Updated September 07, 2011 10:14:58
Dry, cracked, inflamed, itchy, pus-seeping, blistery skin with a burning desire to be scratched – just thinking about it is enough to make a person’s skin crawl.
Eczema is rapidly rising in Australia with as many as one in four children developing the disease before the age of two.
Sufferers liken it to leprosy, while dermatologists say it is sorely misunderstood and has a much greater impact on families than other diseases.
Brett McLennan, a husband and father of three who lives in Melbourne, says his family has battled eczema for years.
“My father had it when he was a child quite badly, but back then there was really no solid treatment for eczema so he was having creams put on him and then being wrapped in plastic overnight to stop himself from scratching,” he said.
“And when I was a young child I had it quite badly, mainly around the annoying parts of my body like the backs of my knees and my elbows. The skin would dry out and would crack, especially in summer when you’re outside in the sun and the sand, so it was quite painful.”
Mr McLennan says two of his sons and his wife also suffer from the disease.
He says the impact eczema has on people’s daily lives is largely underestimated.
It’s not a hidden disease, it’s a very out there kind of thing. When you have an outbreak of eczema, everyone sees it.
Eczema sufferer Brett McLennan
“It’s really difficult to deal with because in your everyday life you tend to not want to have cream over your fingers all the time. you cant pick up paper, you can’t type things, your hands are slippery, you put creams all over the door knobs and door handles, so you want to only use it when you have to,” he said.
“My son and I swim every weekend so we need to coat ourselves with Vaseline or skin cream so hopefully it keeps the chlorine off, but the longer you’re in the water the more the Vaseline wears off, and so you still get breakouts.
“I also love my beach swimming, so even now when I have an outbreak of eczema in summer, it’s that really painful feeling you get when you step into the ocean, the salt water bites and burns – it does the world of good, but it’s really painful.”
It’s not only the physical problems eczema poses. Mr McLennan says the disease is somewhat like leprosy, in that it is extremely visible and evokes a feeling of disfigurement.
“It’s not a hidden disease, it’s a very out there kind of thing. When you have an outbreak of eczema, everyone sees it,” he said.
“People see a visible problem – like a skin condition, a rash, a boil or acne – in very negative ways. It’s up there in people’s faces and they respond to it.
“If you see someone with eczema on their hands, their skin might be very dry or rough and you might have someone with bleeding fingers, so do you shake their hand?
“It’s almost going back to the notion of leprosy, the unclean, people think of those things quite badly.”
Dermatologists say Australia has one of the highest incidences of eczema in the world. They put this down to a number of factors including climate, lifestyle, hygiene and genetics.
“In Australia, up to one in four children develop eczema before the age of two. The corresponding figure 50 years ago was less than 10 per cent,” said paediatric dermatologist Dr John Su.
Dr Su says eczema is a complex disease, which can develop for a number of reasons.
“There is a genetic factor which can be very significant, so if you have a history of eczema in parents there is a significant risk and some people are prone to a type of skin that does not produce natural moisturisers, but there is also a developmental aspect to eczema.
“One theory – the hygiene hypothesis – would say that us becoming more sterile and hygienic is depriving the immune system the opportunity to become educated and so we are getting more eczema. This could be due to direct parenting styles, but also the whole community as well.”
He says the impact of the disease – both financial and psychological – is grossly underestimated.
“Studies have found the impact of moderate and severe eczema on families is significantly higher than the impact of diabetes on families … and financially we also found the community cost of eczema is significantly higher than asthma,” he said.
“Eczema has a huge toll on families. Babies don’t sleep, they get infected, they’re constantly scratching, they get restless. The parents don’t sleep, they get sleep deprived and they can’t go to work.
“I’ve seen parents split up over kids with eczema.”
Dr Su says parents receive an enormous amount of misinformation when it comes to dealing with the disease, and that they should seek medical advice.
“A lot of parents are quite reluctant in the use of products on their babies’ skin, thinking that it is not natural. For example they might be very happy putting olive oil on their babies, but not very happy putting a commercial moisturiser on,” he said.
I’ve seen babies that are extremely dry, and the oils clearly weren’t working, but the mother was still very reluctant to use things because of this phobia of anything which wasn’t ‘natural’.
Paediatric dermatologist Dr John Su
“I’ve seen babies that are extremely dry, and the oils clearly weren’t working, but the mother was still very reluctant to use things because of this phobia of anything which wasn’t ‘natural’.”
He says a similar phobia around the use of steroid creams has developed in recent decades.
“What we know is that if you have inflammation in the skin and you don’t treat that inflammation there are chemicals that are released that further break down the skin barrier, and then it becomes a vicious cycle,” he said.
“Topical steroids are useful in settling down inflammation… because by settling it down you can help restore the healing of the skin.
“Overused, the steroids can cause some local thinning or some absorption and it can actually backfire, but there is a greater tendency now to under-treatment, than there is to over-treatment.”
Dr Su says due to busier lifestyles people are tending to neglect their skin. but he says the use of moisturisers – especially on babies – is crucial for preventing and managing eczema.
“If you don’t look after the skin it does get dry and inflamed, or if you put products on the skin that actually make it worse then the skin becomes more vulnerable and allows the passage of allergens, which then sensitise the immune system to other things.
“So from eczema you can get sensitisation to food allergies, and also asthma and hay fever.
“The hope is that if we can look after children’s skin better we can actually reduce the likelihood that they will develop further sensitisations and more problems with allergies later in life.”
Topics: diseases-and-disorders, health, australia, melbourne-3000
First posted September 07, 2011 09:06:18