Atopic Dermatitis (Eczema)

Atopic dermatitis, commonly known as eczema, is a chronic inflammatory skin condition causing dry, itchy, inflamed patches of skin. It often begins in childhood and is linked to other allergic conditions such as asthma and hay fever.

• Dry, itchy skin, which can be intense, especially at night
• Red to brownish-grey patches, commonly on the hands, feet, ankles, wrists, neck, and the creases of the elbows and knees
• Small, raised bumps that may leak fluid and crust over when scratched
• Thickened, cracked, or scaly skin with long-standing or repeated scratching
• Symptoms typically flare periodically, with calmer periods in between

• Results from a combination of genetic factors affecting the skin barrier and immune system, along with environmental triggers.
• Common triggers include dry skin, irritants (such as soaps or certain fabrics), allergens (such as dust mites or pet dander), stress, sweating, and temperature changes.
• Often occurs alongside other allergic conditions, such as asthma and allergic rhinitis, and tends to run in families.

• Diagnosed clinically based on the characteristic appearance, distribution, and chronic, relapsing pattern of the rash, together with a personal or family history of allergic conditions.
• Specific allergy testing is not usually needed for typical cases but may be considered if a particular trigger is strongly suspected and not obvious from history.

Regular use of a fragrance-free moisturiser, applied generously and frequently, is a cornerstone of management and helps repair and protect the skin barrier.

A topical corticosteroid cream or ointment is used during flares to reduce inflammation and itching, applied for a limited course as directed and then stopped or reduced once the flare settles.

Identifying and avoiding personal triggers — such as certain soaps, fabrics, or known allergens — helps reduce the frequency of flares.

For more persistent or severe eczema not controlled by these measures, additional treatments such as other topical anti-inflammatory medicines or, in more severe cases, systemic treatment may be considered by a specialist.

Keeping fingernails short and addressing itching promptly helps reduce skin damage and secondary infection from scratching.

• Moisturise the skin regularly, especially after bathing, using a fragrance-free product.
• Use lukewarm rather than hot water for bathing, and pat skin dry rather than rubbing.
• Identify and avoid personal triggers, such as certain soaps, fabrics, or known allergens.
• Manage stress, as it can trigger or worsen flares in some people.
• Keep the home environment free of excessive dust where possible, particularly if dust mites are a known trigger.