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Treating atopic eczema in adults

Rongoā mate harehare mō ngā pakeke

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

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.

Moisturisers (also known as emollients) are applied directly onto your skin. They soften it, relieve dryness, reduce itch and provide a protective barrier for your skin.

Moisturisers 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. Moisturisers can also be used as a soap substitute since soaps and bubble bath can make eczema worse.

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

You can buy moisturisers directly from your pharmacy. Or you can get them through prescription from your general practice team.

Tips on applying a moisturiser:

Watch this video on how to apply moisturisers.

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. You apply them directly to your skin.

They come in several different strengths. Usually, you use a stronger topical steroid cream (or ointment) on your body and a weaker one on your face and in skin folds. It is important to use the right strength.

Your general practice team will tell you the correct strength to use and for how long.

Use the steroid cream when your skin is red and inflamed. Stop using it once the redness settles down. Continue using your moisturiser 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 will not 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 general practice team as soon as possible. They may prescribe a short treatment with antibiotics, which should clear the infection.

If you often get skin infections, it may help to add an antiseptic to your bath using Oilatum Plus or QV Flare Up. They are 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 general practice team if:

If you have severe eczema that is not responding well to treatment, your general practice team may refer you to a Hospital Dermatology Department. There 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. You can find a private dermatologist on Healthpoint.

Written by HealthInfo clinical advisers. Last reviewed February 2025.

Sources

Page reference: 37247

Review key: HICOD-326084