The relationship between hay fever and eczema
Having hay fever puts a person at risk of developing eczema, and vice versa. The medical term for eczema is atopic dermatitis and is used to describe patches of very itchy, inflamed skin with swelling, redness, weeping, cracking, crusting, scaling and a propensity towards infection. The itching is often all-consuming in eczema, and the subsequent scratching and rubbing unfortunately worsens the skin inflammation and other symptoms. As a result, an ‘itch-scratch’ cycle results, with the itch demanding to be scratched which in turn worsens the itch. Obviously, trying to stop a small child from scratching an itch is virtually impossible, and even adults with an iron will are likely to scratch m their sleep when conscious control disappears.
There are several different types of eczema; it can develop in infancy °r appear later in life, and there are flare-up periods followed by remissions where the skin makes a partial recovery or clears totally. In many people, although their skin may remain dry and easily irritated, remission is permanent as they reach adulthood. In others, environmental factors such as the use of certain detergents or even skincare products continue to provoke a full flare-up. Emotional factors such as stress can also make eczema worse. It cannot cause eczema, however.
Eczema is an atopic disease, meaning that it belongs to a group of diseases that run in families and are often present at the same time. For instance, an individual prone to both eczema and asthma may find that during an eczema flare-up an asthma attack is experienced too. Eczema affects males and females equally, with approximately 90 per cent of sufferers developing the condition before the age of five. Living in an urban area with higher levels of car exhaust fumes and industrial pollutants appears to increase the risk of developing the condition.
Isolating and avoiding the triggering factor is not always easy. Obvious irritants can be avoided, but the mainstay of eczema management is the regular use of good skin-softening preparations such as aqueous cream and, where necessary, steroid creams such as hydrocortisone (brand name Hc45;. Such products block incoming allergens by making a temporary artificial barrier on the skin. They are therefore able to interrupt the cycle of barrier breakdown, attempted repair and further breakdown. Subsequently, the immune system should calm down and cell growth decelerate.
Unfortunately, some of the barrier creams used can cause undesired side effects such as dermatitis, pustules, broken blood vessels and loss of skin colour. Your doctor will, therefore, need to monitor your progress very carefully.
Because many children with eczema go on to develop the more serious asthma, they may also be treated with medications that suppress the immune system and so prevent asthma from arising – examples are ciclosporin (also spelt cyclosporine) (brand name USAN) and aza-thioprine (brand name Imuran). These medications can also cause undesirable side effects, however, such as adverse reactions with other medications, diarrhoea, vomiting, fever and convulsions.