Eczema… Causes and treatment

It’s finally springtime – my favourite time of year. The day starts getting longer but it’s not yet debilitatingly hot. However, for people like my brother who suffer from the chronic skin conditions, like Eczema springtime is a curse – due to increased allergies his skin is always red and itchy, and it can get so bad that he ends up bleeding.

Summer is also fast approaching – and even though The dry, red and usually, intolerably itchy patches often recede when the air is warm and damp, and skin is exposed more often to sunlight.

Shedding clothes may be embarrassing for many adults; many will refuse to go to the beach because they feel conscious about the appearance of their skin. In the case of children, eczema can often result in teasing and bullying. Even for those who do not mind wearing a bathing suit, swimming in a pool can be problematic if the sensitivity to chlorine worsens the condition and swimming in the sea in Malta where we often encounter algae can cause flare-ups as well as the sand which will cause further irritation.

Types of eczema

Eczema is the name for a group of conditions that cause the skin to become red, itchy and inflamed. There are several types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis and stasis dermatitis.

Eczema is very common. And in many cases, it’s also manageable.

Eczema flares often show up on the backs of the knees

The word “eczema” is derived from a Greek word meaning “to boil over,” which is a good description for the red, inflamed, itchy patches that occur during flare-ups. Eczema can range from mild, moderate, to severe.

What are the symptoms of eczema?

The most important thing to remember is that eczema and its symptoms are different for everyone. Your eczema may not look the same on you as it does on another adult, or on your child. It may even appear in different areas of the body at different times.

Eczema is usually itchy. For many people, the itch is usually only mild, or moderate. But in some cases, it can become much worse and you might develop extremely inflamed skin. Sometimes the itch gets so bad that people scratch it until it bleeds, which can make your eczema worse. This is called the “itch-scratch cycle.”

What to look for:

  • Dry, sensitive skin
  • Red, inflamed skin
  • Very bad itching
  • Dark colored patches of skin
  • Rough, leathery or scaly patches of skin
  • Oozing or crusting
  • Areas of swelling

You might have all of these symptoms of eczema or only just a few. You might have some flare-ups or your symptoms could go away entirely. But the only way to know if you have eczema for sure is to visit your doctor so he or she can look at your skin and ask you about your symptoms.

Why is Eczema becoming so common?

In many countries, eczema has become two or three times more common in recent decades. Approximately between 15 and 30 per cent of children and 2 to 10 per cent of adults suffer from eczema, which nearly always begins in the first five years of life. Fortunately, in more than two-thirds of children with eczema, the condition resolves on its own before they hit puberty. However, there are cases like my brother that as he gets older, the situation worsens especially when working in conditions with lots of allergens present like dust, oil, sand and soil.

In Malta, unfortunately, since the amount of pollution has increased significantly so have skin conditions like eczema. We have also seen an increase in other allergies such as allergic coughs and asthma – all of these can somehow be related.

Eczema is often referred to as “the itch you can’t scratch,” though a wiser description would be “the itch you shouldn’t scratch.” Scratching can make the lesions worse and expose the skin to infection. It can also cause severe bleeding.

How can I avoid developing eczema?

According to the so-called hygiene hypothesis, the more sterile a child’s environment, the higher the risk of developing such conditions. In other words, let your child play in the playground and sand and soil to allow their body to learn what these allergens are and develop an appropriate response when coming in contact with them.

Is eczema contagious?

Eczema is not contagious – so you cannot catch it by touching someone. It would be great if parents educated children about this to avoid bullying children who suffer from it. It is also common for more than one member of a family may be afflicted. A genetic component in this condition has been noticed, however. In identical twins, 77 percent will both have eczema, but it occurs in both fraternal twins only 15 percent of the time.

Another indication is the fact that people with celiac disease (a gluten intolerance) are three times more likely to have eczema; relatives of celiac patients are twice as possible to have eczema as well.

Can my diet influence my skin condition?

Food allergies show up as eczema in some patients. Eliminating one potential culprit at a time, like dairy products, eggs or nuts, may reveal an eczema-inducer.

Some foods are known to cause inflammation and others to reduce it so there might be a connection between food and eczema but you need to start eliminating things one by one and seeing how it influences you.

  1. Eliminate gluten

Gluten-containing grains can trigger inflammation for some. Gluten, a protein that is found in wheat, barley, rye, Kamut and spelt, is known to be pro-inflammatory in the body.


Cow’s milk dairy, which is pro-inflammatory, has large protein molecules that may be difficult to digest for some people. You might want to opt for coconut products like coconut yoghurt, plant-based milk, and cashew “cheese”.


lowering your overall sugar intake has several health benefits. This includes high sugar fruit! Sugar is pro-inflammatory and taking it out might have a huge positive impact on your eczema. Try to stick to raw honey, maple syrup, apples, pears, berries, and sometimes Medjool dates.


Healthy fats are essential for skin health! Focus on all things coconut, good quality olive oil, flax, avocado, oily fish, nuts, seeds, and eggs. “Bad” fats, like trans-fats, are pro-inflammatory and I would try and avoid them as much as possible.

What daily products should I be using to avoid eczema flare ups?

In selecting a moisturizer (often called an emollient), choose a product that contains no scent, which itself can be a skin irritant.

Sweat can also trigger an outbreak, so it is best to shower as soon as possible after exercise. Stress can provoke flare-ups in some people with eczema, so measures to reduce stress may be helpful.

Some people develop a form of eczema that results from skin contact with an irritant, such as clothes detergents. Contact eczema is often an occupational disease stemming from exposure to various cleaning agents or wet cement. The condition may show up only after the skin is exposed to sunlight. People with eczema on their hands are usually advised to wear cotton-lined waterproof gloves when washing dishes or working with irritating substances.

How do I treat my eczema?

Although there is no known cure for eczema, flare-ups can nearly always be minimized and sometimes prevented, luckily we also have many washes and creams available on the market that will help to control it more effectively.

The hallmark of eczema is an alteration in the skin that allows essential water to escape and environmental allergens (like those from pollen, dust, insects, gas fumes and food) to enter. The result is dry, itchy, inflamed patches that are sometimes misdiagnosed as psoriasis.

Now I want to talk a bit about the flora of the skin. That is the bacteria that live on our skin. More than 90 per cent of people with eczema have colonies of the bacterium Staphylococcus aureus growing on their skin and contributing to the skin’s allergic sensitivity and inflammation. If you Scratch your skin you will form lesions on the skin such as sores and it will be easier for these bacteria to get under your skin.

While it has long been known that the skin’s outermost layer functions poorly in people with eczema, researchers at the University of Rochester have identified another reason eczematous skin is susceptible to invasion by allergens. Recent studies have been showing that certain probiotics can also help in reducing skin conditions. So if you are not yet convinced of the benefit of probiotics here you have yet another reason to try using them regularly.

Current treatment focuses on reducing inflammation, loss of moisture and colonisation by bacteria. Doctors typically recommend a prescription steroid, used topically in tiny amounts. I would like to point out that steroids should be used only for a short time and upon the advice of a doctor since when they are overused the side effects and disadvantages will definitely outweigh the benefits. This coupled with an over-the-counter moisturiser applied generously right after showering to hold water in the skin. Only mild, nondrying shower gels should be using try and avoid any perfumed products and products containing soap. As well an excellent probiotic and sometimes an antihistamine. Nonsedating antihistamine, like loratadine (Claritin), fexofenadine (Allegra) or cetirizine (Zyrtec). Can also be useful to speak to your GP or pharmacist about which would be best for you.

For most types of eczema, managing flares comes down to these basics:

  • Know your triggers so that you can avoid exposure
  • Implement a daily bathing and moisturizing routine
  • Use OTC and prescription medication consistently and as prescribed

Bionike – Triderm range

Last year Collis Williams launched the brand BioNike in Malta. Those who know me know I love all things skincare so I was one of the first to read about it and try it. I tried the cleanser and eye cream for myself and they are absolutely amazing. My brother suffers from severe eczema. The kind where his whole body is affected and he ends up bleeding and the only thing that can control it is oral steroid treatment. However, when he tried the products from Bionike they completely changed his life and since he started using them last August he has not had to take oral steroids anymore.

BioNike guarantee that all of their products are nickel, chromium and cobalt tested. According to European law, the maximum concentration of Nickel allowed in products is 0.0000006; however, for very sensitive people this amount can still cause a skin reaction. BioNike takes this recommendation a step further, and they have reduced the amount of nickel in their products to 0.000001 which is good news for my brother who has a nickel allergy and nickel is so often found in so many products. This also makes the products much more suited for people with sensitive skin.

The BioNike products are all preservative, fragrance and gluten-free. Now gluten sensitivity of the skin is as yet, unproven, but makes this product range ideal for anyone who has non-celiac gluten sensitivity.

Another NB benefit of BioNike products is that they are NOT tested on animals!

And BioNike’s mission is to ensure effectiveness, safety, well being and good quality to price ratio for all patients!

I gave my brother the BioNike Triderm oleated wash, it is a No-lather bath oil developed to cleanse the skin very gently while respecting the natural film on the skin that is often damaged in people with eczema and performing a softening and protective effect on the skin. When in contact with water, forms a milky solution that cleanses the skin.

I also recommended the BioNike Triderm body emulsion which is A fluid emulsion giving a long-lasting, refreshing and soothing effect that provides relief from the annoying itch. The special formula has been specifically developed for very sensitive, intolerant and easily-reddening skin.

And finally the holy grail of the range the Triderm Lenil +. This is the product my brother loved the most when his symptoms had flared up. It is a Cream that provides immediate relief from all eczema symptoms. It is useful to treat skin inflammation, especially when of an eczematous nature. The antioxidant action of a patented active ingredient protects skin from cell damage triggered by free radicals which would promote inflammation, thereby countering it. This product supports the rapid restoration of both the balance and the integrity of the epidermal barrier while reducing redness, burning, and itching. He is no longer bleeding since he used these products which improved his quality of life drastically.

Now that his symptoms are well under control he is using the wash and body emulsion and stopped the Lenil+. But he keeps one at home anyway just in case he gets a flare up again especially since its allergy season.

You can find more information on the BioNike range in Malta via their facebook page or you can PM me and I can advise what you can use.

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