Eczema (Atopic Dermatitis)
Sources consulted
This article is original patient-education content.
- NICE—Eczema — atopic. NG190(2023)
- NHS—Atopic eczema(2023)
- AAD—Eczema — American Academy of Dermatology(2024)
Based on international clinical guidelines
Overview
Eczema, also called atopic dermatitis, is a skin condition that makes your skin dry, itchy, and inflamed. It often starts in childhood but can happen at any age.
Key facts
- Eczema is not contagious — you cannot catch it from someone else.
- It often runs in families with a history of allergies, asthma, or hay fever.
- The main symptom is intense itching, which can lead to scratching and skin damage.
Yes, eczema is very common. In the UK, about 1 in 5 children and 1 in 10 adults have it at some point.
Eczema can affect people of all ages, but it often begins in early childhood. Many children outgrow it, but some continue to have symptoms as adults.
Symptoms
- Signs of a severe allergic reaction: difficulty breathing, swelling of the face or throat, rapid heart rate, dizziness
- Signs of widespread skin infection: high fever, chills, red streaks from a rash, large areas of weeping or crusting
- ⚠Painful, spreading redness around the rash
- ⚠Oozing or yellow crusting that does not improve with home care
- ⚠Fever with no other clear cause
- ⚠Severe itching that stops you from sleeping or functioning
Common symptoms
- Dry, sensitive skin
- Intense itching, especially at night
- Red, inflamed patches of skin
- Rough, scaly, or thickened skin
- Small bumps that may ooze fluid when scratched
- Dark or light spots on the skin after a flare-up
Symptoms in children
- Usually appears on the face, scalp, and outer parts of arms and legs
- May cause crying or fussiness due to itching
- Can interfere with sleep and daily activities
- Often starts before age 2
Symptoms in older adults
- Often affects the hands, neck, and flexures (inside of elbows, behind knees)
- Skin may become very dry, cracked, and thick (lichenification)
- Itching can be severe and disrupt sleep
- May have long-lasting or recurring flares
Causes
Main causes
- A combination of genetic and environmental factors
- A defect in the skin barrier that lets moisture out and irritants in
- An overactive immune system that responds to triggers
Risk factors
- Family history of eczema, asthma, or hay fever
- Having allergies, such as food allergies or hay fever
- Living in cold, dry climates or in areas with high pollution
- Exposure to harsh soaps, detergents, or chemicals
When to see a doctor
See a doctor urgently if:
- If you have signs of a skin infection (spreading redness, oozing, crusts, fever)
- If itching is severe and affecting daily life or sleep
- If symptoms get worse despite using moisturisers and other home care
Book a routine appointment if:
- If symptoms appear for the first time and you are not sure what they are
- If you need a management plan or prescription medication
- If the condition is impacting your mental health or quality of life
Diagnosis
A doctor or nurse will usually diagnose eczema by looking at your skin and asking about your symptoms and family history. No specific test is needed.
Tests that may be done
- Sometimes a skin prick test or blood test to check for allergies
- Rarely, a small skin sample (biopsy) if the diagnosis is uncertain
What to expect at your appointment
Your doctor will examine your skin, ask when symptoms started, what makes them worse, and if you have other allergies. They may also recommend keeping a diary of triggers.
Treatment
Treatment focuses on moisturising the skin, reducing inflammation, and managing triggers. Most people can control eczema with a good skincare routine and if needed, medications from their doctor.
Self-care at home
- Moisturise (emollient) every day, even when skin looks clear
- Use fragrance-free, mild cleansers and avoid hot water
- Apply moisturiser immediately after bathing to lock in moisture
- Avoid scratching — keep nails short and wear soft gloves at night
- Identify and avoid triggers such as certain soaps, wool, stress, or dust mites
Medical treatments
Doctors may prescribe topical treatments (creams or ointments) that reduce inflammation or fight infection. They may also recommend light therapy or oral medications for severe cases. Always use treatments as directed.
Living with this condition
Living with eczema means keeping a consistent moisturising routine and avoiding triggers. It may take patience to find what works for you, but most people learn to manage flare-ups.
Lifestyle tips
- Use a humidifier in dry indoor air
- Choose soft, cotton clothing instead of wool or synthetic fabrics
- Avoid extreme temperatures and sweating where possible
- Manage stress with relaxation techniques or hobbies
- Keep a diary to identify personal triggers
Diet and exercise
For most people, diet is not a major trigger. If you suspect a food allergy, see a doctor before cutting out foods. Exercise is good for overall health; shower and moisturise after sweating.
Mental health and emotional wellbeing
Eczema can be emotionally tough. Itching, visible rashes, and sleep loss can cause frustration, embarrassment, or sadness. It's important to talk about your feelings and seek support if needed. If you have thoughts of self-harm, contact a crisis helpline immediately.
Prevention
There is no sure way to prevent eczema, but you can reduce flare-ups by moisturising regularly, avoiding known triggers, and managing stress. For babies at high risk, some studies suggest that regular moisturising from birth may help, but evidence is not strong.
Complications
If left untreated
- Skin infections (bacterial or viral)
- Thickened, leathery skin from chronic scratching (lichenification)
- Sleep problems and tiredness
- Emotional distress, low self-esteem, or depression
Long-term outlook
Eczema can be frustrating, but it often improves with age and good care. Many children outgrow it, and adults can learn to manage it very well. With the right support, most people lead a full, active life.
Find support
International organisations
Local organisations
- Eczema Association Australasia ↗ · Australia
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.