Eczema can be very itchy, making it hard to resist the urge to scratch. Try not to scratch, as scratching can cause inflammation or infection. Children have a particularly difficult time, so keep their fingernails short to limit scratching and have them wear light mittens to bed to prevent scratching during sleep. A cold moisturiser or cooling gel can also help soothe the itch.
Your washing routine
A careful washing routine is important if you have eczema. Very hot water can dry out the skin leaving it susceptible to becoming itchy, so stick to warm water for baths and showers. Consider using a moisturising wash as well as plenty of moisturiser afterwards. Choose a gentle cleanser and avoid harsh or highly fragranced soaps or bubble baths. Don’t scrub at your skin, and gently pat yourself dry before slathering on plenty of moisturiser while your skin is still damp. Moisturising skin soon after washing helps seal in moisture.
The most common type of eczema is atopic eczema – also known as atopic dermatitis - and the best way to soothe it is to keep the skin supple and maintain the skin’s barrier against the elements by regular moisturising. Emollient creams and ointments are more effective than lotions. Keeping supplies at school or work is a good idea. Ask your GP or pharmacist to recommend a product that’s suitable for your skin type, and moisturise as often as possible.
What to wear
Tight clothing and synthetic fabrics can irritate your skin when you have eczema. Also avoid woollens and other coarsely woven materials. Choose loose-fitting clothes made from soft, natural materials like cotton. Some people can also tolerate silk, linen or soft acrylic next to their skin. Pre-wash new clothes before wearing them to avoid potentially irritating chemicals in loose dyes. Use a mild non-biological washing powder, avoid fragranced fabric conditioners and rinse clothes twice to remove soap traces.
Certain triggers, called allergens, can make your symptoms worse. Some allergens linked to eczema include dust mite droppings, mould, pet hair and pollen. Foods like cow's milk, eggs, nuts, shellfish and soya may also be linked to flare-ups. Consult your GP if you think an allergen is triggering your eczema. You can undergo allergy testing or start a symptom diary to help identify allergens and treat allergies.
Topical eczema treatments
Depending on the severity of your eczema, your GP may recommend different strength topical corticosteroids, in addition to emollients. They range from milder treatments, such as over-the-counter hydrocortisone, to stronger treatments like clobetasol propionate. Your GP may also recommend oral corticosteroids for severe flare-ups. Antihistamines may be recommended to relieve itching and antibiotics if the eczema has become infected.
Other eczema treatments
In some cases, including if treatments are not effective, a GP may refer people to a skin specialist or dermatologist. They may recommend and supervise additional treatments, such as light therapy called phototherapy, and medication to suppress the immune system. Psychological support may also be recommended.
Eczema and stress
It’s not fully understood but stress can cause some people to have worse symptoms of eczema. For others, the eczema symptoms themselves trigger stress. Recognising what triggers your stress can help you avoid it. There’s no easy fix but there are ways to minimise your stress-related eczema by regular exercise, relaxation techniques like meditation, relaxing pastimes and talking things through. If your child has eczema, learn to recognise what triggers his stress, such as exams or sporting events. You can help your child manage stress by showing him breathing exercises and encouraging relaxing pastimes.
Body temperature and eczema
Being too hot or too cold can make your eczema worse. Heat produces sweat that can make skin prickly and irritated. During the winter, skin is exposed to indoor heating and low humidity that can cause dry skin and itching. Avoid heavy duvets that make you sweat as you sleep and take short, lukewarm showers, for example, after exercise.
Low self esteem and eczema
About one in five children in the UK are affected by atopic eczema. Eight out of 10 cases develop before the age of 5. Because symptoms can be so visible, children with eczema often suffer the psychological stress of teasing and bullying as well as anxiety, difficulty sleeping and lack of self-esteem. One study found that children with eczema, and their parents, felt that their lives were as difficult as children with more severe diseases. If your child is being picked on or excluded at school, you can get help and support from teachers and your GP.
Slather on sunscreen
Getting sunburned will only make eczema itchier, as your skin flakes and peels. Always wear sunscreen with an SPF of 15 or higher. Consider using sunscreens made for the face, as they are usually less irritating than lotions made for the body. Look for products containing zinc oxide or titanium oxide that are less likely to irritate your skin.
Your eczema outlook
Atopic eczema usually clears up, or significantly improves, in children as they get older. In just over half the children affected (53%) it has cleared up by the age of 11. In 65% of cases it clears up by the age of 16. Some children continue to have dry, irritated skin, or full-blown eczema as they get older. There is no cure for the condition but it can be controlled with treatment. Symptoms are most common in winter months when the air is cold and dry.