Use of emollients in the management of atopic eczema

The terms ‘eczema’ and ‘dermatitis’ are often used interchangeably and refer to an inflammatory condition of the skin. The term eczema comes from the Greek word ekzein, which means ‘to boil’, and relates to the vesicles sometimes seen during an acute phase of the condition (National Eczema Society, 2015a). There are a number of forms of eczema, but these can be broadly categorised into exogenous or endogenous. Exogenous eczema is caused by a natural or synthetic substance that comes into contact with the skin, for example, contact dermatitis. Endogenous eczema is caused by internal factors within the body; the specific cause is usually unknown. The most common form of endogenous eczema is atopic eczema. There is no known cause for atopic eczema, but it occurs in genetically susceptible individuals when exposed to environmental irritants or allergens (Akdis et al, 2006), commonly called ‘triggers’. Triggers are not the same for every individual, and can include pet hair; house-dust mites; pollen; and certain foods, such as cow’s milk and eggs (National Institute for Health and Care Excellence (NICE), 2011). Atopic eczema is a chronic, relapsing, itchy skin condition (Peate, 2011) that is often scaly, pigmented, and thickened, sometimes with signs of lichenification (dry and leathery) due to persistent trauma, such as scratching. This differs from the acute phase or ‘flare up’, when the skin presents with vesicles, redness, weeping, crusting, and scaling.