What is eczema?

Eczema or dermatitis is the medical term for a skin flare-up where patches of skin become itchy, red, dry and inflamed. Your doctor may already have told you that you have eczema, which affects people of all ages. Eczema is one of the most common reasons for dry, sensitive skin, and affects up to 20% of the population. Your eczema may flare up when your skin comes into contact with everyday things. This can be triggered by a reaction to substances that irritate your skin, or by a sensitivity to specific substances that develops, over time, into an allergic reaction.

What triggers skin irritation?

There are many different types of eczema/dermatitis and the causes are often difficult to identify. Triggers for skin flare-ups can be either common irritants or allergens, including household soaps and detergents, engine oils, cold winds, food and plants, nickel and chrome, perfume, and rubber. Avoiding contact with a specific substance may help to reduce the symptoms.

What is the itch-scratch cycle?

The first sign of irritiation is usually itching and the most natural response is to scratch – the more you scratch, the more you itch. This is known as the itch-scratch cycle and it is how a skin flare-up becomes established.

How do I control my skin flare-up of eczema and dermatitis?

The best way to break the itch-scratch cycle is to treat the irritation at the first sign of symptoms, or as soon as you can after the onset. The earlier you start the treatment the more effectively you will be able to relieve the itching and clear the inflammation.

How is eczema treated?

Finding the right treatment is important. These treatments include emollients, steroid creams (also known as corticosteroid creams), antihistamines and antibiotics. Some of these treatments can be found over-the-counter, while other, stronger medications will need a prescription. Adults with severe cases of eczema that have failed to respond to other therapies may be prescribed immunomodulators, drugs that suppress the immune system. These drugs block the production of some immune cells and curb the action of others.

Emollients: These are one of the most important treatments for preventing dryness and cracking. Frequent, regular use will keep the skin moisturised and supple, helping prevent a skin flare-up. They are available in various formulations including creams, ointments and bath oils.

Steroids: When you have eczema or dermatitis, you need a treatment with an active ingredient that works directly on the underlying inflammation. Steroid creams help to break the itch-scratch cycle before it takes hold and reduce inflammation so that the skin can heal. Examples of topical steroids include betamethasone (Diprolene Luxiq), clobetasol propionate (Clobex, Olux, Temovate), hydrocortisone and mometasone (Elocon). Some steroid preparations are available over the counter; ask your doctor or pharmacist for suggestions. Over-the-counter steroids are for short-term use of no longer than seven days for treatment of a skin flare-up. They are not suitable for use on the face and contact with the eyes should be aboided. If the skin becomes infected you may need a prescription for antibiotics from your doctor.

Self-help measures

  • If you can identify the trigger(s) of your eczema, try to avoid it (them) as contact will make treatment more difficult.
  • Maintain your skin moisture levels by using emollients regularly to help stop your skin from drying out.
  • Consider using steroid preparations that can be bought from the pharmacy without a prescription.
  • When using steroid creams read the instructions carefully. Ensure you use the right amount. DO NOT apply to the face.
  • If your skin irritation has not cleared or has worsened after 7 days of treatment with a topical steroid consult your doctor.

Further information

National Institiute of Arthritis and Musculoskeletal and Skin Diseases: