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Treating atopic eczema in adults

Having eczema (dermatitis) can be challenging. While there's no cure for eczema, the key to keeping it well controlled is to avoid irritants, keep your skin well moisturised, bathe regularly and when needed, use topical (rub-on) steroids.

These photos show skin before and after moisturising.

Avoid irritants (triggers)

Avoid things that make your eczema worse (flare up). Common irritants (known as triggers) include soap, detergent, wool and heat. Once you know your triggers you can try to avoid them. For example, wear soft cotton and keep room temperatures cool.

Keep your nails short

Scratching leads to inflammation and itching (this is called the itch-scratch cycle). Keeping your nails short will stop you scratching yourself.

Moisturise your skin

The main aim of eczema treatment is to keep your skin moisturised and hydrated.

Moisturising products, known as emollients, are applied directly onto your skin to soften it, relieve dryness, reduce itch and provide a protective barrier for your skin.

Emollients are available in creams and ointments. Ointments moisturise your skin better than creams but are also thicker and greasier. Because ointments are greasy, some people like to use a cream during the day and an ointment at night. Emollients can also be used for washing as a soap substitute as soaps and bubble bath can make eczema worse.

There are many types of emollients so you might want to ask your pharmacist for advice. If you have moderate or severe eczema, talk to your GP.

You can buy emollients directly from your pharmacy or get them through prescription from your GP.

Tips on applying an emollient:

Watch this video on how to apply emollients.

Bathe or shower daily

Have a bath or shower every day to help moisturise your skin.

Topical corticosteroids for more severe eczema

Topical steroids come in creams and ointments and help by reducing inflammation, making your skin less red and itchy. They are applied directly to your skin and come in several different strengths.

Usually, you use stronger strength topical steroid cream (or ointment) on your body and weaker strength on your face and in skin folds. It's important to use the correct strength.

Your doctor will tell you the correct strength to use and for how long, depending on how severe your eczema is and what part of the body it's on.

Use the steroid cream when your skin is red and inflamed and stop using it once the redness settles down. Continue using your emollients while using the cream.

How to apply topical steroids:

How much steroid cream to use:

Manage infection

Eczema-prone skin is more likely to get infected and this will make the eczema worse. Infected eczema won't improve with your usual treatments. It can be weepy, crusty or have pus-filled blisters. It can be a small patch or cover a large area of skin.

If you think your eczema is infected, see your doctor as soon as possible. They may prescribe a short treatment with antibiotics, which should clear the infection.

If you get skin infections often, it may help to add an antiseptic into your bath using Oilatum Plus or QV Flare up. They're quite expensive, an inexpensive option is to have a bleach bath.

If you have showers rather than baths, add a gel like Microshield to your soap substitute twice a week to prevent infections.

Getting help for eczema

Speak to your GP if:

If you need to find a GP, you can search on this map.

If you have severe eczema that's not responding well to treatment, your GP may refer you to the Christchurch Hospital Dermatology Department, where you will be seen as an outpatient by a doctor who specialises in skin conditions (a dermatologist).

If you prefer, you can pay to see a private dermatologist. Find a private dermatologist on:

Written by HealthInfo clinical advisers. Page created August 2021.

Sources

Page reference: 37247

Review key: HIEXZ-21485