Exploring Eczema: Diagnosis and Management

Eczema— or atopic dermatitis —is one of the most widespread inflammatory skin diseases worldwide. Studies show it affects up to 10–20% of people, particularly children (as many as 20% of kids). It often runs in families with hay fever, asthma, or food allergies.

There’s no single cause; eczema arises from a complex interplay of genetic, environmental and immune factors.

Patients typically have:

• Dry, cracked skin
• Intense itching (which leads to scratching)
• Red, inflamed rashes
• Skin thickening (lichenification) in chronic areas

If untreated, persistent scratching can damage the skin barrier, leading to lichenification, open sores and higher infection risk.

Beyond the physical discomfort, eczema disrupts sleep and daily activities, causing significant emotional distress and reducing quality of life.

Do:

• Relying solely on social media or online “quick fixes”—always consult a healthcare professional for accurate guidance
• Moisturise often with a suitable cream (see next question)
• Use gentle, fragrance-free cleansers
• Take short, lukewarm showers (avoid hot water)
• Identify and avoid personal triggers (e.g. wool, harsh detergents)
• Manage stress—exercise, relaxation techniques and good sleep hygiene all help
• Wear breathable, cotton-based clothing and use gloves for wet work (e.g. washing up)
• Seek professional advice early—your GP or dermatologist can tailor treatment and prescribe topical or systemic therapies

Avoid:

• Long, hot showers (they strip natural oils and worsen dryness)
• Fragranced or dye-filled products that irritate sensitive skin
• Over-scrubbing or using abrasive exfoliants on eczema areas
• Relying solely on social media or online “quick fixes”—always consult a healthcare professional for accurate guidance

Choosing the right moisturiser is crucial. Look for:

• Fragrance-free, dye-free and hypoallergenic formulations (lowest risk of contact allergy)
• Occlusives (e.g. petrolatum) to lock in hydration and prevent water loss
• Humectants (e.g. glycerol, urea, lactic acid, propylene glycol) to draw moisture into the skin’s outer layer
• Skin-identical lipids (e.g. ceramides, filaggrin-rebuilding ingredients) to repair and strengthen the barrier

Many eczema patients also benefit when moisturisers are used alongside prescribed topical treatments (such as corticosteroids or calcineurin inhibitors). That combination reduces inflammation more effectively than either alone.

Early, accurate diagnosis is vital—don’t assume ‘it will go away.’ If over-the-counter measures aren’t enough, consult a dermatologist. In the past decade, systemic treatments (biologics and newer targeted therapies) have transformed care for moderate-to-severe eczema. But even mild cases often require ongoing topical therapy plus moisturisation.

A healthcare professional can:

• Confirm the diagnosis (and rule out mimickers)
• Arrange patch testing if contact allergy is suspected
• Prescribe prescription-strength topical treatments
• Evaluate if a patient would benefit from systemic therapy or phototherapy

Early intervention often means fewer and milder flares, shorter treatment courses and a better overall outcome

• Men don’t need to moisturise. – Eczema does not discriminate by gender; every patient needs regular hydration.
• Hot water is good for skin. – In fact, hot showers strip away natural oils and exacerbate dry, itchy skin.
• Moisturiser alone is enough. – While moisturising is essential, combining it with any prescribed topical treatment reduces inflammation more effectively.

Be proactive—manage your skin daily, avoid known triggers, and moisturise consistently. If you suspect eczema, see your GP or a dermatologist early. Proper, specialist-guided treatment (including the latest systemic options) can dramatically improve outcomes and quality of life.