27 August, 2008

Itching to help – understanding the causes of eczema

A leading St George Hospital professor is part of a team of researchers conducting clinical trials into safer treatments for atopic eczema.

The clinical trials come after an in-depth study into steroid free treatment of eczema.

St George Hospital Head of Dermatology Associate Professor Dedee Murrell said the study revealed that the steroid-free cream could not only improve eczema of the face and eyelids, but had the potential to reverse some of the skin thinning resulting from previous steroid treatment.

"The multicentre international study included 200 adult patients with persistent face and neck atopic eczema. Treatment with the steroid-free pimecrolimus cream was compared with treatment with a placebo vehicle cream," Professor Murrell said.

"A significantly higher percentage of patients treated with the non-steroid cream were cleared, or almost cleared, of facial atopic eczema, compared with the placebo treatment.

"The study also showed in half of the patients treated there were significant improvements in pre-existing atrophy (skin thinning) associated with the use of steroid creams. These results indicate that this non-steroidal cream may be effective in treating patients with head and neck atopic eczema," she said.

Atopic eczema is a recurring, non-infectious inflammatory skin condition, and is the most common form of eczema in babies and children.

"Atopic eczema is characterised by dry, flaky skin, which may not be itchy initially, however after it starts to itch, usually turns red and is hard not to scratch," Professor Murrell said.

Eczema tends to be genetic when it appears in babies and children, however, it can be brought on by environmental factors such as heat, cold, sweating, rough clothing, dust mites and stress.

"You generally need the genetic and environmental factors to bring eczema on, however most children will have a predisposition to eczema due to one of their parents suffering from eczema, asthma or hay fever," Professor Murrell said.

Professor Murrell said recent studies had demonstrated that a majority of atopic eczema patients carry particular variants of genes for a protein that is important in maintaining the skin barrier, called filaggrin.

"When they inherit a ‘double dose’ of this, they can develop a form of very dry skin as well, called ichthyosis," she said.
 

"Dry skin, heat, environmental and chemical irritants and infections can weaken the skin barrier, allowing substances to penetrate the skin and aggravate eczema and should be avoided, or exposure to them minimised, where possible.

"As well as minimising exposure to the aggravators, soaking in warm baths containing moisturising bath oil daily, rather than showers, and moisturising after every bath is the key to managing eczema, in addition to specific treatments," Professor Murrell said.


Eczema Awareness Week is from 1 – 7 September.

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Media Officer Maxine Brennan 9113 2601, 0413 028 776