Eczema
What is eczema?
Eczema pronounced eg-zuh-muh is an inflammatory skin condition characterised by dry, itchy and sometimes irritated skin, which can be cracked and sore. It’s also known as dermatitis.
Eczema comes in many forms, each with its characteristics. Each type may look and feel different and have specific triggers, but they all share the common feature of disrupting the skin’s barrier. Eczema is not contagious.
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How to manage eczema
Eczema describes a condition where the skin becomes itchy, dry, red and cracked. Different types of eczema may have symptoms which can cause discomfort and sometimes affect quality of life, however, atopic eczema is the most common type.
While the exact cause of eczema is still being researched, it’s thought to be a combination of genetic and environmental factors. It's important to work with healthcare professionals to accurately diagnose your specific type of eczema and develop an appropriate treatment plan tailored to your needs.
Eczema triggers vary from person to person and depend on the type of eczema someone has. There are lots of things that can trigger eczema symptoms. Some common triggers include:
• Irritants like soaps, shampoos, washing-up liquids and bubble baths
• Perfumes and preservatives in toiletries or cosmetics
• Solvents
• Water, especially hard, chalky water or chlorinated water like swimming baths
• Antiseptics and antibacterials
• Environmental factors like cold, dry weather and dampness
• Allergens like house dust mites, pet fur, pollen and mould
• Food allergies like cows’ milk, eggs, peanuts, soya or wheat
• Certain materials next to the skin like wool and synthetic fabrics
• Hormonal changes, some people may find their symptoms get worse in the days leading up to their period or during pregnancy
• Skin infections, for example, bacterial or viral infections
• Stress
• Change in weather
• Insect bites
• Certain sun creams
• Being unwell
• Teething in babies
• Minor skin injuries like insect bites or burns
• Dry environments and cold climates
In some types of eczema, for example, contact dermatitis or hand eczema, avoiding triggers can help with symptoms.
Although there is no cure for eczema, several treatment options can help manage symptoms and improve the skin's condition. Please note, the treatment options depend on the type of eczema. Most eczema treatments are topical, which means ‘applied to the skin surface’, but in severe cases some people may have to take oral medication, which is taken by mouth.
‘Complete emollient therapy’ can help manage eczema, this means moisturising regularly with gentle, fragrance-free creams or ointments known as emollients. You can also shower with emollients. Using moisturising products helps to keep the skin hydrated and protected.
To control eczema symptoms, it may be appropriate to consider:
• Topical corticosteroids to help reduce swelling, redness and itching
• Antihistamines for itch relief
Other ways to help manage eczema symptoms include:
• Self-care techniques like reducing scratching and avoiding triggers
• Bandages or special body suits to allow the body to heal
• Dietary changes, but it’s important to note, that no significant changes to your diet should be done without speaking to your GP first
• Use a high-protection sun cream and make sure to apply it generously when in the sun
• Use a laundry detergent formulated for sensitive skin
You may also choose to access a Circle Health Group private dermatologist for face-to-face assessment and, if appropriate, treatment1. To help you prepare for an appointment with a doctor or dermatologist, you may wish to complete the Atopic Dermatitis Questionnaire which allows you to better understand the impact of your skin on several aspects of daily life. Your results can be the starting point for a discussion about the best way to manage your eczema moving forward.
Eczema can’t be cured, but just like your local GP, Boots Online Doctor Eczema Treatment Service2 is here to support you if you have been diagnosed with atopic eczema by a healthcare professional. It offers expert advice and, if suitable access to treatment to help you manage your eczema.
Complete an online consultation
Tell us your health history, select pick up in store or delivery & make payment. Takes 5–10 minutes.
Clinical assessment
We’ll review everything within 24 hours and prescribe treatment if appropriate. We’ll message or call you if we have any follow-up questions.
Pick up in-store
We provide simple instructions on how to use your eczema treatment.
Eczema is frequently seen in babies and young children. Eczema, especially atopic dermatitis, often appears in the first six months to five years of a child’s life. Although eczema can occur at any age, it’s commonly seen in childhood, with many people outgrowing it as they enter adulthood. Eczema doesn’t look the same in every child. In more severe cases, there can be weeping, crusting, and splitting of the skin, which can make children even more itchy and can cause discomfort and sleepless nights.
