eczema risks and benefits for patients

Overview

Eczema is a long-term skin condition that makes the skin dry, itchy, and easily irritated. It is sometimes called atopic dermatitis. It is not contagious, so you cannot pass it to someone else.

Very common — around 1 in 5 children in the UK have eczema at some point, and many adults continue to manage it.

It usually starts in early childhood, often before age 2, but it can appear at any age. It affects people of all ethnicities and skin types.

Symptoms

Common symptoms

• Dry, sensitive skin
• Severe itching, especially at night
• Red or dark patches on the skin
• Rough, cracked, or scaly areas
• Oozing or crusting if scratched a lot

Symptoms in children

• Eczema often appears on the face, cheeks, or chin in babies
• In older children, it often affects the inside of elbows and knees
• It can make sleep difficult because of intense itching
• Children may be restless or irritable during flare-ups

Symptoms in older adults

• Skin may become very dry and thick
• Eczema commonly affects the hands, arms, and around the eyes
• It may be linked to varicose veins in the lower legs
• Older adults may be more prone to skin infections because of thinner skin

Causes

Main causes

• A problem with the skin barrier, which lets moisture escape and irritants get in
• An overactive immune system that reacts to triggers
• A genetic (inherited) tendency — eczema often runs in families

Risk factors

• Having a family history of eczema, allergies, asthma, or hay fever
• Living in a dry or cold climate
• Exposure to harsh soaps, detergents, or chemicals
• Stress — it can make symptoms worse
• Some people have triggers like dust mites, pet dander, or certain foods, but this is very individual

When to see a doctor

See a doctor urgently if:

• If your eczema is getting worse despite using moisturisers and avoiding triggers
• If you see signs of infection, such as weeping, yellow crusts, or growing redness
• If the itching interferes with your sleep or everyday activities

Book a routine appointment if:

• A routine check-up with a GP or dermatologist helps keep your management plan up to date
• If you or your child have frequent flare-ups, ask for a written skin care plan
• If you need information about new or different treatment options

Diagnosis

A doctor can usually diagnose eczema by looking at the skin and asking about your symptoms, your family history, and any triggers you have noticed.

Tests that may be done

• There is no single test for eczema
• Sometimes doctors do patch tests or allergy tests if they suspect a specific trigger
• Occasionally a skin swab is taken to check for infection

What to expect at your appointment

Your doctor will examine your skin, ask questions about your symptoms, and may suggest a trial of moisturisers or a treatment plan. You may be referred to a skin specialist (dermatologist) if needed.

Treatment

Treatment for eczema focuses on three things: repairing the skin barrier, controlling inflammation, and reducing itching. The goal is to prevent flare-ups and keep your skin comfortable.

Self-care at home

• Moisturise your skin at least twice a day, even when it feels fine
• Use lukewarm water for baths and showers — hot water dries skin out
• Pat skin dry with a soft towel instead of rubbing
• Wear soft, breathable fabrics like cotton
• Keep your nails short to reduce damage from scratching
• Avoid known triggers, such as harsh soaps or rough fabrics

Medical treatments

If you need more help, a doctor might prescribe topical treatments (creams and ointments to put on the skin), such as emollients or steroid creams to reduce inflammation. For more severe eczema, they may also discuss light therapy (phototherapy) or tablets that affect the immune system. Only use treatments as directed by your healthcare provider.

When is surgery considered?

Surgery is not usually used for eczema. In rare cases, a surgical procedure might be needed to drain an abscess if a skin infection develops, but this is not a common treatment.

Living with this condition

Caring for eczema is often about building a simple daily routine. Moisturise, avoid scratching, and manage triggers. Keep a small tube of emollient with you so you can apply it during the day if your skin feels dry.

Lifestyle tips

• Take short, lukewarm showers or baths
• Dry your skin carefully and moisturise within 3 minutes
• Wear gloves when using cleaning products or doing dishes
• Choose fragrance-free and natural fabric alternatives where possible
• Manage stress with simple activities like walking, breathing exercises, or hobbies

Diet and exercise

No specific diet can cure eczema, but some people find that certain foods make their skin worse. Keep a diary if you think food might be a trigger. Exercise is good for you, but shower afterwards and apply moisturiser to avoid sweat irritating your skin.

Mental health and emotional wellbeing

Eczema can be draining, especially when itching disturbs your sleep or makes you feel self-conscious. It’s normal to feel frustrated or low at times. Talking to a therapist or counselling service can help. If you ever have thoughts of harming yourself, please call your local emergency number or a crisis helpline right away — you deserve help and support.

Prevention

You cannot always prevent eczema, but you may be able to reduce flare-ups by moisturising regularly, managing stress, and avoiding things that irritate your skin.

Vaccines

There is no vaccine for eczema. However, keeping your vaccinations up to date helps protect against infections that could make eczema worse.

Screening programmes

There is no routine screening test for eczema. If you notice any unusual changes in your skin, such as a new mole or a sore that will not heal, check with a doctor.

Complications

If left untreated

• Skin infections from scratching can become serious
• Chronic scratching can cause thickened, leathery skin
• Disrupted sleep can affect your mood, focus, and quality of life
• Chronic inflammation may be linked to other health conditions, though this is still being studied

Long-term outlook

The outlook for eczema is generally good. Many children outgrow it or have much milder symptoms as they get older. With a consistent skin care routine and the right treatment for flare-ups, most people can control their symptoms and enjoy a full, active life.

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