Until having two children who suffer from eczema, I hadn’t experienced the condition first-hand, and so hadn’t realised how horrendous it can be. However, when my oldest child developed shocking red patches of eczema all over her body – so itchy she’d sometimes be dragging herself along the carpet to try and relieve the discomfort – I started to realise what I was up against.
Five years later, and after numerous GP appointments (most of which were useless), hours of Googling, dozens of products that Mumsnet users said would ‘cure’ eczema (again often useless) and several trips to the dermatologist, I now find myself an amateur expert on eczema.
Annoyingly, I’ve also realised that it’s one of those tricksy conditions where one person’s miracle solution – a high street body lotion or easy-to-do lifestyle change – does naff-all for another. If there’s one thing I do recommend, it’s getting yourself to a dermatologist – preferably one specialising in eczema – as soon as possible.
Of course, getting access to a dermatologist often means going down the private medical route (NHS dermatologists do exist, but the waiting lists are long), which is not possible for everyone.
In the meantime, I’ve spoken to Dr Angelika Likhtareva, dermatologist at ALTA Medispa and Dr Mazin Al-Khafaji of dermatology-m.com, for their tips and guidance on this irritating condition.
What is eczema and how does it appear on the skin?
‘Eczema – also known as dermatitis – is a broad term used to describe a group of inflammatory skin disorders that cause the skin to become red, itchy, dry, and often scaly or cracked,’ says Mazin. ‘In more acute stages, it may also ooze, blister, or become weepy and crusty, while in chronic cases the skin can thicken, become leathery (known as lichenification), or develop persistent pigmentation due to repeated scratching or rubbing.
Eczema can often manifest in itchy, stubborn patches on the skin and some creams can help
‘Eczema is not a single disease but a pattern of reactivity in the skin, and it can present in many different ways depending on the individual and the specific type of eczema involved. Several subtypes are recognised, each named according to either the underlying cause or the characteristic appearance and location of the inflammation.’
Mazin outlines the various types of eczema below:
• Atopic eczema, by far the most common form of eczema, is linked to a genetic tendency toward allergic conditions such as asthma and hay fever and most often begins in childhood. Most often manifest in the flexures of the limbs (elbows, knees etc).
• Nummular eczema presents as round, coin-shaped patches that are typically blistering, itchy, and inflamed.
• Pompholyx (dyshidrotic) eczema affects the palms of the hands and soles of the feet, causing small, intensely itchy blisters.
• Contact dermatitis results from direct irritation or allergic reaction to substances that touch the skin, such as soaps, detergents, or metals.
• Contact allergic dermatitis is caused by an allergic reaction to specific substances that meet the skin, such as nickel, fragrances, preservatives, or certain plants.
• Seborrhoeic eczema (also known as Seborrhoeic dermatitis) affects areas rich in sebaceous glands (oil glands) so mostly affects the scalp, face, or chest.
Why is eczema sometimes misdiagnosed?
Getting eczema – as well as other skin conditions – properly diagnosed can be difficult. According to Mazin ‘eczema can closely resemble several other skin conditions, such as fungal infections or psoriasis, which can lead to misdiagnosis. This is partly because eczema is not a single, uniform disease – its appearance can vary widely from person to person, and especially in children; it often presents in atypical ways.’
Short, perfunctory medical appointments can also be an issue, says Likhtareva, ‘especially in a GP setting where time is limited. Unless someone’s really familiar with the nuances of different skin issues, they might just label it as “dry skin” or a rash, when in fact it’s part of a wider barrier dysfunction issue.’
Why is eczema often mistreated?
Bagging yourself a hard-to-get GP appointment, only to be prescribed a cream (often steroids) that doesn’t make your eczema go away, can be hugely disappointing. Even if the medication does work, you may find that as soon as you finish the prescribed course the eczema comes roaring back.
‘Many treatments focus on short-term symptom relief, rather than getting to the root of the issue,’ says Likhtareva. ‘In children especially, GPs tend to reach for the same handful of emollients or low-strength steroids without tailoring the treatment to the child’s skin, triggers, or environment. Parents are often left frustrated – and understandably so.’
You may think slathering yourself in moisturiser is key, but you need to pick your potion carefully. ‘Moisturisers often work by forming an occlusive barrier to reduce water loss, but they do little to actively support the skin’s own production of vital lipids such as ceramides and filaggrin – both essential for maintaining a healthy barrier,’ says Mazin. He is keen to stress that looking at the causes of eczema is as important as addressing the symptoms. ‘Treatment is typically reactive, limited in scope, and overlooks broader systemic or environmental influences,’ he adds.
If shop-bought products or GP prescriptions are not working, you need to see a dermatologist to get to the root of the problem, and have a bespoke skincare program prescribed. ‘In my experience, a dermatologist can provide a much more targeted approach, including lifestyle advice, stronger barrier-support products, and proper flare-up management,’ says Likhtareva.
Who is most prone to eczema?
