eczema flare ups

Overview

Eczema (also called atopic dermatitis) is a skin condition that makes your skin dry, itchy, and red. A flare-up is when these symptoms suddenly get worse, sometimes with small bumps or weeping, crusty patches. It is not contagious, so you cannot pass it to anyone by touch.

Yes, eczema is very common. It affects around 1 in 5 children and up to 1 in 10 adults in the UK, many parts of Europe, and other countries.

Eczema often begins in infancy or early childhood, but it can appear at any age. It is more likely if you or a close family member has asthma, hay fever, or food allergies.

Symptoms

Common symptoms

• Intense itching, especially at night
• Dry, sensitive, red or discoloured skin
• Small raised bumps that may weep or crust
• Rough, thick, or scaly patches
• Raw or broken skin from scratching

Symptoms in children

• Patches often appear on the face, scalp, and the outside of the arms and legs.
• Children may scratch a lot, which can disturb sleep and sometimes cause infections.
• In some children, eczema during the early years changes or clears by later childhood.

Symptoms in older adults

• The skin tends to be very dry and itchy, and may look different from childhood eczema.
• Patches often affect the hands, eyelids, neck, or skin creases.
• Older adults may also have darker, thickened skin in areas they frequently scratch.

Causes

Main causes

• Eczema is not caused by one single thing. It happens because of a mix of an over-active immune system, a weaker skin barrier, and your environment.
• Common triggers include harsh soaps, detergents, perfumes, rough wool or synthetic fabrics, heat, sweat, and dry winter air.
• Stress and certain allergies (for example to pollen, house dust mites, or pet dander) can also cause flares in some people.

Risk factors

• Having a family history of eczema, asthma, hay fever, or allergies
• Living in a cold, dry climate or being around air conditioning/central heating
• Working in occupations with lots of hand washing, wet work, or exposure to chemicals

When to see a doctor

See a doctor urgently if:

• If you have signs of a deeper skin infection, such as fever, spreading redness, warmth, pain, or pus
• If the eczema is so uncomfortable that you can't sleep or do everyday things

Book a routine appointment if:

• If flare-ups happen often despite good daily skin care
• If you aren't sure whether your rash is eczema or something else
• If you want a clear skin care plan and advice about treatments suitable for you

Diagnosis

A doctor or nurse will usually diagnose eczema by looking at your skin and asking about your symptoms, your personal and family history, and your triggers. They may also ask about how your skin affects your sleep or daily life.

Tests that may be done

• Most of the time, no tests are needed.
• If there is concern about allergies, you may be referred for a patch test or skin prick test.
• If the skin looks infected, a simple swab may be taken to identify the cause.

What to expect at your appointment

During the appointment, the healthcare provider will look at the affected skin. They might ask you to undress to your underwear so they can see any patches elsewhere. You can ask for a chaperone if you prefer. After the examination, they will explain their findings and suggest a care plan.

Treatment

Treatment for eczema aims to keep your skin hydrated, reduce itching and inflammation, and prevent flare-ups. You and your healthcare provider will build a plan based on your age, where your eczema is, and how severe it is.

Self-care at home

• Keep skin well moisturized using gentle, unscented moisturizing creams or ointments every day.
• Take lukewarm (not hot) baths, and apply moisturizer within a few minutes of gently patting dry.
• Avoid harsh soaps, bubble baths, and alcohol-based skin products.
• Wear soft, loose cotton clothing and avoid wool or rough fabrics next to the skin.
• Keep your nails short and try not to scratch – you can use a cool compress or press on the itch instead.
• Try to reduce stress, for example with breathing exercises, walking, or talking to someone you trust.

Medical treatments

Your healthcare provider may recommend over-the-counter or prescription creams. These often include emollients (rich moisturizers) and anti-inflammatory creams or ointments, such as topical corticosteroids, that you apply to the affected skin. If your eczema does not improve, other options might include non-steroid topical treatments, phototherapy (carefully controlled light treatment), or oral or injectable medicines that calm the immune system. It is important to use any treatment exactly as your healthcare provider advises. (We're not naming specific brands or doses here – your doctor or pharmacist will guide you.)

When is surgery considered?

Surgery is not used to treat eczema. If you develop a complication such as a skin infection, that may need separate medical treatment, but not surgery.

Living with this condition

Living with eczema means making a simple but consistent daily routine. Moisturize often, keep a tube or pot at home, at work, and in your bag. Learn your personal triggers – for example certain soaps, heat, or stress – and try to avoid them. When a flare begins, start your care plan early to keep it from getting worse.

Lifestyle tips

• Take short lukewarm showers and avoid scrubbing your skin.
• Choose laundry detergents without perfumes and a second rinse cycle to remove residues.
• Use a humidifier in your bedroom if the air is dry.
• Keep your fingernails trimmed and consider cotton gloves at night if scratching is a problem.
• Wear a hat and scarf in cold, windy weather to protect exposed skin.

Diet and exercise

There is no one-size-fits-all diet for eczema. Some foods can trigger flares in some people, but this varies. If you notice a pattern, talk to a doctor or registered dietitian before cutting out food groups, especially in children. Exercise is good for health and for stress relief. Shower soon after exercise, use a mild cleanser, and reapply moisturizer while your skin is still damp.

Mental health and emotional wellbeing

Living with a visible skin condition can be emotionally challenging. You may feel uncomfortable, self-conscious, or stressed by constant itching and sleeping problems. These feelings are normal. Tell your healthcare provider if eczema is affecting your mood or mental wellbeing. They can offer support or recommend counselling. If you ever feel overwhelmed or are having thoughts of harming yourself, reach out immediately to your local emergency services or a crisis helpline.

Prevention

You can't always prevent eczema from appearing, but you can reduce the number of flare-ups. The best way is to keep your skin well moisturised and to learn and avoid your personal triggers. Regular use of emollients even when the skin looks clear can help stop flare-ups from starting.

Vaccines

There is no vaccine for eczema. However, staying up to date with your routine vaccinations is important for your overall health. If your child has eczema and you have concerns about vaccines, talk to your health visitor or GP.

Screening programmes

There is no routine screening test for eczema. You can be checked by a doctor if you notice new, persistent, or changing skin patches, but this is not a formal screening programme.

Complications

If left untreated

• Skin infections can develop, especially if you scratch and break the skin.
• Sleep problems, which can lead to tiredness and low mood.
• Long-term scratching can thicken the skin (changed in colour and in texture).
• In some cases, eczema can affect the skin around the eyes or cause other discomfort.

Long-term outlook

The long-term outlook for eczema is generally good. With the right routine and support, most people manage their symptoms and enjoy life. Many children find their eczema improves or clears by their teens. Even if you are an adult with flares, you can learn to stay on top of them and feel in control. You are not alone, and help is available.

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