E45.com provides comprehensive information about why eczema occurs, its symptoms and common triggers

Eczema really is a common skin condition - the numbers speak for themselves: according to the National Eczema Society, one in five children and one in twelve adults in the UK have it. If you are one of them, you may be aware that eczema does not have a 'cure', but that it usually can be managed effectively.

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But why does eczema occur at all? And will your child suffer their whole life? This section explains about the symptoms, causes and triggers of eczema, examines how children and teenagers are affected and provides answers to some frequently-asked questions.
Eczema appears as sore, itchy, red patches on the skin, often with tiny blisters (also called vesicles). The rash usually affects the back of the knees, the creases of the elbows and the face and neck. Sometimes, in severe cases, it also appears on the torso.
The itching of eczema can be intense. Sufferers - especially young children - tend to scratch the inflamed patches. When scratching is hard enough to break the skin, the inflamed area may also become infected. In the long run, repeated scratching can lead to permanent skin thickening.
Eczema symptoms
• Dry, red, scaly rash, often on the face, neck, hands and creases of the limbs.
• Itching, often worse at night.
• Skin discolouration, with reddish to brown-gray patches, due to increased blood flow to inflamed areas.
• Weeping blisters.
• Redness, due to bacterial infection (usually staphylococcus).
• Thickening of the skin, due to repeated scratching.

Symptoms of eczema>>

Why does eczema occur?

Skin acts as a protective barrier for our bodies, keeping moisture in and infection and irritants out. Skin with eczema is less able to retain water. This allows gaps to open up between the skin cells and allergens and irritants to pass through more easily.
Because skin with eczema is prone to drying out and is easily damaged, it is more liable to get red, inflamed and itchy.
Triggers
No matter how well you look after your skin, there are some things that can cause a flare-up. By understanding your particular triggers, you can minimise their effect. Here are the most common:

Common Triggers
Soaps and perfumed bath or shower products
• Use emollient washes and bath oils designed for people with eczema.
Detergents and washing powders
• Use non-bio washing powder.
• Wear protective gloves when cleaning or washing up, preferably PVC and cotton-lined.
Central heating
• Keep rooms cool, particularly your bedroom.
Animal hair and dander
• Avoid contact with animals if possible.
• Wash your hands after contact with pets.
Woollen clothes, man-made fibres
• Avoid wearing woollen or man-made fibres
• Instead, wear smooth, soft cotton clothes and use cotton bed sheets.
Cold/hot weather
• Wear gloves in cold winter weather.
House dust mites
• Use a mattress protector and wash it regularly.
• Vacuum carpets regularly and wash curtains.

Illness is also a trigger, so keeping as healthy as possible helps.
Other triggers can be emotionally linked e.g. stress and anxiety. This means that flare-ups occur exactly when they are least welcome, such as during job interviews, weddings and other important dates. So try and relax - deep breathing techniques may help.
All about eczema>>

Teens with dry skin and eczema

Eczema is pretty common. In fact, around one in five children in the UK suffer from it. If your teenager is one of them, however mild or severe, you will know how it can affect their daily life. However, it is possible to manage their dry skin and atopic eczema, so that it doesn't rule their lives.
Keep on top of flare-ups
Read the section on causes to find out what can trigger flare-ups, but others that may affect your teenager are:
Harsh soaps and detergents
• Tell your teenager to avoid them.
Make-up or shaving foam and creams
• Test them on a little area of skin first.
• Discuss with their doctor or nurse which cosmetic products would be most suitable for your teenager.
Perfume, aftershave
• Suggest they spray a little on their clothes, rather than their skin.
Chlorine in swimming pools
• Avoid chlorinated pools, look for ozone- or UV-purified, salt-water or fresh-water alternatives.
• Make sure they apply emollients before and after swimming.
Other triggers can be emotionally linked - like when they suffer from stress at school,so try to help them stay relaxed.

Eczema in Teenagers>>

A new veterinary site is launched called Atopica.com which covers common canine skin disorders, in particular Atopic Dermatitis.

