condition icon


Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 5 minutes read

Eczema is one of the most common skin conditions treated by doctors as well as being one of the most troublesome. There are several types of eczema, the most common being known as atopic eczema, where the affected person is born with a tendency for the skin to become inflamed or eczematous. It is very common, and tends to be an ongoing, recurring condition, usually starting in childhood with most children finding their eczema improving as they become older. There is no clear-cut answer as to why eczema develops but it is widely acknowledged that environmental factors, genetics and the body’s immune system all play a part. There is a strong link between the skin condition and allergies, with most eczema patients having a personal or family history of another atopic illness such as asthma or hay fever. If there is no such history of allergy, then stress, infections and injuries to the skin are probably more important. You can’t catch eczema, and it does not spread from one person to another. Symptoms sometimes flare up for no obvious reason but certain triggers can set off eczema including chemicals and detergents, pollen, infection, dry skin, stress, and changes in hormone levels - eczema can be worse in women before their monthly period.

What types of eczema are there?

There are a number of different types of eczema but by far the most common is known as atopic eczema, considered to be one of three ‘atopic’ disorders, along with asthma and hay fever. ‘Atopic' people are often hypersensitive to certain allergens, and people with a family history of asthma and allergies often develop eczema. Other types include; Allergic contact dermatitis. This is a reaction to a substance that the skin comes directly in contact with and is commonly caused by nickel, rubber, perfumes, paints, dyes, soaps and detergents. Infantile seborrhoeic eczema. Also known as cradle-cap, this scaly skin condition commonly affects babies on the scalp or nappy area - it is not sore or itchy and generally clears up without intervention.
Adult Seborrhoeic eczema. This can be due to an over-reaction to the natural yeasts in the skin, or may be hormone-related (it is often worse cyclically in women). It is usually found on the nose and eye-brows, scalp, chest and back.
Photodermatitis. Typically causes a pattern of heat-rash and itchy spots, caused by sensitivity to sunlight.
Eczema can be graded from very mild, with red dots or a rash, to severe, where the skin becomes swollen, blistered or cracked and very sore. Areas of eczema can become infected, with weeping or crusting over the top, soreness and failure to respond to eczema treatment. If you think this is a mild case, covering a small area, you could see your pharmacist and they can recommend emollients, which are medical grade moisturisers.

Doctor’s advice

Is eczema contagious?

Eczema is not contagious, but there is a genetic link, so family members may suffer from eczema or other associated conditions such as asthma or hay fever.

Healthwords pharmacists' top tips

There are three main areas to consider when managing eczema. The first is to avoid using irritants to the skin wherever possible, secondly to use moisturising creams frequently to help prevent eczema patches developing and third to use steroid creams when the eczema flares up. Emollients are moisturisers which soothe, smooth and add water to hydrate the skin. They are the most common overall treatment for eczema and should be used every day - examples include aqueous cream and E45 cream – and these can be applied directly as lotions, creams or ointments. Mild steroid creams, such as hydrocortisone, are also excellent at calming flare-ups of eczema and these act by suppressing the body's inflammatory response, but always ask the advice of a pharmacist or see your GP before using any steroid cream as the stronger steroids are only available on prescription. Emollients should be used at the same time as steroid creams for most people.

If emollients and mild steroids don't help, your doctor can prescribe other treatments such as stronger steroid creams. However, these should be used sparingly since if used for too long or on a delicate area of skin such as the face and armpits, it can thin the skin, leading to wrinkles and blemishes. Other possible treatments include oral steroids tablets (prednisolone) used for very short periods of time, immunosuppressant tablets, such as azathioprine or ciclosporin, used only with severe eczema, and immunosuppressant creams or lotions applied to the skin to reduce inflammation. These are sometimes prescribed if other treatments have not worked or have unacceptable side-effects and the newer ones of these do not contain steroids so may have less side-effects. Antibiotics can be prescribed if the skin is infected, and antihistamine tablets can help some people with irritating eczema to sleep.

Am I fit for work?

You may be fit for work, depending on how bothersome the eczema is. If you suspect or know that allergens or irritants at work are responsible for your eczema you may need to avoid these while awaiting medical advice.

Can lifestyle changes help?

Yes. Always avoid soaps, bubble baths, detergents and any other things that seem to irritate, for example, woollen clothes and extremes of temperature. Washing the skin itself can be aggravating, so it is best to keep washing and bathing to a minimum and use cool water with a soap substitute plus a bath or shower emollient (moisturiser). Some people with eczema say that cutting out dairy products and refined sugars from their diet significantly improves their eczema although hard evidence for this is lacking. Taking a daily multivitamin rich in the antioxidant vitamins A and E plus 50mg of zinc per day can also prove to be beneficial, as can quercetin, found in foods such as garlic and onions, broccoli, and red cherries but available in supplement form.

Complementary treatments do seem to help many eczema sufferers but several may need to be tried before the full benefits for each individual are found. Examples of these include rosehip oil, massaged into the affected skin daily can help reduce itching and irritation of that area, and starflower cream that can be good at relieving the itching of eczema, both in children and adults.

When should I see my doctor?

Using the descriptions above, if you would rate your eczema as severe, infected or not responding to treatments from your pharmacist or any eczema treatments you have been prescribed previously, book an appointment with your doctor. Depending on how bothersome and widespread the eczema is, you may decide to ask for an urgent or routine appointment.

The doctor can prescribe steroid creams, antibiotics or emollients to treat the eczema, depending on their assessment.

Was this helpful?

Was this helpful?

Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
App Store
Google Play
Piff tick
Version 2.28.0
© 2024 Healthwords Ltd. All Rights Reserved