Eczema

Eczema affects around 1 in 5 children and 1 in 10 adults in the UK. It’s also the leading cause of work-related skin conditions, accounting for 84–90% of occupational skin diseases. In milder cases, eczema causes dryness, redness, and flaking. In more severe cases, the skin may ooze, crust over, or bleed.

Eczema Triggers: What to Watch Out For

Eczema flare-ups can be triggered by a range of factors that vary from person to person. Identifying your personal triggers is key to managing symptoms effectively.

Weather Changes

Cold, dry air can strip moisture from the skin, while hot, humid weather and sudden temperature shifts can lead to sweating or irritation, worsening eczema.

Food Sensitivities

Some people notice flare-ups after consuming dairy, eggs, wheat, or soy, though food triggers are uncommon and usually play a minor role in eczema.

Irritants

Everyday substances can inflame sensitive skin. Common triggers include:

• Soaps and detergents
• Cleaning products
• Fragranced lotions or sprays
• Scratchy fabrics (e.g. wool)
• Dust and pollution
• Allergens

People with eczema often have an overactive immune response. Triggers can include:

• Dust mites
• Pet dander
• Mould
• Certain foods (e.g. dairy, nuts, eggs)
• Yeast Overgrowth

Seborrhoeic dermatitis, a form of eczema, can be worsened by an overgrowth of Malassezia yeast, particularly in oily areas like the scalp and face.

Microbial Imbalance

An overgrowth of bacteria such as Staphylococcus aureus is common in eczema-prone skin and may lead to flare-ups.

Skin pH Imbalance

Healthy skin is slightly acidic, which protects the skin barrier. In eczema, pH may become too alkaline, weakening the barrier and increasing sensitivity.

• Dry, flaky skin – often the first noticeable sign
• Itching – can range from mild to intense, and is often worse at night
• Red or inflamed patches – commonly on the hands, face, neck, or behind the knees
• Cracked or scaly skin – especially in chronic cases
• Small bumps – may ooze fluid and form a crust when scratched
• Thickened or leathery skin – due to repeated scratching
• Sensitivity to irritants – soaps, detergents, and rough fabrics may worsen symptoms
• Infected skin – areas may become swollen, sore, or filled with pus if bacteria enter broken skin

Symptoms can vary in severity and may flare up periodically, often triggered by stress, allergens, or changes in weather.

There is currently no cure for eczema, but symptoms can be managed effectively with the right approach. Treatment focuses on avoiding triggers, maintaining a healthy skin barrier, and using the right combination of skincare and medications.

Moisturisers: A Daily Essential

Moisturising regularly is one of the most important steps in managing eczema. Applying a thick emollient several times a day helps lock in moisture, restore the skin’s protective barrier, and reduce the risk of flare-ups. Choose products that are free from fragrances, alcohol, or harsh chemicals, and suitable for sensitive skin.

Key types of moisturising ingredients include:

• Humectants like glycerin and hyaluronic acid to draw moisture into the skin
• Emollients such as shea butter to soften and smooth rough skin
• Occlusives like petroleum jelly to prevent water loss
• Barrier-repair creams containing ceramides and cholesterol to strengthen the skin barrier
• Anti-inflammatory agents like aloe vera to calm irritation

Popular moisturising creams include:

• CeraVe Moisturising Cream – Contains ceramides and hyaluronic acid, ideal for sensitive ski
• Cetaphil Moisturising Cream – Glycerin-rich and non-comedogenic, suitable for daily use
• Doublebase Gel – Combines isopropyl myristate and liquid paraffin to trap moisture
• Aveeno Cream – Contains colloidal oatmeal to soothe itching and irritation

Medicated Creams and Ointments

For flare-ups, prescription-strength creams may be needed.

Topical Steroids reduce redness and inflammation. They come in different strengths and should be used in short courses to avoid side effects such as skin thinning.

• Mild steroids include Hydrocortisone 1%, suitable for sensitive areas
• Moderate options include Clobetasone butyrate (Eumovate) and Mometasone (Elocon)
• Potent steroids such as Betamethasone (Betnovate) or Clobetasol (Dermovate) are used for severe cases

Calcineurin Inhibitors are non-steroidal alternatives used on delicate areas like the face or neck. They reduce inflammation without the risk of thinning the skin.

• Tacrolimus (Protopic) is available in 0.03% and 0.1% strengths
• Pimecrolimus (Elidel) is another option, although not always available over the counter

While moisturisers should be used daily, steroid creams and calcineurin inhibitors are used intermittently, only during flare-ups. A healthcare professional can advise on the right balance.

Oral Medications

Antihistamines are sometimes used to reduce itching, especially if allergies trigger your eczema. They’re not a cure, but can help reduce scratching and discomfort.

• Sedating antihistamines, like chlorphenamine (Piriton) or hydroxyzine (Atarax), may help at night or during severe flare-ups by easing itch and improving sleep
• Non-sedating antihistamines, such as cetirizine, loratadine, levocetirizine, and rupatadine, are often used during the day to relieve itch with minimal drowsiness

Summary

Eczema management requires a personalised approach. While daily moisturising helps maintain the skin barrier, short-term medicated treatments can manage flare-ups. Identifying and avoiding personal triggers, combined with the right skincare and medications, can significantly improve symptoms.

Always consult a healthcare professional before starting new treatments to ensure they are suitable for your skin and condition.