Living with eczema

Overview

Eczema (also called atopic dermatitis) is a condition where the skin becomes dry, itchy, red, and sometimes cracked or weepy. It is a long-term condition that often comes and goes. Eczema is not contagious, so you cannot catch it from someone else.

Yes, eczema is one of the most common skin conditions worldwide. In the UK, it affects about 1 in 5 children and 1 in 10 adults at some point in their lives.

Eczema often starts in babies and young children. Many children see big improvements as they get older. Adults can also develop eczema, especially on their hands if they work with water, soaps, or chemicals.

Symptoms

Common symptoms

• Intense itching, often worse at night
• Dry, rough, or scaly patches of skin
• Red or darker patches, depending on your natural skin tone
• Small bumps that may weep or crust
• Thickened, leathery skin from repeated scratching

Symptoms in children

• Patches on the face, scalp, elbows, and knees
• Irritability and trouble sleeping due to itching
• Rubbing or scratching against bedding or clothing
• Weeping or crusting in the folds of the skin

Symptoms in older adults

• Often affects hands, neck, and the inside of elbows and knees
• Skin may be very dry and fragile
• Itching can be intense and disrupt sleep
• Symptoms may be more widespread than in younger people

Causes

Main causes

• A weakened skin barrier that lets moisture out and irritants in
• An overactive immune system that reacts to triggers with inflammation
• Dry skin, irritants like harsh soaps, detergents, and wool
• Allergens such as dust mites, pollen, pet dander, and some foods
• Hot or cold weather, sweat, and stress

Risk factors

• Family history of eczema, asthma, or hay fever
• Having a personal history of allergies
• Living in cold, dry, or polluted areas
• Working with chemicals, water, or cleaning products
• Being born with certain gene changes that affect the skin barrier

When to see a doctor

See a doctor urgently if:

• If you have signs of a skin infection, such as spreading redness, warm skin, pus, or fever
• If the itching is severe and prevents you or your child from sleeping or doing daily activities
• If your usual treatment is not helping and symptoms are getting worse

Book a routine appointment if:

• If you think you or your child might have eczema for the first time
• If you need a clearer skincare plan or advice on how to use treatments
• If you have tried moisturisers and avoiding triggers but symptoms persist

Diagnosis

A doctor or nurse can usually diagnose eczema by looking at your skin and asking about your symptoms, family history, and possible triggers. There is no single test needed for a clear diagnosis.

Tests that may be done

• In some cases, allergy tests may be offered if a specific allergen seems to be causing flares.
• Patch testing can be used to check for contact allergies to things like chemicals or metals.
• Skin swabs may be taken if an infection is suspected.

What to expect at your appointment

The doctor will examine the affected areas and may ask about your daily routine, sleep, stress, and what makes the itching worse. They will explain your triggers and give you a written skincare and treatment plan to follow at home.

Treatment

Treatment for eczema focuses on repairing the skin barrier, reducing itching, and controlling flare-ups. It usually involves a regular moisturising routine and using prescribed treatments as needed. There is no one-size-fits-all approach, but with the right plan, most people see major improvement.

Self-care at home

• Apply a fragrance-free moisturiser every day, even when your skin feels fine
• Use lukewarm water for baths and showers, not hot water
• Wash with a gentle, soap-free cleanser
• Pat your skin dry, then moisturise immediately
• Wear soft, breathable cotton clothing and avoid wool or rough fabrics
• Keep your nails short to reduce damage from scratching

Medical treatments

Doctors may prescribe medicated creams or ointments to apply during flare-ups. These are often corticosteroids that reduce inflammation and itching. For more severe eczema, other options include light therapy, prescription tablets, or injections that help control the immune system. If a bacterial infection develops, antibiotics may be prescribed. Always use any treatment exactly as your healthcare provider advises.

When is surgery considered?

Surgery is not a standard treatment for eczema.

Living with this condition

Living with eczema means building a simple daily routine that protects your skin. Moisturising regularly, avoiding known triggers, and treating flare-ups early can make a big difference. It may take some trial and error, but most people find a routine that works for them.

Lifestyle tips

• Keep your home cool and not too dry, especially in winter
• Use a humidifier in dry weather or heated rooms
• Take quick, lukewarm showers and rinse off sweat after exercise
• Choose mild, fragrance-free laundry products
• Learn stress management techniques like breathing exercises or meditation
• Try not to scratch; use a cold compress or gently press on the itchy area instead

Diet and exercise

There is no special diet that cures eczema. Eat a balanced diet and keep exercise as part of your routine. Sweating can irritate skin, so rinse off gently after workouts. If you notice that a specific food seems to make your eczema worse, talk to a doctor before cutting it out.

Mental health and emotional wellbeing

Eczema can affect more than just your skin. It can disturb sleep, make you feel self-conscious, and cause frustration or low mood. These feelings are normal. If you are struggling, talk to your healthcare provider or consider speaking to a counsellor. You deserve support.

Prevention

There is no sure way to prevent eczema, but you can reduce the chance of flare-ups by keeping your skin well moisturised and avoiding triggers. For babies with a family history of eczema, regular moisturising from birth may help.

Vaccines

There is no vaccine for eczema. However, having eczema should not stop you from receiving routine vaccines. If you are taking medications that affect your immune system, ask your doctor which vaccines are safe for you.

Screening programmes

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

Complications

If left untreated

• Scratching can break the skin and lead to bacterial infections that require antibiotics
• Persistent scratching can cause the skin to become thick and leathery
• Sleep problems from itching can lead to tiredness and difficulty concentrating
• Eczema can affect self-esteem and social interactions, especially in children
• In rare cases, severe skin infections could spread and become serious

Long-term outlook

Eczema is a long-term condition, but the outlook is positive. With consistent care, most people keep their symptoms under control, and many children outgrow eczema entirely. Even if you have flare-ups, there are many effective ways to manage them. You can live a full and active life.

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