eczema, Public Health

Is there any hope for eczema sufferers?


Eczema is a skin condition that affects many people across the globe. I myself am a long time sufferer and while it’s improved as I’ve gotten older, I’ve found that it’s one of those things that doesn’t necessarily go away even with treatment.

There is no cure for eczema and finding one is difficult due to its varying nature.

I have always been interested in the medical developments of widespread conditions like eczema, particularly because it mostly affects children and also because of it’s potential to flare up later in life.

What is eczema?

According to WHO, eczema is:

(also called atopic dermatitis (AD)) is an inflammatory, chronically relapsing, non-contagious and extremely pruritic skin disease

Symptoms of eczema:

  • Itchy skin
  • Cracked, red, sore skin
  • Dry skin
  • Oozing skin
  • Disrupted sleep
  • General discomfort

Eczema tends to be worse during childhood, although it is present in adults. The most common areas in which it affects are the hands, feet, neck and back of the knees.

Currently, there is no cure, but first we need to understand what causes eczema.

While no specific cause has been identified, eczema is though to be brought on by changes in the skin’s barrier and over reactive inflammatory and allergy responses. Research has shown that different gene involved in maintaining a healthy skin barrier may be modified in patients that suffer from eczema. When the body comes into contact with an allergen, this triggers the immune system and leads to inflammation of the skin cells.

Triggers of eczema include:

  • irritants
    • soap, detergent, perfume, certain creams and ointments
  • environmental factors
    • dry/cold season
    • pet fur
    • pollen
    • mould
    • dust
  • allergies
    • food
      • milk, eggs, wheat
  • materials
    • clothing
      • synthetic
      • chemicals i.e. dye found in certain fabrics
  • hormones
    • period
    • pregnancy
    • stress

How to treat eczema

Currently, steroid ointments are the main treatment used for eczema.

pillbox-1013220_1280.jpg

Other treatments include

  • antihistamines to help with itching
  • moisturisers
  • wet wrap therapy
  • medication
    • antibiotics
    • corticosteroid tablets
      • only used in severe cases
      • 5-7 day course of treatment

Is there any hope for eczema sufferers?

Last year a group of scientists based at the University of Colorado and the University of California tested a bacteria infused cream aimed at counteracting harmful bacteria on the skin. Due to the temperamental nature of eczema, sufferers often have a diminished skin barrier.

The patients participating had to apply the cream twice daily and the researchers would analyse their skin to see if the unfavorable bacteria had reduced. If effective, the cream should remove all bad bacteria entirely. This will happen by the restoration of the natural balance of bacteria and hopefully, improvement of the skin barrier (which keeps harmful bacteria out).

The aim is that this will offer a longer term solution than what’s currently available.

Another treatment that is currently being tested is etokimab, a therapy administered by injection, designed to target the immune system, specifically a signalling molecule IL-33. Signalling molecules transmit messages between cells in the body. IL-33 is released by damaged skin cells and calls over immune cells to the site – leading to the rapid inflammation experienced by eczema sufferers. The drug, etokimab, is designed to block IL-33 and therefore prevent the buildup of immune cells.

After 29 days, researchers found that etokimab led to an improvement in physical symptoms in 83% of the test subjects. There was also a 40% reduction in eosinophils – the immune cell involved in hypersensitivity – after 29 days.

This shows that there is some hope for eczema sufferers and drugs and new treatments are being developed.

Final words…

While having eczema is generally an unpleasant part of life, there may be one upside….having eczema may prevent patients from developing skin cancer. Researchers based at King’s College London found that tumours may be prevented from forming due to the immune response triggered by eczema. This response could involve the shedding of skin cells that may be cancerous – meaning that there’s less chance of the patient developing skin cancer.


References & Resources

https://www.britishskinfoundation.org.uk/eczema

https://www.eurekalert.org/pub_releases/2018-06/uoca-rp060418.php

https://www.sciencedaily.com/releases/2014/05/140505211355.htm

https://www.nhs.uk/conditions/atopic-eczema/treatment/

https://www.imm.ox.ac.uk/about/news/promising-therapy-for-common-form-of-eczema-identified-in-early-stage-trial

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