Here you can read about the causes, clinical signs, diagnosis, treatment and management of these disorders and view images of affected animals. Guidance on diagnostic techniques provides practical help for confident diagnoses and there's also a section with helpful tips and advice about explaining to pet owners.

Atopica.com>>

The site offers several key features such as the derma-tool. A Vet can use this tool by answering seven questions about their Patient and they will be given a list of the most likely differential diagnoses.

Derma tool>>

A simple diagnostic approach leads to faster comfort for pruritic dogs. A Vet can use Favrot Criteria to help identify dogs that may have atopic dermatitis. Firstly they can confirm that history & clinical signs are compatible with atopic dermatitis, then use the site to rule out resembling diseases, so that they can prescribe Atopica with confidence.

Simple diagnosis>>

Dr Tim Nuttall of Liverpool University, UK, talks about the challenges of piecing together the evidence to diagnose atopic dermatitis in practice and how to keep up with the latest developments in dermatology. Plus he shares his views on what’s changed in recent years to make diagnosis more simple and long-term treatment more effective.
On the site, Dr Wayne Rosenkrantz also talks you through his approach to simple diagnosis in practice and offers tips and advice on what steps to follow. Vets can download a simple fact sheet to help outline a protocol for simple diagnosis in their practice.
There is a Treatment journal on the site which is a useful monitor for vets to see how a dog is responding to treatment.

Treatment Journal>>

Owners of dogs with atopic dermatitis are asked to register and update an online Treatment Journal. Details of treatment and the dog’s wellbeing are recorded, with an option for owners to upload photographs of their dog’s progress. Access to any Treatment Journal is via a unique pet owner ID. Vets can also set up a Treatment Journal on behalf of a pet owner.

Diagnosis techniques- When you suspect that a dog could be atopic by using the Favrot Diagnosis Criteria and assessing history and clinical signs, you need to rule out resembling diseases.

Simple tests such as cytology and skin scrapes can identify other diseases that could be causing pruritus (e.g. fleas, sarcoptic mange, demodicosis) as well as secondary 'flare' factors that contribute to pruritus in dogs with atopic dermatitis (e.g. pyoderma, Malassezia).

Diagnosis Techniques>>

Vets can use simple step-by-step guides to remind them of the basic procedures as well as provide references for the clinical symptoms to look out for.

What is the best way to deal with constipation during pregnancy?

It is estimated that one in five women get constipation during pregnancy, many of whom have never had constipation before. There are a variety of reasons for this.

Hormonal changes affect bowel movements. During pregnancy, the body produces more progesterone, which relaxes the muscles to allow the baby to grow. However, the wall of the intestine is made of muscle, too. As the progesterone makes it relax, it can become less efficient at moving along food and waste.

Many women take iron supplements during pregnancy which can also be a contributing factor to constipation. Tastes can change at this time and many women alter their diet. This change in eating habits can also affect bowel activity, particularly if it means a reduction in fibre-rich foods.

Constipation during pregnancy>>

The growing baby puts pressure on the bowel, while the discomfort of its weight and general tiredness may lead to a lack of exercise. Both can slow down bowel movements.

Even after pregnancy, some 29% of women continue to get constipation.

I still suffered from constipation even after I had the baby. Maybe you are more aware of what goes on down there when you have had a child. You are more stressed having a new baby, you're run down, everything... You are not eating properly, and worrying about going back to work

Constipation Relief during Pregnancy

First of all, do not worry. There are a number of things you can do to help get your digestive system moving again during this time.

• Increase your fibre intake
Your digestive system may need a little help during this exciting time. Eating more fibre-rich foods, like fruit, vegetables, cereals and wholemeal bread will help provide the necessary roughage to keep your system moving.

• Drink plenty of fluids
Drinking a lot of fluid helps keep the stool soft and easy to pass. At least 7-8 glasses a day is recommended. You can drink as much water and fruit juices (particularly prune juice) as you like and even a little tea or coffee counts towards the total.

