Atopic eczema is a chronic inflammatory skin condition affecting around 15% of children and 10% of adults in the UK. It causes dry, intensely itchy and inflamed skin — and while there’s no cure, it can be managed very effectively with the right approach.

What Is Eczema and What Causes It?

Eczema is caused by a combination of genetic susceptibility and environmental triggers. The fundamental problem is a weakened skin barrier that allows moisture to escape and irritants and allergens to penetrate more easily. This triggers an inflammatory cycle: dryness → itching → scratching → further skin damage → more inflammation. Common triggers: soaps, detergents, synthetic fabrics, dust mites, pet dander, certain foods (in young children), pollen, stress.

The Cornerstone of Treatment: Emollients

Emollients (moisturisers) are the single most important treatment for eczema. They work by restoring the impaired skin barrier — trapping moisture in the skin and forming a protective layer against irritants. For eczema management: apply emollients liberally and frequently (at least twice daily and after every wash), choose ointments or thick creams rather than watery lotions, and use an emollient as soap substitute when washing.

Topical Corticosteroids: Safe and Effective Use

Topical steroids are prescribed for eczema flares. OTC hydrocortisone 1% can be used for mild flares on the body (not on face, broken or infected skin). Apply thinly to affected areas only. Use for a maximum of 7 days OTC; longer use requires medical supervision. Use a fingertip unit (FTU) to guide the amount needed. Common fear about thinning skin is largely unfounded with short courses of mild steroids at appropriate sites — the risk is very real with prolonged use of potent steroids, but not with appropriate use of mild OTC hydrocortisone.

Reducing Itch

Sedating antihistamines (chlorphenamine/Piriton) at night can break the itch-scratch cycle enough to allow sleep. Non-sedating antihistamines have less evidence for eczema itch specifically but are useful if allergic triggers are present. Cool, wet wrapping can be highly effective for severe flares (usually under medical supervision).

Trigger Management

Use non-biological detergents, fabric softener-free washing. Wear cotton or natural fabrics next to skin. Bathe in lukewarm water (not hot). Use fragrance-free skincare products throughout. Maintain cool bedroom temperature and cover duvets to reduce dust mite exposure.

Shop Eczema Products at Chemist 2 Customer. Related: Skincare Guide, Dry Skin Remedies.