Atopic eczema, contact dermatitis, dyshidrotic eczema and seborrheic dermatitis, also known as ‘cradle cap’, are the most common types of eczema in babies and children. Special care is needed for babies and children with eczema including using over-the-counter medication as directed or any prescription medication as prescribed.
For many types of eczema, managing symptoms can be done by:
• Knowing your child’s triggers to avoid exposure
• Starting a daily bathing and moisturising routine with emollients to protect the skin and lock in moisture
• Wet wraps on moisturised skin to seal in moisture
• Keeping nails short with nail clippers to prevent scratching or using scratch mitts in babies
• Using soft fabrics for clothing
A Boots pharmacist will be able to help you find an emollient which will be suitable for your child. As mentioned earlier, there’s no cure for eczema, but there are new treatments being developed.
Eczema may look and behave differently as your child grows up. It’s important to understand what eczema your child has so you can treat and manage it as they get older. To be sure of the type of eczema your child has, make an appointment with your GP. The location and look of eczema changes as they grow.
As eczema can cause your skin to crack and break, there’s a risk of the skin becoming infected with bacteria, especially if you scratch your eczema. It’s important to be aware of the signs of infections, such as:
• Fluid oozing from the skin
• A yellow crust on the skin
• Small yellowish-white spots on the eczema
• The skin becoming swollen and sore
• High temperature (fever) and feeling generally unwell
If you or your child have any signs of infection, you should speak to your GP. Usually, they’ll prescribe antibiotics to treat the infection and they’ll make sure the skin inflammation is controlled. If your antibiotics don’t work, speak to your GP again.
If your eczema becomes infected with the herpes simplex virus (which causes cold sores), this can develop into a condition called eczema herpeticum, which has the following symptoms:
• Areas of painful eczema that get worse quickly
• Groups of fluid-filled blisters that break open and leave small, shallow open sores on the skin
If you think you have eczema herpeticum, contact your GP straight away. If you can’t contact your GP, call NHS 111 or go to your nearest hospital. They may prescribe an antiviral medicine.
When your infection has cleared, a GP will prescribe new supplies of creams and ointments to avoid any contamination. If you have any old treatments remaining, throw them away to avoid getting the infection again.
Atopic eczema, also known as atopic dermatitis, is the most common form of eczema. One in every five children in the UK is affected by atopic eczema at some stage. It might also start later in life in those who didn’t have eczema as children. It often begins in infancy and is characterised by dry, itchy and inflamed skin. Atopic eczema tends to run in families with a history of allergies, asthma or hay fever. Some people only have small patches of dry skin, but other people may have widespread red, inflamed skin all over the body. On lighter skin, the inflamed skin can look red, and on darker skin, it can look purple or grey. It can also be harder to see on darker skin.
It can affect any part of the body, but the most common areas that can be affected are:
• Backs or fronts of the knees
• Outside or inside of the elbows
• Around the neck
• Hands
• Cheeks
• Scalp
People who have atopic eczema usually have times when their symptoms are less noticeable, as well as times when their symptoms are more severe (this is called a flare-up). These may happen as often as two or three times a month. The severity of atopic eczema can vary. In mild eczema, you may only have small areas of dry skin that are sometimes itchy, but in more severe cases, the inflammation can spread all over the body and the itching can be constant. If you have symptoms of atopic eczema, it’s important to see a GP so that they can diagnose you. You may wish to complete the Atopic Dermatitis Questionnaire as this may help you communicate the severity of your symptoms and the impact that they have on your quality of life.
Atopic means it runs in families and or affects people who already have other types of allergies. If someone has atopic eczema, they’re more likely to have more than one allergy, for example, eczema, asthma, hay fever or a food allergy. There’s currently no cure for atopic eczema, but there are some treatment options that can help relieve the symptoms and help improve the cases.
