Can I lead a normal life?
Yes, you can work, go to school, and participate in sports like everyone else. If you are young and prone to severe atopic eczema, you may want to choose a career that does not involve excess handwashing or exposure to chemicals – office work is ideal. For sports, loose breathable clothing is advisable. If you like to swim, it is important to moisturize beforehand and, after swimming, to immediately shower then reapply moisturizer.
If atopic eczema is affecting your mood, or your ability to work or go to school, please seek help from your GP or specialist.
Are vaccinations safe to have? Will they make atopic eczema worse?
There is no evidence that vaccinations cause or worsen atopic eczema, and vaccinations are safe to administer in most circumstances. If you are taking a tablet medication for atopic eczema, there are some types of vaccinations (usually “live” vaccinations) that may not be suitable and need to be checked with a specialist before they can be given.
Am I allergic to a certain food? If I avoid it, will my atopic eczema go away?
Most patients with atopic eczema do not have food allergies. Even for the minority of patients that do, avoiding that food entirely (which is advisable!) may not necessarily make atopic eczema disappear entirely. Similarly, environmental allergies (e.g. to dust mite, pollens, and animal dander) are common in people with atopic eczema, but these allergens are difficult to completely avoid. Unfortunately, desensitisation for dust-mite allergy has not been proven to be greatly beneficial for atopic eczema. Thus, although allergies may make atopic eczema worse, they are not the only or main driving factor.
Sometimes certain foods can be irritating to the skin, rather representing a true allergy. For example, tomatoes, strawberries, and citrus fruit, which are acidic, can irritate the skin around the mouth and cause a flare of atopic eczema there.
It is important for people with atopic eczema to maintain a healthy and balanced diet. It is best to avoid foods with a high glycaemic index (high GI foods). If you have a young baby or toddler with severe atopic eczema and you are concerned about allergies, please see a GP or specialist.
Am I allergic to a cream? If I avoid it, will my atopic eczema go away?
Sometimes as soon as you put on a topical medication, it stings and burns the skin. This is typically caused by white-coloured creams and gels rather than greasy ointments, and represents an irritant reaction than a true allergy. It is more likely to occur on scratched and broken skin. Switching to an ointment-based medication will help.
Sometimes certain topical medications e.g. topical calcineurin inhibitors (Elidel® or Tacrolimus) or Staquis® can sting for the first few days of use; this usually abates with time and again, represents irritation rather than allergy.
However, there is a special form of allergy called “allergic contact dermatitis”, which can be caused by preservatives, fragrances and other chemicals that come into contact with the skin. This is a delayed-onset type of allergy, also known as a type 4 hypersensitivity reaction (food and environmental allergies are typically immediate-onset type 1 hypersensitivity reactions). Some patients (usually adults) with atopic eczema can be affected by allergic contact dermatitis. Certain patterns of eczema like severe hand dermatitis are more likely to be at least partly caused by allergic contact dermatitis. The diagnosis of allergic contact dermatitis is a complex process; if you are concerned about this please speak to your specialist.
It is important to remember that even though avoiding the allergen in allergic contact dermatitis is important and may make the eczema better, there may still be some underlying eczema that may not completely go away.
For more information about eczema, visit our Eczema Awareness Hub.