• Make sure you get enough exercise
Although you may feel heavy and uncomfortable, exercise helps prevent your digestive system becoming 'sluggish'. Safe exercise during pregnancy includes walking, swimming and other low-impact activity where there is little chance of sprains or accidents. Approximately 20-30 minutes of exercise two or three times a week can have a beneficial effect, not only for your digestive system, but also your general well-being.

• Your doctor may suggest a remedy.
(always read the label and consult a doctor before using any medicines in pregnancy)
- A simple way to help maintain regularity is by taking Fybogel, which is safe for use throughout pregnancy. Fybogel granules are dissolved in a glass of water to make a convenient drink which is easy to take and speeds up the passage of waste through the bowel. (contains ispaghula husk - always read the label and consult a doctor before using any medicines in pregnancy).

ItchFreePet offers online pre-diagnosis tool for dog skin conditions, for dog owners to take to their next veterinary appointment

ItchFreePet.com knows only too well that there are many causes and treatments for skin conditions in dogs. They have listed the most common skin conditions in dogs, on their new site, which dog owners can click on for a description of what it looks like and to see a picture of an affected animal. They have also provided an online Atopic Dermatitis test to start a discussion with your vet, and take with you at you next veterinary appointment.

Dog skin conditions

The ten most common causes of skin conditions in dogs are Atopic dermatitis; Food allergy; Flea allergy; Sarcoptic mange (fox mange/scabies); Demodicosis (mange); Other parasites; Bacterial infection; Yeast infection; Ringworm and Otitis (ear infection).

In humans, Atopic dermatitis is known as eczema. It's one of the most common dog skin conditions, affecting around 1 in 10 dogs. It's often a result of the animal becoming too sensitive to one or more allergens in the environment, for example house dust mites, pollens, mould spores and occasionally foods.
Your dog might have atopic dermatitis if it
• has itchy, red skin
• has infected or crusted spots
• is losing its hair
• has thickened, discoloured skin

Food allergies can happen when a dog becomes too sensitive to certain foods.
Your dog might have food allergy if it has
• itchy, red skin
• hair loss
• rashes
• tummy upsets, sickness or changes in bowel habits
Food allergies can cause signs of atopic dermatitis. It’s a difficult condition to diagnose and a food elimination trial may be needed to confirm exactly what foods the dog is allergic to.

Fleas bite through the dog’s skin and the flea saliva causes the allergic reaction. Dogs can get flea allergy even if a flea treatment has been applied. When dogs are allergic to flea saliva, they’ll show signs of itchiness even if only a few fleas are present, so just because you don’t see any fleas, it doesn’t mean they are not causing a problem
Your dog might have flea allergy if it
• has bumps on the skin that last for several days and then scab over
• is itching and scratching, especially on its rump
• has red, sore skin
• starts losing some hair
• has thickened and/or discoloured skin
If a dog has flea allergy the typical area affected will be its top and back half– around the tail base and on its outer and inner thighs.

Sarcoptic mange is also known as fox mange or scabies. Some areas have an increased risk of this type of mange due to infection from local wildlife, such as urban foxes or coyotes.
It’s a contagious skin disease caused by mites that burrow into the skin and make it really itchy. It’s so itchy that quite often dogs may stop eating, playing or exercising just to scratch. Initially the most commonly affected areas are the outer ears and elbows. It can then spread to the head and eventually all over the body.
Your dog might have sarcoptic mange if it
• is intensely itchy,
• possibly with infected or bleeding spots
• eventually loses some hair
As it’s very contagious, owners may also develop an itchy, bumpy rash if their dog is infected.

Demodicosis is also known as demodectic mange or red mange. Small numbers of the demodex mite are normally found in the skin and ears of healthy dogs without causing any problems. Sometimes, however, the number of mites can suddenly increase and cause a disease called demodicosis, especially in young dogs
Your dog might have demodicosis if it
• has bald patches on its face, especially around its eyes, and on its legs
• has a rash
The dog rarely finds it itchy unless any of the patches get infected, so scratching may be unlikely. If left untreated it can get more severe, spreading all over the body, and making the dog unwell. Demodicosis that develops in adult dogs can be a sign that the dog has an underlying illness.

