ABOUT ACNE

1. FACTS:

Eczema (also called dermatitis or skin rash) is proven to be caused by a combination of two factors:

​Genetic factor

Mutated filaggrin gene can lead to the development of eczema.​ It is important to note that having the gene factor alone is not enough to cause eczema. Environmental factors are needed to initiate the eczema process. This explains why being an inherited condition, but eczema does not happen to every family member. Furthermore, the onset of eczema though more common in early childhood, people with the gene can develop eczema at any stage of life – from infant to the elderly.

Environmental factors

There are many factors from the environment that can directly trigger or worsen eczema condition. It should be acknowledged that eczema is neither caused nor made worse by diet (*). There is strong link between food allergy, asthma and hay fever. And this link is the cause of confusion even between medical profession regarding the connection of eczema to food allergy. There is growing evidence that allergens introduced into the body through the skin can lead to the later development of food allergy, asthma and hay fever. Put it in another way, eczema is the cause of food allergy [and asthma, and hay fever], not the other way around. It is recommended that eczema should be treated aggressively to restore normal skin barrier function. This will lower the risk of future development of food allergy, asthma and hay fever in this population (*).

The main and most important environmental factor is the germs factor. The current consensus among dermatologists is that the skin microbiota plays a critical role in inflammatory skin conditions like atopic dermatitis (eczema), psoriasis, acne, and rosacea. There is strong evidence that an imbalance in the skin microbiome (dysbiosis) contributes to inflammation, barrier dysfunction, and immune dysregulation. 

Lesser factors such as weather or climate, chemicals, and pollution can also contribute to the making of eczema. But these are mostly indirect factors, for examples: eczema in the skin folds tends to get worse in Summers, it is because hot and sweating skin promotes microbial growth. Similarly, the less frequent shower during Winter of some people will help the pathogens to build up. Stress has been proven to trigger or worsen eczema via two separate mechanisms: weakening the skin immune system at the same time causing changes in the skin microenvironment which promotes germ growth (**).

2. APPLICATION:

Restoring skin symbiosis is the ultimate goal in the management and prevention of inflammatory skin conditions such as eczema.

For ongoing maintenance and prevention of flareups:

1. Practice Proper Hygiene daily, shower daily using gentle cleansing agents such as Laroche Possay Lipikar Syndet, avoid harsh soaps.

2. Daily use of microbiome friendly moisturisers such as LarochePossay Lipikar Baume, BHC Body Moisturiser.

3. Remember the golden rule “Prevention is Better Than Cure”

For symptoms management:

1. opical steroid is effective and safe for reducing symptoms of eczema for many. Antimicrobial therapy such as bleach bath and antibiotic is useful, especially when secondary infection such as impetigo is present.

2. Biologic immune modulator such as Dupixent is helpful for severe eczema.

3. New treatment based on restoring skin symbiosis is emerging.

Copyright – bhcmedicalcentre.com.au