Eczema in adults

Overview

Eczema is a long-lasting skin condition that makes your skin dry, itchy, and inflamed. It is not contagious, so you cannot catch it from someone else.

Yes, eczema is very common in adults. It is estimated that around 1 in 10 adults in the UK have eczema at some point.

Eczema can affect anyone, but it often starts in childhood and may continue into adulthood. Some people develop it for the first time as an adult.

Symptoms

Common symptoms

• Intense itching, often worse at night
• Dry, sensitive skin that may feel rough or scaly
• Red or inflamed patches, often on hands, neck, inside elbows, and behind knees
• Thickened or cracked skin that may bleed or ooze when scratched

Symptoms in children

• Eczema in children usually appears on the face, scalp, and outer arms or legs.
• Children may have difficulty sleeping due to itching.
• Scratching can lead to skin infections that need treatment.

Symptoms in older adults

• In older adults, eczema often appears as dry, scaly patches on the arms, legs, and torso.
• The skin may become very thin and fragile, making it easy to tear.
• Itching can be severe and may be mistaken for other skin conditions like shingles.

Causes

Main causes

• Eczema is caused by a combination of genetic and environmental factors. People with eczema have a weakened skin barrier and an overactive immune response that leads to inflammation.
• Common triggers include irritants (like soaps, detergents, and solvents), allergens (like dust mites, pollen, and pet dander), stress, and changes in weather.

Risk factors

• Having a family history of eczema, asthma, or hay fever increases your risk.
• Having a job that exposes you to irritants or frequent hand washing (such as healthcare or hairdressing) can raise your chances.
• Living in a dry or cold climate may make eczema more likely to flare.

When to see a doctor

See a doctor urgently if:

• If your eczema is very painful, weeping a lot, or you have signs of infection (fever, swelling, red streaks).
• If usual self-care is not helping and the rash is spreading quickly.

Book a routine appointment if:

• If you suspect you have eczema for the first time, or if flare-ups are frequent and affecting your daily life.
• If over-the-counter moisturisers are not enough to keep your skin comfortable.

Diagnosis

Your doctor will typically diagnose eczema by examining your skin and asking about your symptoms, family history, and any known triggers. There is no single test for eczema.

Tests that may be done

• Sometimes a skin patch test may be done to check for allergic contact dermatitis, which can look like eczema.
• If infection is suspected, a swab of the skin may be taken to check for bacteria.

What to expect at your appointment

Your doctor will ask about when the rash started, what makes it better or worse, and if you have other health conditions. They may also recommend seeing a dermatologist (skin specialist) if the diagnosis is unclear or if treatment is not working.

Treatment

Treatment for eczema focuses on reducing symptoms, preventing flare-ups, and improving skin health. It usually involves a combination of daily skin care and medical treatments. Your doctor will work with you to find a plan that suits you.

Self-care at home

• Moisturise your skin at least twice a day with a fragrance-free emollient (medical moisturiser). Apply it right after bathing to lock in moisture.
• Use gentle, fragrance-free soaps and laundry detergents. Avoid harsh scrubbing or hot water.
• Keep your nails short and wear soft cotton gloves at night to reduce damage from scratching.
• Identify and avoid your personal triggers, such as certain fabrics, stress, or specific foods.

Medical treatments

Doctors may prescribe topical treatments such as corticosteroid creams or ointments to reduce inflammation during flares. They might also recommend calcineurin inhibitors or other non-steroid creams. For more severe cases, oral medications, phototherapy (light therapy), or biologic injections may be options. Always use any prescribed treatment exactly as directed.

When is surgery considered?

Surgery is not a treatment for eczema. In rare cases, if a severe infection leads to an abscess, surgical drainage might be needed, but this is very unusual.

Living with this condition

Living with eczema means making skin care part of your daily routine. Keep moisturiser in your bag and at your desk. Wear soft, breathable fabrics like cotton. Avoid overheating and long, hot baths. Try to manage stress with relaxation techniques, as stress is a common trigger.

Lifestyle tips

• Use a humidifier in dry rooms to add moisture to the air.
• Choose gentle, fragrance-free skincare and household products.
• Wear gloves when doing dishes or using chemicals.

Diet and exercise

There is no special diet for eczema, but some people notice their skin flares after eating certain foods like dairy or eggs. If you suspect a link, keep a food diary and discuss with your doctor. Exercise is good for overall health, but shower and moisturise afterwards to wash off sweat, which can irritate skin.

Mental health and emotional wellbeing

Eczema can affect your confidence, sleep, and mood. It is common to feel frustrated or embarrassed. If you feel down or overly stressed, talk to your doctor or a mental health professional. Remember that you are not alone, and many people find support helpful. If you are in crisis, reach out to a crisis support service in your area.

Prevention

Eczema itself cannot be prevented, but you can often reduce the number and severity of flare-ups by identifying and avoiding your personal triggers, keeping your skin well moisturised, and managing stress.

Vaccines

There are no vaccines for eczema. However, people with eczema should get the flu vaccine and other routine vaccines as recommended by their doctor, unless they have a specific allergy to a vaccine component.

Screening programmes

There is no screening test for eczema. Diagnosis is based on symptoms and examination.

Complications

If left untreated

• Repeated scratching can lead to thickened skin (lichenification).
• Broken skin from scratching can become infected with bacteria (such as Staphylococcus aureus), leading to impetigo or cellulitis.
• Sleep disturbance and poor quality of life are common complications.

Long-term outlook

With proper care, most people with eczema can manage their symptoms well and lead a normal, active life. Flare-ups may come and go, but treatments continue to improve. Many people find that their eczema becomes less severe as they get older. You can have a full and comfortable life with eczema.

Find support

Local organisations

• National Eczema Society (UK) · United Kingdom
• National Eczema Association (USA) · United States
• Eczema Association Australasia · Australia/New Zealand

Helplines

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