of this is when you use cheap hotel soap and your face can feel really tight. This is because you’ve stripped away the oily layer of the skin. In normal healthy skin, half an hour later your skin feels better, as the oily layer is restored. Eczema skin sufferers never restore that layer quickly enough, so by the time they wash again they have stripped away the next part of what oily layer is still left.
So why is this happening? Let’s break it down to the layers of the skin:
Top layer - Stratum corneum
- Dead skin cells are stuck together in a lipid (oily) layer. These include cholesterols, free fatty acids and ceramides.
- The best way to imagine this is to think about when you are making a cake. You have your dry ingredients (flour and sugar) and then your wet ingredients (eggs, butter and milk). So, like your cake, the top layer of the skin will be too dry without enough of the wet ingredients combined.
- That oily layer sticks all your dead skin cells together to make it nice, smooth and act as a good barrier, just like with your cake!
- Eczema sufferers are also deficient in the ceramide component of this layer. This makes up about 40-50% of this layer, so it’s almost like trying to make a cake without eggs!
- Considering this, eczema skin is essentially dead skin cells floating around on top. You may have a little bit of those lipids hanging around, but you have gaps between your epidermis and your dermis, which are your next layers of skin.
Second layer - Epidermis
- This is where all your glycerine is, which is where all your water is contained. Glycerin is a humectant, which basically means that it works to suck water into the skin. This allows it to absorb and retain the water, and therefore keep the skin hydrated, to stay all nice and supple.
Third layer – Dermis
- This contains your skin's blood vessels and nerve endings.
So what can you do to treat this?
Firstly, a good soap-free skin cleanser is recommended. Soap-free (eg. free of sodium lauryl sulphate) is important to avoid irritating detergents entering the skin and aggravating the skin further. Previously with cleansers, all we wanted to do was cleanse the skin without stripping away that fatty layer. As we know, soaps do this and don’t help eczema skin at all. Newer products enhance the glycerol content and replace the missing ingredients eczema sufferer's skin needs. The Ego range of products are designed with this in mind, to suit the needs of varying levels of eczema severity and help to respond to inevitable flare-ups that occur. We stock many of these, as well as a less expensive equivalent range for a more cost-effective option.
QV Bath Oil – contains mostly liquid paraffin
QV Wash - contains 5% glycerin. If the skin starts to get even drier use QV Gentle Wash, which contains 10% glycerin. These can be used as an everyday cleanser in the shower or bath.
QV Intensive Cleanser – contains 60% glycerin, a lot more hydrating than the standard QV Wash!
QV Intensive Body Moisturiser – this is essentially like an ointment, but because there is no water in it, it is sting-free. It can be used for dry, cracked skin. It is a greasy product in feel, but if you can imagine really dry skin, it will “suck it all up”.
QV Intensive “with ceramides” range – this is to be used when you are starting to need something “a little more clinical" - ie. serious/moderate eczema, possibly using corticosteroids. Let’s use an analogy of bricks and mortar, where moisturisers are like putting plaster over the top. There may be cracks in the mortar between the bricks, but the plaster layer stops anything from going in and out, and then your skin has to repair the mortar itself. Now, we have this product range which contains the ceramides to fill in the mortar in between the bricks.
So you’re probably wondering, “where do I begin"?
Our recommended tier of product use:
Start with either standard QV Wash or QV Gentle Wash, and/or QV Cream
(if skin getting really dry) progress to the QV Intensive range
(if skin getting really dry and problematic) progress to the QV Intensive “with ceramides” range
Steroid creams are available (mild hydrocortisone over-the-counter or stronger options via prescription from your doctor) for those that know their skin is starting to flare up. If unresponsive, QV Flare-up products (containing antibacterial agents) are available if the skin is infected (which can easily occur due to scratching!) and you need to exfoliate the staph bacteria off the skin. At this point, you can begin treatment with these products until a GP appointment can occur.
Pop in to speak with our Pharmacists for more advice on eczema and to help choose the right products for you!