The epidemiology and experience of atopic eczema during childhood: a discussion paper on the implications of current knowledge for health care, public health policy and research

Atopic eczema is a chronic skin condition affecting between 5% and 20% of c hildren aged up to 11 years at one time or other. Research suggests that pr evalence is increasing and various environmental factors have been implicat ed in the aetiology. While often seen to be a minor problem, research sugge sts that it can cause considerable disruption to the lives of children and their carers and involves significant cost for the family;and health care s ystems. The current consensus is that the majority of cases of atopic eczem a are most appropriately managed within primary care. However, management o f the condition is problematic because diagnosis is often difficult. Consul tations tend to focus on the physical aspects of the problems neglecting th e psychosocial, while treatment remains mainly palliative and can be as div erse as the condition itself. More appropriate: and effective primary care management and support for children with atopic eczema; and their carers wi ll only be developed if health professionals become more aware of the socia l context of the disease and the impact on the lives of those affected. Pub lic health responses focusing on primary prevention are also needed. This p aper reviews a diverse literature on the epidemiology of the condition, the way in which it affects the lives of children and their carers and the fac tors that shape their help seeking decisions. The aim is to contribute to a more substantial knowledge base for public health and primary care develop ments and to point to areas for future research.