eczema and family life

Overview

Eczema is a common skin condition that makes your skin dry, itchy, and inflamed. It is also called atopic dermatitis. It comes and goes, and it often affects young children but can also start in adults. Eczema is not contagious, so you cannot catch it from someone else.

Yes. Eczema is very common. Around one in five children and one in ten adults in the UK have eczema at some point.

Eczema can affect anyone at any age, but it most often starts in early childhood. Many children outgrow it or have milder symptoms as they get older. It also affects many adults, and can be especially challenging for older adults whose skin is naturally drier.

Symptoms

Common symptoms

• Itchy skin, sometimes severe
• Dry, sensitive skin
• Red or darker patches of skin, depending on your skin tone
• Rough, scaly, or thickened patches
• Small raised bumps that may leak fluid when scratched
• Crusting or oozing during flare-ups

Symptoms in children

• In babies, eczema often appears on the face, scalp, and outer arms and legs.
• In older children, it may appear in skin folds such as elbows, knees, wrists, and behind the ears.
• Children may scratch to the point of bleeding, which can disrupt sleep and daily activities.

Symptoms in older adults

• Older adults may have widespread dry, scaly skin, especially on the legs, hands, and lower back.
• Itching can be intense and may interfere with sleep and quality of life.
• Skin becomes thinner with age, so treatments need to be gentle to avoid further irritation.

Causes

Main causes

• A problem with the skin barrier, which lets moisture out and irritants in, leading to dryness and inflammation.
• An overactive immune system that reacts to triggers and causes inflammation.
• Triggers such as harsh soaps, perfumes, dust mites, pollen, certain foods, stress, and hormonal changes.

Risk factors

• A family history of eczema, asthma, hay fever, or food allergies.
• Being born with a genetic tendency that affects the skin barrier function.
• Living in urban areas or in cold, dry climates where skin is exposed to indoor heating and air conditioning.

When to see a doctor

See a doctor urgently if:

• If the eczema is painful, spreading, or accompanied by fever.
• If you see signs of infection, such as yellow crusting, oozing, red streaks, or a swollen warm area.
• If the eczema causes severe distress or keeps your child awake most nights.

Book a routine appointment if:

• If you or your child have eczema that is not controlled with regular moisturizers and gentle skincare.
• If the eczema keeps coming back or interferes with sleep, school, or work.
• If you need help developing a daily skincare plan.

Diagnosis

A doctor (often a GP or dermatologist) can usually diagnose eczema by looking at the skin and asking about symptoms, medical history, and family history. They may also ask about triggers and sleep habits.

Tests that may be done

• Sometimes a skin patch test to check for contact allergies.
• Sometimes allergy tests, such as skin prick tests or blood tests, if an allergy is suspected.
• In rare cases, a skin biopsy (a small sample taken to examine) to rule out other conditions.

What to expect at your appointment

The doctor will examine your skin, ask about your history, and talk with you about triggers and treatment options. They may suggest trying emollients (moisturizers) and other skincare first before prescribing stronger treatments.

Treatment

Treatment for eczema focuses on soothing the skin, repairing the skin barrier, and reducing flare-ups. Most people can manage eczema with regular moisturizing, gentle skincare, and occasional use of prescription treatments when needed. Treatment plans should be tailored to you or your child's needs.

Self-care at home

• Apply a rich, fragrance-free moisturizer (emollient) all over the body at least twice a day, even when skin looks good.
• Take short, lukewarm baths and gently pat the skin dry instead of rubbing.
• Use mild, soap-free cleansers and avoid scented products, including washing powders and fabric softeners.
• Wear soft, breathable clothing like cotton, and avoid wool or rough fabrics.
• Keep fingernails short and use cotton gloves overnight to reduce scratching damage.
• Identify and avoid personal triggers, such as known allergens, stress, or irritants.

Medical treatments

Doctors may prescribe creams or ointments to reduce inflammation and itching, such as topical corticosteroids. They may also recommend light therapy or oral medications that affect the immune system for severe eczema. Always discuss the risks and benefits with your healthcare provider. Never share prescription treatments with others.

When is surgery considered?

Surgery is not used to treat eczema. In rare cases, a doctor might discuss other procedures to manage complications, but this is not a standard treatment.

Living with this condition

Living with eczema means making gentle skincare part of your daily routine. It can help to set a regular schedule for bathing and moisturizing, and to involve the whole family in supporting good habits. If your child has eczema, try to keep bedtime calm and use cotton sheets to reduce itching at night.

Lifestyle tips

• Create a cool, even temperature in your home and use a humidifier in dry rooms to add moisture to the air.
• Reduce stress through activities like gentle exercise, meditation, or hobbies you enjoy.
• Wear gloves when handling cleaning products or washing up, and use fragrance-free laundry products.
• Keep a diary to track flare-ups and possible triggers.
• Join a support group (in person or online) to share experiences with other families.

Diet and exercise

For most people, diet does not cause eczema. But some people find that certain foods, such as cow's milk, eggs, or nuts, trigger their symptoms. If you suspect a food link, talk to your doctor before removing foods from your diet, especially for children. Regular exercise is good for overall health and can reduce stress, but rinse off after swimming and moisturize well to soothe skin exposed to chlorine or salt.

Mental health and emotional wellbeing

Eczema can affect how you and your family feel emotionally. Itching, visible skin changes, and sleep loss can lead to frustration, low self-esteem, and even anxiety or depression. It's important to talk about these feelings and to seek support from your healthcare team or a counsellor if needed. If you or someone in your family is feeling very low, speak to a trusted healthcare professional.

Prevention

There is no known way to prevent eczema completely, especially if you have a family history. However, with good skincare and avoiding triggers, you may be able to prevent many flare-ups and keep the skin calm for longer periods.

Vaccines

Routine vaccinations are recommended for everyone, including people with eczema. In rare cases, some live vaccines may need special consideration if you are taking immunosuppressive medication. Always tell your healthcare provider about your eczema and any medicines you use before getting vaccinated.

Screening programmes

There is no routine screening test for eczema. A doctor can diagnose it by examination and by asking about your symptoms and history.

Complications

If left untreated

• Skin infections with bacteria, such as staphylococcal infection, can develop when skin is broken from scratching.
• Poor sleep due to itching can affect concentration at work or school and increase stress.
• Constant scratching can cause skin colour changes, thickening, or scarring.
• Itching and visible skin changes can lead to anxiety, depression, or social isolation.

Long-term outlook

With the right skincare, treatment, and support, most people with eczema can keep their symptoms under control and enjoy a full, active family life. Eczema often improves with age, and many children outgrow it. Even if it continues into adulthood, it can be managed well.

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