Many parasites can cause itchiness in dogs. Itching may start as a reaction to a bite, or if the parasite burrows into the dog's skin. Different areas of the world have different parasites.
• Ear mites are common in younger dogs and are found in and around the dog's ear. They can cause the ear to itch and produce excessive amounts of brown ear wax.
• Fur mites live in dogs' fur and are very infectious. They cause mild itching and lots of dandruff. Owners of infested dogs may also be bitten and develop reactions.
• Harvest mites mostly live in vegetation and attach to a dog's skin around the eyes, ears, legs, toes, rump and belly, i.e. areas in contact with grass and vegetation. They can cause itching, crusty spots, scaling, and hair loss. They generally only occur in the autumn.
• Lice - these parasites can attach to the base of the hair, particularly around the head, neck and tail. Here they feed on hair and skin scales. They can also attach to the skin of the neck and shoulders, where they feed on blood. They cause intense itching, leading to chewing, scratching, restlessness and hair loss. The dog's coat might look rough and matted because of all the eggs (nits) and lice in its hair.
• Ticks - there are many different types of tick across the world, but the brown dog tick is found in most parts. Ticks feed on blood and their bites cause itching. They're commonly found on the face and ears, around the rump and joints, and in between the toes, but they may be found anywhere on the body. Some types of tick carry a poison in their saliva, which can lead to a bitten dog becoming paralysed. Most ticks only feed once a year and they fall off the dog after a few days, when they have had a blood meal.
• Flies can cause painful, swollen bite wounds mostly around the dog's head, neck, ears and body. Hair over the bite may become matted. If the wound becomes infected it may get very itchy and there may be a smelly or bloody discharge.
• Hookworms - these parasites live in the dog's gut. They're passed out via dog faeces into the environment where other dogs can pick them up, sometimes through their paws, causing inflamed feet. Hookworms can also cause weight loss, diarrhoea with blood in it and anaemia.

It's quite normal for healthy dogs to have bacteria living on their skin. However, if the skin gets damaged in any way it can result in a bacterial infection (often called pyoderma).
This means any skin condition can lead to bacterial infection, as these conditions usually cause the dog to itch and scratch, therefore damaging its skin.
Body areas that can be particularly affected include skin or body folds such as those of the face, lips and tail. It also often affects the feet and ears.
Your dog might have a bacterial infection if it
• is itching and scratching
• has got red, weeping wounds
• has started losing its hair
• has swollen, painful spots and scabs
As the infection spreads, the dog can become very unwell.

Yeast infection is a common fungal skin infection that usually occurs together with other skin diseases. Yeast (known as Malassezia) are normally found even on healthy skin. However when dogs have another skin condition, the yeast often develops into an infection, causing itching.
Your dog might have a yeast infection if it
• has red, greasy skin
• has lots of crusty, flaky spots
• is losing its hair
• is itching, scratching and clawing at its skin
• smells stale or 'yeasty'

Ringworm is a skin infection caused by a fungus that attacks the dog’s claws, hair and skin. It spreads through direct contact with infected animals or through contact with infected hairs or skin flakes on surfaces such as grooming equipment and bedding, or from the infected animal’s environment.
Your dog might have ringworm if it
• is only itching very mildly
• is losing its fur in patches, often starting on the face and forelegs
• has skin flaking
Some dogs, however, may have ringworm without showing any symptoms at all.
It’s possible for pet owners and their families to develop ringworm infection after handling an infected dog.

Otitis (ear infection) is a common ear complaint. Lots of different things can lead to ear infections, including
• foreign bodies (e.g. grass seeds) or parasites (ear mites) in the ear
• narrow or floppy ears, or ears that are very hairy inside
• excessive ear wax
• some skin diseases
• regular swimming, bathing or grooming
One of the most common causes of repeated or long standing ear infections is atopic dermatitis.
Your dog might have an ear infection if it
• has a red or swollen ear
• is itching, scratching or pawing at its ear
• is shaking its head or holding its head on one side
• has smelly wax or pus coming out of its ear

Atopic dermatitis test