Treatment options include:
• Using emollients every day to stop the skin from becoming dry
• Using topical corticosteroids in the form of creams and ointments to reduce swelling and redness during flare-ups
• Antihistamines for itching
• More powerful treatments offered by a skin specialist (a dermatologist)
It’s also helpful to try to reduce the damage from scratching. As eczema is sometimes itchy, it can be very tempting to scratch the areas that are affected. Scratching usually damages the skin, which can make eczema worse. A GP can work with you to help work out what’s triggering your flare-ups. Once you know your triggers, you can try to avoid them.
For example:
• Avoiding wearing certain fabrics that irritate your skin, and stick to soft, fine-weave clothing or natural materials
• Keeping the rooms in your home cool if your eczema is made worse by heat
• Using soap substitutes if soaps and detergents affect your skin
Contact dermatitis is a type of eczema which is triggered when the skin comes into direct contact with an irritant or allergen. It makes the skin itchy, blistered, dry and cracked. It can be further divided into two types: irritant contact dermatitis and allergic contact dermatitis.
Irritant contact dermatitis is caused by exposure to things like chemicals or detergents, while allergic contact dermatitis is triggered by an allergic reaction to certain substances, such as metals, fragrances or latex. It normally improves or clears up completely if you avoid the trigger, but treatments are also available to ease symptoms.
Contact dermatitis can look like:
• In lighter skin: red
• In darker skin: dark brown, purple or grey
If your contact dermatitis is bothering you, you can speak to a Boots pharmacist who can recommend emollients which can stop your skin from getting dry. If you have persistent, recurring or severe symptoms of contact dermatitis, you can see your GP who can try and identify why it’s happening and then suggest suitable treatments. If you’re diagnosed with contact dermatitis, Boots Online Doctor Contact Dermatitis Service2 can also help with suitable treatments.
Discoid eczema, also known as nummular eczema, is characterised by round or oval-shaped patches of red, swollen and cracked skin. The patches can range in size from a few millimetres to a few centimetres and can affect any part of the body, but they don’t usually affect the face or the scalp.
The patches are sometimes swollen and covered with small fluid-filled pockets (blistered), which can ooze fluid at first, but they can crust over and become dry, cracked and flaky over time. The patches might clear up on their own, but without treatment, this can take weeks, months or even years. They tend to be very itchy, especially at night.
Its cause is unknown, but it might happen due to having particularly dry skin. This is because when you’ve got dry skin, there’s no protective barrier against substances, so even potentially harmless things like soap, can irritate your skin.
Other triggers include:
• Minor skin injuries like an insect bite or a burn
• Dry environments and cold climates
• Some medicines, but it’s important to remember that you should not stop taking any prescription medications without speaking to your GP
On lighter skin, the patches will be pink or red. On darker skin, the patches can be dark brown or sometimes paler than the surrounding skin.
Discoid eczema can affect any part of the body, but it doesn’t usually affect the face or scalp. Because the patches form rings, it can often be mistaken for ringworm. In some cases, patches of discoid eczema can sometimes become infected. It’s important to see your GP if you have any signs of infection (which are covered in the ‘signs of infection’ section).
Seborrheic dermatitis commonly affects areas that have many oil glands (sebaceous glands) like the scalp, face and upper chest. It rarely causes severe harm, but it can be uncomfortable to live with the symptoms.
It’s characterised by red, scaly patches that may be accompanied by itching. Seborrheic dermatitis can also occur in infants (cradle cap) and is often linked to an overgrowth of Malassezia yeast on the skin. Malassezia yeast normally lives on the skin, but it can overgrow, which causes the immune system to overreact, leading to a fungal infection that results in skin changes.
There are certain medical conditions that can increase people’s risk of developing seborrheic dermatitis including:
• Psoriasis
• HIV
• Acne
• Rosacea
• Parkinson’s disease
• Epilepsy
• Alcoholism
• Depression
• Eating disorders
• Recovery from a stroke or heart attack
For many children and some adults, seborrheic dermatitis goes away on its own, but if not, there are effective methods of managing the symptoms and helping to stop future flare-ups. Regular anti-dandruff shampoos can be used to manage a scalp prone to dandruff. There are different types that can be bought from pharmacies or supermarkets, and there are medicated shampoos that can be used as a treatment rather than a hair wash.
