Getting Rid Of The Itch Of Eczema

Overview

Eczema is a skin condition that makes patches of skin dry, red and very itchy. The most common type is called atopic dermatitis (say: ay-TOP-ik der-muh-TY-tis). Your skin has a natural barrier that holds moisture in and keeps irritants out. In eczema, that barrier does not work as well as it should, so the skin dries out and easily gets sore and itchy. Scratching then makes the skin more irritated, and the itch-scratch cycle begins. Eczema is not contagious — you cannot catch it from someone or pass it on.

Yes, eczema is very common. It affects millions of people worldwide and is one of the most frequent reasons people visit a doctor or pharmacist about their skin. In many countries it affects roughly 1 in 5 children and around 1 in 10 adults at some point in their lives.

Eczema can affect anyone at any age. It most often starts in babies and young children, and many children grow out of it or see it improve a lot by their teens. Some people have it for the first time as adults. It tends to run in families, along with asthma and hay fever. People with very dry or sensitive skin, and those living in cold, dry or very hot climates, may find their skin is more easily irritated.

Symptoms

Common symptoms

• Dry, rough or scaly skin patches
• Intense itching, which is often worse at night
• Redness on lighter skin; on darker skin, patches may look brown, purple or grey, or be harder to see
• Small bumps, or skin that feels thickened and leathery where it has been scratched a lot
• Cracked skin that may weep clear fluid or crust over
• Raw, sore or stinging skin from scratching
• Patches most often in the folds of the elbows and knees, on the hands, neck, eyelids, and around the ankles

Symptoms in children

• In babies, red, crusty or weepy patches on the cheeks, scalp, forehead and outer arms and legs
• In older children, itchy patches in the elbow and knee creases, on the wrists and ankles, and around the neck
• Restless sleep and fussiness because of night-time itching
• Scratching until the skin bleeds, which can lead to infection

Symptoms in older adults

• Very dry, thinning skin that itches and tears easily
• Eczema on the hands, face, neck and legs, rather than only in the skin folds
• Skin that becomes fragile and bruises or marks easily after scratching
• Itch that disturbs sleep and affects mood or daily energy

Causes

Main causes

• A weakened skin barrier: the skin loses water too easily and lets irritants in. This is largely something you inherit.
• An over-reactive immune system in the skin, which causes inflammation and itching when the skin is triggered.
• Genetics: eczema often runs in families alongside asthma and hay fever.
• Triggers that set off flares rather than cause the condition itself — such as soaps, bubble bath, wool or synthetic fabrics, heat and sweat, dust mites, pet fur, stress, and some foods in young children.

Risk factors

• A parent, brother or sister with eczema, asthma or hay fever
• Having very dry or sensitive skin
• Living in a cold, dry climate or in a home with very dry heating
• Frequent washing, or using harsh soaps, shower gels or detergents
• Working with water, chemicals or food, which can irritate the hands
• Stress and poor sleep, which can make itching feel worse
• In children, certain food allergies can be linked with flares, but food is not the cause for most people

When to see a doctor

See a doctor urgently if:

• Skin that looks infected — weeping pus, hot and painful, or with spreading redness
• A flare that is suddenly much worse and not improving with your usual care
• Eczema near the eye that is red, swollen or affecting your vision
• Severe itching that stops you or your child sleeping for several nights
• A baby under 6 months old with a new itchy rash

Book a routine appointment if:

• Your eczema is not controlled with daily moisturising and short courses of treatment
• You need to use treatment most days of the month
• Itching is affecting sleep, work, school or mood
• You are unsure what is triggering flares
• Your skin is thickening, scarring or changing colour
• You want to review your treatment plan or discuss other options

Diagnosis

Eczema is usually diagnosed by talking about your symptoms and looking closely at your skin. A doctor or nurse will ask when the itching started, where the patches are, whether they come and go, and whether anyone in the family has eczema, asthma or hay fever. They will check the pattern of the rash, because eczema has a typical look and typical places it appears. No special test is usually needed.

Tests that may be done

• Usually none — the diagnosis is made from your history and a skin examination
• If the skin looks infected, a small swab may be taken to check for bacteria
• Patch testing or allergy testing may be suggested if a contact allergy or food trigger is suspected
• A skin scraping may be checked if another condition, such as a fungal infection, is possible

What to expect at your appointment

The appointment is quick and painless. Your clinician will look at your skin and may ask you to show all the affected areas, so it helps to wear loose clothing that is easy to roll up. Bring a note of the products you use, how often you use them, and any recent flares. You should leave with a clear plan: what to use every day, what to use during a flare, and when to come back.

Treatment

Treatment has two parts: everyday care that keeps the skin barrier strong, and extra treatment to calm flares when they happen. The everyday part matters most. Well-moisturised skin itches less, flares less often, and needs less of everything else. Your doctor or pharmacist can help you find a routine that fits your life and your skin.

