eczema treatment options overview

Overview

Eczema (also called atopic dermatitis) is a common 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, especially in children. It affects millions of people worldwide, and the number of people with eczema has been increasing over time.

While eczema can start at any age, it usually begins in early childhood. Many children outgrow it by their teens, but some continue to have symptoms as adults. It affects both males and females and people of all ethnic backgrounds.

Symptoms

Common symptoms

• Dry, sensitive skin
• Intense itching
• Red or brownish patches of skin, often on the hands, elbows, knees, and face
• Small raised bumps that may weep fluid or crust over when scratched
• Thickened, cracked or scaly skin

Symptoms in children

• In babies, eczema often appears on the face, scalp, and the outer parts of the arms and legs.
• In older children, the rash commonly affects the inside of the elbows, behind the knees, and on the neck.
• Children may rub or scratch their skin, which can lead to sleep problems and daytime irritability.

Symptoms in older adults

• In older adults, eczema often affects the hands, eyelids, and the back of the knees or neck.
• The skin may become very dry and thick, and itching can be severe.
• Older adults are also more likely to have other health conditions or take medications that can make eczema symptoms worse.

Causes

Main causes

• A problem with the skin barrier, which allows moisture to escape and irritants to enter.
• An overactive immune system that reacts to harmless triggers, causing inflammation.
• A combination of genetic and environmental factors.

Risk factors

• A family history of eczema, asthma, or hay fever (allergies)
• A personal history of allergies or asthma
• Living in a dry climate or cold weather
• Exposure to irritants such as soaps, detergents, or rough fabrics
• Stress or emotional upset, which can trigger flare-ups

When to see a doctor

See a doctor urgently if:

• If you suspect a skin infection (for example, spreading redness, warmth, or yellow crusting), seek medical care the same day.
• If your eczema is causing severe pain, swelling, or weeping, or if you have a fever, see a doctor promptly.

Book a routine appointment if:

• If your eczema is not controlled by moisturizers and self-care measures, make an appointment.
• If the rash is very large, painful, or affecting your daily activities, it is worth seeing a doctor.
• If your child's eczema is disruptive to sleep or school, talk to a healthcare provider.

Diagnosis

A doctor or nurse will usually diagnose eczema by looking at your skin and asking about your symptoms, medical history, and any family history of eczema or allergies. They may also ask about what triggers your flare-ups.

Tests that may be done

• No standard laboratory test is needed for eczema in most cases.
• Your doctor might refer you for allergy testing if they suspect an allergy is triggering your eczema.
• If the skin looks infected, a swab may be taken to check for bacteria.

What to expect at your appointment

At your appointment, the doctor will examine your skin closely and may ask questions about your daily routine, your triggers, and how much your eczema affects your life. Based on this, they will explain your likely diagnosis and work with you to create a treatment plan. You can ask any questions and mention any worries you have.

Treatment

There is no cure for eczema, but treatment focuses on repairing the skin barrier, reducing inflammation, controlling itching, and preventing flare-ups. A good treatment plan often includes a mix of daily skin care and treatments used only during flare-ups. Your doctor will tailor your plan according to your skin, how severe your symptoms are, and what triggered them.

Self-care at home

• Moisturize your skin at least twice a day, especially after bathing, to lock in moisture.
• Use lukewarm water instead of hot water when bathing or showering, and keep it short.
• Pat your skin dry with a soft towel — don't rub.
• Avoid known irritants like harsh soaps, perfumed products, and wool clothing.
• Try not to scratch; instead, apply a cool compress or moisturizer to ease itching.
• Keep fingernails short to reduce damage from scratching.

Medical treatments

Your doctor may suggest several treatment approaches, depending on how mild or severe your eczema is. These could include specially designed moisturizers and barrier creams to protect your skin, anti-inflammatory creams or ointments to reduce redness and itching during flare-ups, and in some cases, other prescription treatments that calm the immune system or target specific parts of the inflammation process. If the skin is infected, the doctor may recommend an antibacterial or antifungal treatment. For severe eczema, doctors may consider light therapy or medicines that affect the whole immune system. Always ask your doctor about the brand, strength, and how often to apply any treatment — never share prescriptions or use someone else's medication.

When is surgery considered?

Surgery is not used to treat eczema. Rarely, if the skin becomes severely infected or there is a complication, a small procedure may be needed to drain an abscess, but this is not a treatment for eczema itself.

Living with this condition

Living with eczema can be frustrating, but a consistent daily routine can make a big difference. Make simple changes like using fragrance-free soap, wearing soft cotton clothing, and keeping your home at a comfortable temperature with a humidifier in dry weather. Remember that eczema tends to wax and wane — sometimes it is good and sometimes it flares up, and that's normal.

Lifestyle tips

• Use a gentle, fragrance-free cleanser and moisturize immediately after washing.
• Choose smooth, breathable fabrics like cotton and avoid scratchy wool.
• Keep your bedroom cool at night to reduce itching and improve sleep.
• Manage stress with activities you enjoy, such as walking, reading, or talking to a friend.
• Avoid extreme temperature changes and excessive sweating if they trigger your eczema.

Diet and exercise

Healthy eating and regular exercise are generally good for overall health, but there is no single 'eczema diet'. Some people find certain foods trigger their flare-ups, but this varies. If you suspect a food is a problem, talk to a dietitian or doctor before cutting it out, so you don't miss out on essential nutrients. Exercise is encouraged for wellbeing; after exercise, rinse off sweat and apply moisturizer to help your skin recover.

Mental health and emotional wellbeing

Eczema can affect how you feel about yourself, especially when it is visible on your hands, face, or other noticeable areas. Itching and sleep problems can leave you exhausted and drained. It is completely natural to feel frustrated, anxious, or low at times. Talking to a counsellor or a support group can help. If you ever feel hopeless or think about hurting yourself, it is important to reach out for support right away — contact your local crisis helpline or your local emergency number.

Prevention

Eczema itself cannot be prevented, because it has a strong genetic basis. However, many flare-ups can be avoided by recognizing and steering clear of your personal triggers. Good daily skin care with plenty of moisturizer can help keep the skin barrier strong and reduce the chance of new patches appearing.

Complications

If left untreated

• Persistent scratching can break the skin and allow bacteria to enter, leading to skin infections that need medical treatment.
• Severe and constant itching can interfere with sleep, school, and work, affecting mood and quality of life.
• Long-term inflammation can cause thick, leathery skin (lichenification) and changes in skin color.

Long-term outlook

The outlook for eczema is generally positive. With the right skin care and treatments, most people are able to keep their symptoms under control and lead a full, active life. Many children with eczema see big improvements as they grow older, and flare-ups often become less frequent and less severe over time. Even if eczema is a long-term condition, new treatments continue to be developed, and your healthcare team is there to help you find what works best for you.

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