Atopic eczema is a very common, non-contagious, chronic inflammatory skin condition.
While the exact cause is not known, certain factors are thought to be important in its development, these include an inherited predisposition to have a weakened skin barrier, as well as altered inflammatory and allergy responses.
Atopic eczema most frequently begins in infancy but may also develop for the first time in adulthood.
It affects one in five children and up to one in ten adults.
Although there is no cure for eczema yet, there are a number of treatments available to help manage the condition.
Eczema most frequently begins in infancy but may also develop for the first time in adulthood – certain factors such as an inherited predisposition to have a weakened skin barrier, as well as altered inflammatory and allergy responses are thought to be important in its development.
Symptoms include red, dry, itchy skin, which can sometimes weep, become blistered, crusted and thickened.
The appearance of eczema and the locations of the body affected can vary greatly depending on the age of the person affected.
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The main aim is to improve symptoms and achieve long-term control.
In atopic eczema, the skin’s protective barrier is weakened which allows moisture to be lost, and irritants and allergens to pass through the skin more easily.
It is important to remember that on-going (every day), frequent and generous use of emollients form the basis of eczema management, but when your eczema flares up, other treatments, such as topical steroids, are needed and are usually prescribed by your healthcare professional.
For more detailed information about prescribed medical treatments including: topical steroids and other topical treatments (creams or ointments applied directly to the skin), ultraviolet light therapy (also called phototherapy, delivered in hospital dermatology departments), and systemic medications (medicines that work inside your body), please see our What you need to know about eczema booklet.
The skin’s protective barrier is weakened which allows moisture to be lost, and irritants and allergens to pass through the skin more easily.
Emollients are an essential part of daily care, even when skin is clear.
Emollients are moisturisers that are used in two ways – applied directly to the skin as a leave-on moisturiser, and as a soap substitute instead of soap or shower gel which should be avoided as they dry out the skin by stripping away its natural oils.
Used several times a day, emollients help to soothe dry, itchy skin and repair the skin’s barrier, thereby preventing entry of irritants and allergens, which can trigger eczema flares.
Choosing an emollient
Emollients come as lotions, creams and ointments.
Finding the right emollient is often a matter of trial and error but the best emollients are ones that you (or your child) prefer to use and will continue to use every day.
Even when skin is clear, emollients are an essential part of daily care! Used several times a day, emollients help to soothe dry, itchy skin and repair the skin’s barrier, thereby preventing entry of irritants and allergens.
The British Association of Dermatologists developed this video describing the different types of emollients and how to apply them to the skin.
Some practical tips for emollient therapy
- Establish a good daily skin care routine and try to stick to it.
- Don’t stop moisturising when your skin is clear.
- Emollients tend to be bland and fragrance-free (unperfumed); ask your healthcare professional for advice.
- Apply emollients in a smooth, downward motion, in the direction of the hair growth.
- Never stick your fingers into a tub of emollient – always use a clean spoon or spatula.
- A child with atopic eczema often requires a minimum of 250g of ‘leave-on’ emollient per week, while an adult may need approximately 500g per week.
- Bathwater should be a lukewarm temperature. 5 minutes with an emollient bath additive is sufficient.
- Remember – avoid soap, bubble bath and shower gel! Use soap-free products for bathing and specially formulated shampoos.
- After bathing or showering, gently pat skin dry. This is a great time to apply emollient all over when the skin is still ‘slightly humid’.
- Remember to change your tub of emollient at least every six weeks, as it can become contaminated, or use a pump dispenser.
It is very important to establish the right diagnosis and management approach, so if you are concerned about your skin, you should always speak with your doctor.
CAUTION: This article mentions ‘emollients’ (moisturisers). According to the British Association of Dermatologists: “Emollients, creams, lotions and ointments contain oils which can catch fire. When emollient products get in contact with dressings, clothing, bed linen or hair, there is a danger that a naked flame or cigarette smoking could cause these to catch fire. To reduce the fire risk, patients using skincare or haircare products are advised to be very careful near naked flames to reduce the risk of clothing, hair or bedding catching fire. In particular smoking cigarettes should be avoided and being near people who are smoking or using naked flames, especially in bed. Candles may also risk fire. It is advisable to wash clothing daily which is in contact with emollients and bed linen regularly”.
If you need guidance or support about managing a skin disorder, contact the ISF Helpline for free assistance and information.