Eczema (or atopic dermatitis)

It is a long-term, or chronic, condition which often occurs alongside asthma, hay fever and other allergies.

Atopic eczema is the most common form of the condition and it mainly affects children, (but is known to continue into adulthood).

Eczema is very common and up to one in five children in the UK have some form of eczema.

Symptoms of eczema include

• Red, brownish-gray coloured patches of skin
• Cracked or scaly skin
• Itching, which can be severe, especially at night
• Small, raised bumps, which can leak fluid and crust over after being scratched
• Skin becomes raw and sensitive as a result of scratching
  

Where eczema commonly occurs

Though patches of eczema can occur anywhere on the body, they most often appear on hands and feet, in the front of the bend of the elbow, behind the knees, and on the ankles, wrists, face and neck.

Eczema can also affect the skin around the eyes, including your eyelids. Scratching can cause redness and swelling around the eyes.

What can make eczema worse?

• Dry skin
• Stress
• Hard water
• Sweating
• Soaps, detergents, wool or man-made fabrics, dust
• Living in highly polluted areas
• Some foods like eggs, milk, fish, soy or wheat
  

Treatment of eczema

There are a range of medicines available from your GP/pharmacist to help control symptoms of eczema, although at present there is no cure for the condition.

Steroid creams

These creams contain steroids, such as hydrocortisone, which work to reduce inflammation and to relieve itching. There are different strength steroid creams available which need to be matched to the severity of an individual's symptoms.

All steroid creams need to be applied thinly and only over the affected areas. We recommend you use the mildest cream that works for you. Steroid creams should be applied once or twice a day to manage symptoms. Spread the cream thinly over your skin and use emollients before applying steroid creams to give moisture to the skin.

Stronger steroid creams, such as betamethasone (better known to eczema sufferers as Betnovate) are available via prescription. Using stronger steroid creams to often, especially on delicate areas like ones face, can thin your skin. This can make your skin bruise more easily.

Other treatment on prescription

If steroid creams don’t help your eczema, there is a range of other medicines available on prescription.

• Topical immunosuppressants, such as tacrolimus (most notably Protopic) or pimecrolimus are creams that you apply to your skin to reduce inflammation. You may be prescribed these if other treatments haven’t worked or if you can’t use them because of their side-effects as a result of the steroid.
• Antibiotics, such as flucloxacillin or erythromycin, are used if your eczema has become infected.
• Antihistamine tablets are not often recommended, however if your eczema is stopping you from sleeping, they may be prescribed to reduce irritation and itching, which in turn will greatly improve your quality of life.
• Oral steroids, such as prednisolone, are available as tablets to treat severe eczema. You will be prescribed these for as short a time as possible but they should be used as a last resort.
  

Hospital treatment from a dermatologist

If you have severe eczema and none of the more conventional treatments mentioned above have helped, you may need to come in and see a dermatologist at one of our hospitals.

This may include the use of medicated paste bandages to soothe and protect your skin. This is especially effective on young children and can help limit scratching. There is also the option of ultraviolet light treatment, known as phototherapy.