Eczema: Symptoms, Treatment and Everyday Support

Eczema is very common and, for most people, it can be managed well at home with the right routine and the right treatments. It can still be exhausting: the itch is real, sleep suffers, and flare-ups often arrive without an obvious reason.

This page is general information only. It cannot tell you whether your own skin problem is eczema — several conditions look similar — and it is not a diagnosis or a promise of a cure. Please do not stop or change any prescribed treatment because of something you have read online, here or anywhere else. Speak to a GP, pharmacist, practice nurse or dermatology team instead.

Eczema (also called dermatitis) is a group of conditions in which the skin barrier does not hold moisture well and becomes easily irritated and inflamed. The skin may be dry, itchy, cracked, sore or thickened, and it often feels tight or sensitive.

• It is not contagious. You cannot catch eczema from someone else or pass it on.
• It fluctuates. Skin can be settled for weeks or months and then flare — sometimes with an obvious trigger, sometimes not.
• Atopic eczema often begins in childhood. Many children improve as they grow up, but eczema can continue into adulthood or start for the first time in adult life.
• It looks different on different skin tones. On paler skin it often appears red or pink. On brown and black skin it may look purple, grey, ashen or darker than the surrounding skin, and inflammation can be easier to feel than to see.
• Scratching makes things worse. It damages the skin surface, keeps the itch cycle going and increases the risk of infection.

Different types behave differently and may be managed differently. Because several skin conditions look alike, a proper assessment is sometimes needed before assuming a rash is eczema.

Not everyone has every symptom, and severity varies a great deal from person to person and from week to week. Symptoms can include:

• dry, rough or scaly skin
• itching, which may be worse at night
• inflammation — redness on paler skin; purple, grey, ashen or darker patches on brown and black skin
• cracked, sore or bleeding skin, especially over joints and on the hands
• small blisters in some types, such as pompholyx
• weeping or crusting during a flare
• thickened, leathery skin (lichenification) after repeated scratching
• lighter or darker marks left behind after a flare settles
• disturbed sleep, tiredness and difficulty concentrating at work or school

Triggers differ from person to person, and many flares have no obvious cause at all. Some people find it useful to keep a simple note of flares and what was happening at the time. Possible triggers include:

• soaps, bubble baths, detergents and fragranced products
• heat, sweating and sudden changes in temperature
• cold, dry weather and indoor heating
• certain fabrics, such as wool or rough seams and labels
• stress, worry and poor sleep
• skin infections
• house dust mites, pollen, pet dander or workplace irritants
• hormonal changes, including around periods and pregnancy
• occupational exposure — cleaning products, chemicals, wet work and frequent handwashing

A steady, unglamorous routine usually does more good than any single product. The aim is to keep the skin barrier moisturised and to reduce contact with things that irritate it.

• use emollients (moisturisers) regularly and generously, as advised — including when the skin looks settled
• apply gently in the direction of hair growth rather than rubbing in hard
• use a soap substitute or emollient wash where this has been recommended
• keep baths and showers comfortably warm rather than hot, and pat skin dry
• keep fingernails short and smooth; cotton mittens can help babies at night
• avoid overheating — layers, lighter bedding and a cooler bedroom often help the itch
• choose comfortable, loose clothing and remove scratchy labels
• rinse laundry thoroughly and avoid detergents or conditioners that seem to irritate the skin
• carry moisturiser when away from home, at work or at school
• take emollient from a tub with clean hands or a clean spoon, to avoid contaminating the pot — pump dispensers are often easier

Treatment is usually stepped: everyone uses emollients, and other treatments are added during flares or for more severe eczema. This page does not give doses — follow the instructions from your clinician or pharmacist and the leaflet that comes with the medicine.

Eczema is common in babies and young children and often improves with age. The routine matters more than any single product, and parents and carers should not feel blamed when skin flares.

• keep skin moisturised every day, not only during flares — most children need emollient several times a day
• itching frequently disturbs sleep, for the child and for the whole household; say so at appointments, because it is a measure of severity
• tell nursery or school about prescribed treatments, when they should be applied, and known triggers
• ask for a written treatment plan so different carers follow the same routine
• try not to scold a child for scratching — distraction, cool compresses and keeping nails short usually help more
• ask for medical advice if feeding, growth, sleep, mood, school or everyday life are being affected
• check any medicine questions with a pharmacist or GP; Medicines for Children has plain-English leaflets written for parents

Living with eczema is not only a skin problem. Constant itching, broken sleep and visible skin changes can affect confidence, mood, concentration, relationships, school and work. Comments from other people, or worries about being seen as contagious, can be wearing.

• tell your GP if eczema is affecting your mood, sleep or daily life — it is a legitimate part of the consultation
• ask about adjustments at work or school: gloves, changes to wet work, uniform flexibility, time for treatment, or exam considerations
• peer support can help; the National Eczema Society offers information and a helpline
• talking therapies and habit-reversal approaches can help some people break the scratch cycle
• if someone feels unable to cope, or is having thoughts of harming themselves, get help now — contact NHS 111, a GP urgently, or call 999 in an emergency

Please make an appointment if:

• symptoms are severe, widespread or keep coming back
• itching is stopping sleep or normal activities
• the treatment you have is not helping, or has stopped helping
• you think the skin may be infected (see the panel above)
• you are not sure whether the problem is eczema at all
• eczema affects the eyes or eyelids, face, genitals, hands, or a large area of the body
• a baby or young child has significant symptoms, or eczema is affecting feeding, growth or sleep
• eczema is affecting mental wellbeing, confidence, school or work

A GP can also refer to a dermatology service if the diagnosis is uncertain, the eczema is severe, or usual treatments are not working.

Appointments are short. Taking a few notes usually makes them more useful:

• when did the symptoms begin, and how have they changed?
• where on the body do they appear?
• what makes them better or worse?
• which products, treatments and medicines have already been tried, and for how long?
• is sleep being affected — for the person, or for the family?
• are there any signs of infection?
• are work, school, hobbies or daily activities affected?
• take photographs of flare-ups, because skin often looks calmer on the day of the appointment
• bring a list or photographs of soaps, washes, creams and detergents currently used
• write down your questions in advance, and ask for a written treatment plan

Triggers and treatments vary, so treat the following as ideas to test rather than rules. What works for one person may not suit another.

Eczema is not always caused by an allergy, and most people with eczema do not need allergy testing. These pages may still be useful.