Shampoo to treat dandruff often contains one of these ingredients:
• Zinc pyrithione
• Salicylic acid
• Selenium sulphide (sometimes written as selenium sulfide)
• Ketoconazole
• Coal tar
If ever unsure, a Boots pharmacist can tell you how to use the shampoo. Use the shampoo for a month to see if your dandruff improves but note that you might need to try more than one type to find one that’s suitable for you. You should speak to your GP if you have any severe flare-ups or have worse symptoms than usual.
You should also see a GP if:
• You still have dandruff symptoms after using anti-dandruff shampoo for a month
• Your dandruff is bad or your scalp is very itchy
• Your scalp is red or swollen
• You have flaky, itchy patches on your face or other parts of your body
In cases like this, your doctor can help you develop a treatment plan that’s suitable for you.
If your baby has cradle cap, there are things you can do to help:
• You can lightly massage an emollient on your baby’s scalp to help loosen any scales
• You can gently brush your baby’s scalp with a soft brush and then wash it with baby shampoo
• Don’t use olive oil, as it may not be suitable for skin use
• Don’t use peanut oil because of the risk of allergies
• Don’t use soap or adult shampoos
• Don’t pick crusts as this can increase the chance of infection
Your pharmacists can also help with cradle cap. You can ask them about emollients suitable for babies, unperfumed baby shampoos and barrier creams that you can use if your baby’s nappy area is also affected.
Neurodermatitis which is also called lichen simplex chronicus, is characterised by thick, scaly patches of skin that are often intensely itchy. It’s commonly caused by repetitive scratching or rubbing of an area, leading to the thickening and discolouration of the skin. The most common areas to develop neurodermatitis are places that can be easily itched like:
• Feet
• Ankles
• Hands
• Wrists
• Elbows
• Shoulders
• Neck
• Scalp
• Eyelids
• Genital and anal areas
Unlike atopic dermatitis, which can be widespread, neurodermatitis is usually confined to one or two patches of skin. It rarely goes away without any treatment and due to the extreme itchiness, nerve endings in the skin can be irritated. Neurodermatitis can be triggered by tight clothing, especially if it's wool or synthetic fabric, insect bites, nerve injury and dry skin.
Treatment and management of neurodermatitis is aimed at healing the skin and reducing itching. Topical steroids can be used to help calm any inflammation and itching. Covering the affected area can also help control the itching and make it harder to scratch.
Varicose dermatitis, also known as stasis, venous or gravitational dermatitis, is common in people with varicose veins. It affects the lower legs and tends to be a long-term problem. However, treatments are available to help keep it controlled.
Varicose dermatitis is often caused by increased pressure in the veins in the leg, rather than triggers like other types of eczema. The small valves in the veins can stop working, which makes it harder for blood to be pushed up. This means it can leak backwards, increasing the pressure in the veins. It’s thought that varicose eczema can develop because of the immune system reacting to the excess fluid.
There are some factors that increase the chance of getting varicose dermatitis:
• It’s more common in women
• Being obese can increase the pressure in your leg veins
• Being pregnant can increase the pressure in your leg veins
• A family history of venous insufficiency, which is where the veins in your leg have trouble returning blood back to your heart
• Previous deep vein thrombosis
• Not being able to move your legs for a long time
• Increasing age
Varicose dermatitis can look:
• Itchy and swollen
• Dry and flaky
• Scaly, crusty or blistered
On white skin, it looks red or brown, and on black or brown skin, it tends to look dark brown, purple or grey, which sometimes makes it more difficult to see. There can be times when the symptoms get better, and times when they get more severe.
Varicose dermatitis may make your legs swollen, especially at the end of the day or after standing for a long time. Varicose veins are sometimes visible too. Other symptoms include:
• Tender and tight skin that can eventually harden (lipodermatosclerosis)
• Small, white scars (atrophie blanche)
• Pain
• Eczema on other parts of the body
If varicose dermatitis isn’t treated, it can cause leg ulcers to develop. Leg ulcers are wounds that form where the skin is damaged. If you have any symptoms of varicose dermatitis, speak to your GP and they will be able to help you make a diagnosis. They might refer you for further tests depending on the severity.