‘Eczema is incredibly common in children – especially those with a family history of atopic conditions like asthma, hay fever, or allergies. But it’s not exclusive to kids,’ explains Likhtareva. ‘Adults can develop eczema later in life, particularly if they have underlying sensitivities or work in environments with irritants.’
For those who suddenly develop eczema later in life, ‘triggers can include high levels of stress, hormonal shifts (especially during pregnancy or menopause), environmental factors like cold weather or central heating, or even certain skincare products,’ says Likhtareva. ‘Skin barrier health naturally declines with age too, which can make us more reactive over time.’
Mazin agrees: ‘Individuals with compromised immunity, high stress levels, poor dietary habits, or a tendency toward inflammatory or allergic responses are generally more susceptible.’
How should you treat eczema?
As well as visiting a dermatologist to get a proper treatment plan in place, there are other things you can do to help improve and manage eczema flare-ups.
‘Keep your skincare simple and focused on repair,’ says Likhtareva. ‘Use fragrance-free, lipid-rich moisturisers with ceramides, niacinamide, or colloidal oatmeal, and avoid foaming cleansers or hot water. It’s also worth looking at lifestyle factors from managing stress, to keeping nails short to reduce scratching. Diet can play a role for some too – common culprits include dairy, gluten, or highly processed foods, though this varies person to person.’
Avoiding known triggers is key, says Mazin. ‘It’s important to avoid synthetic fragrances, harsh detergents, and petroleum-based creams, all of which can further disrupt the skin barrier.’
He also recommends you avoid overheating the body – ‘this includes excessive consumption of spicy food, alcohol, shellfish etc as well as late nights, excessive stress all of which can aggravate “internal heat” and trigger flares,’ says Mazin.
‘Support digestion by reducing – or ideally avoiding – ultra-processed foods (UPFs), refined sugar, and other inflammatory triggers,’ he adds. ‘A healthy, balanced diet rich in a wide variety of vegetables, fruits, berries, nuts, and seeds (provided there are no allergies) is key. Also avoid any foods that clearly aggravate your skin, such as alcohol or shellfish.’
‘Consistency is everything,’ says Likhtareva. ‘Eczema can’t be “cured” overnight, but you can absolutely manage it long-term. Keep a diary to track flare-up triggers, stay moisturised year-round (not just when it’s dry), and seek expert support if you’re not getting results. And remember – what works for one person might not work for another, so be patient while you find what suits your skin.’
Are steroids effective for treating eczema?
Steroid creams are often the go-to method for treating eczema flare-ups, but this can make users (and especially parents of young children who are prescribed them) feel nervous.
‘Steroids are a valuable tool when used correctly – they reduce inflammation and help bring a flare under control fast,’ says Likhtareva. ‘The fear comes from long-term, unsupervised use, which can lead to skin thinning. But with a personalised plan and proper guidance, they can be safely incorporated into an eczema routine. For anyone nervous, it’s about using the right strength for the right duration – and always tapering off gradually, rather than stopping cold turkey.’
Dr Angelika Likhtareva, dermatologist at ALTA Medispa, shares her advice on eczema
Does eczema damage the skin in any lasting way if left untreated?
Obviously few people would decide to leave eczema untreated in kids, but some adults might feel the need to grin and bear it rather than addressing the problem.
However, Likhtareva says long-term damage can occur if eczema is left untreated. ‘Constant scratching and inflammation can thicken the skin over time (a process known as lichenification), cause pigmentation issues, and increase the risk of infection,’ she says. ‘That’s why early intervention and ongoing management are so important. Eczema isn’t just cosmetic – it can really affect quality of life, especially in children, so taking it seriously matters.’
Mazin adds: ‘Repeated scratching breaks the skin’s barrier, increasing the risk of secondary infections that further drives the inflammation and complicate the picture further. However, with proper and consistent treatment – even in long-standing cases – much of this can be reversed or significantly improved.’
Can you do anything to soothe the itchiness of eczema during a flare-up?
Mazin recommends avoiding hot showers, which can increase itchiness, and if possible resisting the urge to scratch. ‘Gently patting or tapping the skin can help ease the sensation without causing further damage,’ he says.
Likhtareva’s tips include ‘applying moisturiser straight from the fridge, using cold compresses, or soaking in a lukewarm bath with colloidal oatmeal. Anti-itch creams with menthol or pramoxine can also help. Protective clothing or gloves at night can be useful to resist scratching.’
Any advice for those who want to disguise eczema with make-up?
‘Always choose fragrance-free, hypoallergenic products, and test them on a small patch of unaffected skin before full application,’ advises Mazin. ‘Begin with a protective barrier – such as a gentle, non-irritating moisturiser – before applying any cosmetic product. This helps shield the skin and minimises the risk of further irritation. Remove the make up as soon as it’s no longer needed using a gentle and effective cleanser.’
If redness is an issue, then Likhtareva says a green-tinted primer can help neutralise this. ‘Mineral foundations are often better tolerated than liquid formulas,’ she says. ‘Never apply make-up to broken or weeping skin – it’s better to treat first, cover later.’