Atopic eczema symptoms, treatment and causes – Bupa UK

If you had atopic eczema as a child, you may find it improves as you get older. However, certain triggers may still cause it to flare up. There are many different ways of keeping your eczema under control, depending on how severe your symptoms are.

Keeping a diary about your eczema symptoms may help you spot any triggers that make your eczema worse. Common triggers include stress, pets and temperature changes.

If your eczema becomes itchy, try not to scratch it. Scratching can make your eczema worse and may cause your skin to thicken. Anti-scratch mittens for babies and young children can be helpful. If you need to relieve an itch, gently rub your skin with your fingertips instead of using your nails. Keep your nails short.

If your eczema isnt getting better, its especially important to avoid skin irritants such as soaps, shower gels and bubble baths.

Although theres no cure for eczema, theres a range of medicines available from your pharmacist or GP to help control your symptoms. Always ask your pharmacist or GP for advice and read the patient information leaflet that comes with your medicine.

Emollients soothe and soften dry skin. They moisturise your skin by preventing water loss and adding water back into your skin. They can also help to repair any skin damage. Using emollients can ease itching and prevent your skin becoming infected.

Emollients are most effective at preventing flare-ups of eczema if you use them all the time, even when you dont have any eczema symptoms. Apply them as often as you need to ideally at least every four hours or up to three to four times a day. It can also really help to use emollients during and after a bath or shower.

Smooth emollients onto your skin rather than rubbing them in. Always apply them in the direction of hair growth. This will reduce your risk of developing an infection at the bottom of your hair follicles.

Emollients are available as creams, lotions, oils or washes. There are many different types of emollient. Examples are shown in the table below.

Emulsifying ointment, BP

Hydrous ointment, BP

Liquid and White soft paraffin ointment, NPF

Aveeno

E45

Hydromol Cream

Ultrabase Cream

Epaderm

Hydromol Ointment

Zeroderm Ointment

Dermamist spray application

Doublebase gel

QV lotion

Aveeno colloidal bath additive

Cetraben emollient bath additive

Oilatum emollient bath additive

Generally, most emollients will help improve the appearance of your eczema. However, if your eczema is severe, you may need to try a greasier emollient formulation, such as an ointment rather than a cream. Emollient products containing urea may be particularly helpful for severe eczema or in older people. Dont use emollients containing antibacterial ingredients unless your skin is infected or your doctor recommends it.

Different products suit different people. You may have to try several different emollients before you find the best one for you. For emollients that come in pots, use a clean spoon or spatula to get it out when youre applying the emollient to your skin. This will stop the emollient inside the pot becoming contaminated with bacteria.

Sometimes, emollients on their own aren't able to control your eczema symptoms. If this is the case, you may need to use a steroid cream for a short time. Steroid creams reduce inflammation and help to relieve itching. There are different strength steroid creams, from mild to very potent. Mild steroid creams (such as hydrocortisone) are available over the counter. Your pharmacist can offer advice about how much you can use and how often you can apply it. Use the mildest cream that works for you.

If your GP prescribes a steroid cream, always follow their advice about how much to use. You can apply a steroid cream directly to your skin, but only use it on areas with visible eczema. You will usually only need to apply the cream once a day. However, if this doesnt help to relieve your symptoms, your GP or dermatologist may recommend using the cream twice a day.

Always continue using your emollients while you are using the steroids. You can use steroid creams before or after applying your emollient, but you need to leave around half an hour between applying the two different creams. This prevents the active ingredients in your steroid cream from being diluted by your emollient.

Potent or very potent steroid creams, such as betamethasone valerate, are available on prescription. Using stronger steroid creams too often, or on delicate skin (such as on your face), can thin your skin. This can make your skin bruise more easily. Always follow your GP or dermatologists advice about using any type of steroid cream. For more information, see our FAQs.

If emollients or steroid creams dont help your eczema, your GP or dermatologist may prescribe some other medicines. These include the following.

If you have severe eczema, you may need to use medicated paste bandages to soothe and protect your skin. These contain emollients and other medicines, such as ichthammol, to help relieve itching and reduce thickening of your skin. You usually apply them to your arms or legs, and they act as a barrier to prevent scratching.

Your doctor may also recommend using wet wraps, which are cooling bandages that can help to soothe severe eczema. Once you have smoothed an emollient onto your skin, you cover the emollient with wet bandages and then a layer of dry bandages. These wet wraps help to prevent you from scratching and allow your skin to absorb as much of the emollient as possible. These are often useful when treating young children with severe eczema, particularly at night. Dont use bandages or wet wraps if your eczema is infected because this can cause the infection to spread.

Your doctor may suggest trying ultraviolet light (UV) treatment (phototherapy), to relieve your symptoms. This is usually given in hospital by a dermatologist.

Some people consider trying complementary treatments, such as herbal creams and homeopathy. But there isnt any good evidence that these therapies are effective in treating eczema. If you do try them, remember that even products marketed as natural arent necessarily harmless. Herbal remedies contain active ingredients and may interact with other medicines or cause side-effects. Always speak to your pharmacist or GP before trying complementary therapies. If you do decide to try a complementary therapy, check that your therapist belongs to a recognised professional body.

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Atopic eczema symptoms, treatment and causes - Bupa UK