Managing varicose dermatitis symptoms is like other types of eczema. The aim of treatment or management is to improve the condition of your skin, treat your symptoms and help improve your blood flow.
For many people, treatment and management might involve long-term treatment which is a combination of:
• Self-help techniques
• Emollients
• Topical corticosteroids
• Compression stockings can also be used to squeeze your legs tightly and help improve your circulation
Hand eczema is one of the most common types of eczema and it mainly affects the hands, especially the palms. It can affect about one in every 20 people. Three types of eczema can cause hand eczema:
• Atopic eczema
• Contact dermatitis
• Dyshidrotic eczema (pompholyx)
Alongside dryness, the main symptoms are:
• Rashes
• Itchiness
• Scaly skin
• Chapped skin
• Small blisters
• Painful cracks
• Cuts
In many people, the cause of hand dermatitis is unknown, and there’s no identifiable trigger however, some triggers can include:
• Irritants
• Allergens
• Frequent handwashing
• Cleaning agents
• Chemicals in acrylic nails
It’s also common for someone to have more than one trigger for their hand eczema.
The skin on your palms is thicker than other places on your body (apart from your feet) so normally it can cope with a substantial amount of wear and tear. However, if you regularly have your hands wet in detergents or solvents, the protective barrier of the skin can break down, allowing eczema to develop.
In most cases, treatment can help with hand eczema, but it doesn’t cure it. Avoiding the allergens can help, but emollients are an essential part of treating it. Emollients can help to repair the outer skin and lock moisture in the skin. Carrying a hand cream (that’s suitable for eczema-prone skin) to keep your hands moisturised and protected is also a good idea.
Using an emollient as a soap substitute can help clean the skin without drying and damaging it as other soaps can. Steroid creams and ointments are commonly prescribed treatments for hand eczema, if suitable, as they can help relieve symptoms and calm the skin.
Dyshidrotic eczema, also known as pompholyx, is characterised by small, itchy blisters that mainly affect the palms of the hands and soles of the feet. It’s usually a long-term condition and the symptoms usually last two to three weeks at a time, but treatment can help control the symptoms.
Symptoms of pompholyx include:
• Itchy blisters which may leak fluid
• A burning or prickling feeling in the affected area
• Redness
• Peeling
• Flaking
It’s recommended to speak to your GP if:
• You think you have pompholyx
• You have pompholyx and the blisters are very painful, leaking yellow or green pus or are covered in a yellow-brown crust (these are signs of infection)
• You have any other changes to your skin that you’re worried about
The exact cause of pompholyx isn’t clear, but certain things are thought to trigger symptoms including:
• Contact with strong chemicals like soaps, cleansers and detergents
• Allergies or sensitivities to certain metals like nickel or cobalt
• Getting your hands wet regularly for example being a hairdresser
• Stress
• Heat and sweat
There are things you can do to manage symptoms of pompholyx like:
• Washing your hands with warm water and using an emollient soap rather than a regular soap
• Wearing protective gloves while handling chemicals like shampoos, cleansers and detergents
• Wearing socks, tights or stockings made from cotton or silk, not nylon
• Wearing leather shoes instead of plastic or rubber
• Avoiding triggers
Treatments for pompholyx include:
• Moisturisers (emollients) are used daily to stop the skin from becoming dry
• Steroid creams and ointments (topical steroids) are used for a few weeks at a time to help reduce soreness
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Frequently Asked Questions
Eczema is not contagious so you cannot catch it from someone else.
There’s no cure for eczema, but treatments can ease the symptoms. The main treatments for eczema are emollients (moisturisers) – used every day to stop the skin from becoming dry, however, some types of eczema for example contact dermatitis, can improve if its triggers are avoided.
Seborrheic dermatitis also known as seborrheic eczema often results in dandruff as well, which can vary in severity.
1Subject to availability. Eligibility criteria may apply. Charges may apply.
2Access to prescription-only treatment is subject to an online consultation with a clinician to assess suitability. Subject to availability. Charges apply.