Self-care at home

• Moisturise (use an emollient) at least twice a day, every day — even when your skin looks clear. Ointments and thick creams hold moisture best; lotions are lighter but need to be used more often.
• Apply moisturiser within a few minutes of a bath or shower, while the skin is still slightly damp, to lock water in.
• Use a gentle, fragrance-free wash or a soap substitute instead of soap, shower gel or bubble bath.
• Keep baths and showers short and lukewarm rather than hot.
• Pat skin dry gently with a soft towel — do not rub.
• Keep nails short and smooth, and try cotton gloves or socks on the hands at night to reduce damage from scratching.
• Wear soft, breathable fabrics such as cotton next to the skin, and cut out scratchy labels.
• Use a fragrance-free, dye-free washing powder and skip fabric softener.
• Keep the bedroom cool and well ventilated, since heat and sweat make itching worse.
• Try the 'soak and seal' method for very dry skin: a short lukewarm soak, pat dry, then moisturiser straight away.
• Avoid known triggers where you reasonably can — but do not try to remove everything at once, or it becomes impossible to know what helped.

Medical treatments

When the skin is inflamed, clinicians use treatments that calm the inflammation from the inside of the skin. These are usually creams or ointments applied directly to the sore patches, used in short courses alongside your everyday moisturiser. How strong a treatment you need depends on how inflamed the skin is and where it is — thinner skin, such as the face and neck, needs gentler options. Your doctor or nurse will explain exactly where to apply it, how often, and for how long, and will review you regularly. If creams are not enough, other options exist, including treatments that affect the immune system, light (phototherapy) therapy, and specialist referral for severe eczema. Antibiotics are only needed if the skin has become infected — eczema itself is not an infection. Ask your pharmacist before buying anything over the counter, and always follow the instructions given by your own clinician.

When is surgery considered?

Surgery is not a treatment for eczema. In rare cases, a specialist may discuss procedures for complications such as severe scarring, but this is not a usual part of eczema care.

Living with this condition

Living with eczema usually means building a simple routine you can keep up even on busy or tired days. Put moisturiser where you will see it — by the bed, in the bathroom, in your bag. Make it part of getting dressed. Try to treat itching early rather than waiting until it is unbearable, because calm skin is easier to keep calm. Expect good days and harder days; a flare is not a failure, it is a signal to go back to basics for a few days.

Lifestyle tips

• Keep a short diary of flares and possible triggers for a few weeks — it often reveals a pattern without guesswork
• Choose fragrance-free, unperfumed toiletries, deodorant and cosmetics
• Manage stress where you can: gentle exercise, breathing exercises, and time outdoors can all help
• Keep the home from getting too dry or too hot, and air rooms regularly
• Wash new clothes before wearing them to remove finishes that irritate skin
• Protect hands with gloves for washing up, cleaning and gardening, and use cotton liners under rubber gloves
• Rinse and moisturise hands after contact with water, food or cleaning products

Diet and exercise

There is no special eczema diet that works for everyone. Most people with eczema do not need to avoid any foods, and cutting out foods without advice can do more harm than good, especially for children. If you suspect a food triggers flares, talk to your doctor before removing it — they may suggest testing or a referral. Exercise is good for you and for stress, but sweat can sting. Try to shower soon after exercise, use lukewarm water and a soap substitute, pat dry, and moisturise straight away. Loose, breathable clothing makes exercise more comfortable.

Mental health and emotional wellbeing

Eczema is not 'just a skin problem'. Constant itching, broken sleep, visible patches and the effort of daily routines can wear you down. It is very common to feel embarrassed, frustrated, anxious or low at times, and children can feel self-conscious at school. These feelings are real and worth mentioning — they are part of your health, not a weakness. If low mood, worry or sleep loss is building up, tell your doctor; support is available and treating the skin and the mood together works better than either alone.

Prevention

Eczema cannot be cured, and there is no proven way to stop it starting in the first place. But you can greatly reduce how often flares happen and how severe they are. The key is daily skin care, not just reacting when things get bad: moisturise every day, wash gently with fragrance-free products, avoid known irritants, and treat early signs of a flare straight away rather than waiting.

Screening programmes

There is no screening programme for eczema. Regular skin checks at home are useful, though — notice any patch that is not healing, is getting thicker, or looks different from your usual eczema, and show it to your doctor.

Complications

If left untreated

• The itch-scratch cycle gets worse, leading to thicker, leathery skin that itches even more
• Skin infection, because broken skin lets bacteria in
• Poor sleep, tiredness and difficulty concentrating at school or work
• Low mood, anxiety, and self-consciousness about appearance
• In children, slowed growth or reduced quality of life in severe, long-standing cases
• Eye problems such as itchy, sore eyelids, which need checking

Long-term outlook

The outlook is genuinely encouraging. Most people improve with a steady moisturising routine and short treatment courses when needed, and many children find their eczema becomes much milder as they get older. Eczema can be a long-term companion, but for most people it becomes something you manage in the background rather than something that runs your life. If your current plan is not working, that usually means it needs adjusting — not that nothing will ever help.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.