HealthInfo Canterbury
Eczema treatments for adults
If you have eczema your skin is prone to being dry and inflamed, so you need to take care to avoid things that can irritate it and make it worse (irritants). These include soaps, detergents, wool, and scratching.
However, even if you avoid irritants, sometimes eczema can flare up for no obvious reason. The key to controlling this is to keep your skin well moisturised and bathe regularly, and to use topical (rub on) steroids when you need them. Antihistamines can sometimes help, and it is also important to manage any infections.
Moisturisers and bathing
Moisturisers
Moisturisers (sometimes called emollients) help to put moisture back into your skin. There are many types of moisturisers specifically for eczema, available as creams and ointments. Normal lotions don't provide enough moisture.
- Ointments moisturise better than creams, but are also thicker and greasier.
- Because ointments are quite greasy, some people like to use a cream during the day and an ointment at night.
You can buy moisturisers directly from the pharmacy or get them through prescription from your GP. Many moisturisers are subsidised, so if you see your general practice team, you may be able to get them at a lower cost.
Tips
- Apply moisturiser at least two to three times a day. An adult should be using about 500 g a week. You can't overdose on moisturiser if you have eczema!
- When you apply moisturiser, smooth it on to the skin in the direction that your hair grows. But don't rub it in – let your skin absorb the moisturiser on its own.
- Use a spoon to get the moisturiser out of the container, and keep your hands out of the container. This helps to stop bugs getting into the moisturiser, and so helps to prevent infection.
Bathing
Having a shower or bath every day helps to moisturise your skin and so will help to control your eczema. To get the most benefit from daily bathing:
- don't have the water too hot (so your skin doesn't dry out), and limit your time in the shower or bath to less than 15 minutes
- avoid soap and liquid soap, as these can dry out your skin. Instead use soap substitutes such as aqueous cream and emulsifying ointment (available from your pharmacy or through your general practice). You can put these on before getting in the shower or bath, then wash them off
- use bath oil to moisturise your skin. You can buy bath oils or dissolve a teaspoon of emulsifying ointment under the hot tap
- use a special shampoo that has fewer irritants, or, if you use a normal shampoo, wash your hair in the sink rather than the shower or bath. If you get eczema or dermatitis on your hands, wear gloves when washing your hair with normal shampoo
- if you often get infected eczema, your doctor may suggest that you add 50 ml of household bleach (for example, Janola) to every 10 cm of water in the bath. However, don't use a bleach bath more than twice a week
- after getting out of the shower or bath, pat your skin dry then immediately apply moisturisers.
Topical (rub-on) steroids
Topical steroid creams can reduce skin irritation and itching that you get with eczema. Make sure you use them as instructed, because you can damage your skin if you use them incorrectly. Your doctor may prescribe a topical steroid for you to try, and will give you specific instructions on how to use it.
Topical steroids are identified by their strength (also called potency), and they range from low potency, for example, 0.5 to 1% hydrocortisone, right up to very potent creams.
Unlike moisturiser, which you should apply liberally, you should only apply a thin layer of a steroid cream. A useful measurement is the finger-tip unit. One finger-tip unit (FTU) is measured as a thin line of cream from the last joint of your index (second) finger to your finger tip. Use this amount of cream to cover an area that is double the size of the palm of your hand.
How much steroid cream to use
Body part |
Number of finger-tip units |
|---|---|
Face and neck |
2.5 |
Trunk |
7 for front 7 for back |
Arm |
3 each |
Hand |
1 each |
Leg |
6 each |
Foot |
2 each |
An average-sized man would use 20 g a day for one whole body treatment, or around 140 g a week. |
|
Apply the moisturiser first, wait 10 minutes, then apply the steroid cream.
Use the steroid cream when your skin is red and inflamed, and stop using it once the redness settles down. You should continue using your moisturisers while using the steroid cream.
Antihistamines
Sometimes an antihistamine can help to reduce itching and scratching, especially at night. Some of these medicines are available over the counter at the pharmacy, but they are cheaper when prescribed by your doctor.
Managing infection
Eczema-prone skin is more likely to get infected and this will make the eczema worse. Infected eczema will not improve with your usual treatments.
Infected eczema can be weepy, crusty, or can have pus-filled blisters. It can be just a small patch or cover a large area of skin.
If you think your eczema is infected, see your doctor as soon as possible. A short treatment with antibiotics should clear the infection.
On the next page: More information about eczema (dermatitis)
Written by HealthInfo clinical advisers. Last reviewed March 2017.
SourcesReview key: HIEXZ-21485
