Eczema

What is eczema?

Eczema is an umbrella term for several types of skin inflammation. The most common form — atopic eczema — is closely linked to a family history of asthma, hay fever, and food allergies. It is caused by a combination of a defective skin barrier and immune dysregulation that makes the skin hypersensitive to irritants and allergens.

Other types include contact dermatitis (triggered by direct contact with an irritant or allergen), seborrhoeic eczema (affecting oily areas like the scalp and face), and discoid eczema (coin-shaped patches typically on the limbs).

Symptoms

• Intense itching — often worse at night and disrupting sleep
• Dry, sensitive skin that may crack, bleed, or weep during flares
• Red or darkened, inflamed patches — commonly on the face, neck, hands, inner elbows, and behind the knees
• Thickened or leathery skin (lichenification) from repeated scratching
• Small, raised bumps that may weep fluid when scratched
• Skin infections — the damaged barrier increases vulnerability to bacterial and viral infections

Common triggers

• Soaps, detergents, shampoos, and harsh skin care products
• Allergens — house dust mites, pet dander, pollen, and mould
• Certain foods — particularly in young children
• Stress and emotional upset
• Heat, sweating, and temperature changes
• Scratchy fabrics such as wool
• Hormonal changes — flares often worsen around menstruation

When to see a doctor

See a doctor if eczema is affecting your sleep, school, or work — or if over-the-counter moisturisers are not providing sufficient relief. Signs of skin infection (increased redness, warmth, oozing, or crusting) require prompt medical attention.

Treatment options

• Emollients — the cornerstone of management, applied generously and frequently to restore the skin barrier
• Topical corticosteroids — applied during flares to reduce inflammation rapidly
• Topical calcineurin inhibitors (tacrolimus, pimecrolimus) — steroid-free options for sensitive areas or long-term maintenance
• Antihistamines — for itch control, particularly at night
• Antibiotics — for secondary bacterial infections
• Dupilumab (biologic) — a highly effective injection for adults with moderate-severe eczema not controlled by topical treatments
• Trigger identification and avoidance to reduce the frequency of flares

How eMedClinic can help

Our dermatologists provide personalised eczema management plans, prescribe effective treatments, and help identify your specific triggers. Whether you are newly diagnosed or managing long-term eczema without access to your usual dermatologist, we provide expert English-speaking care online.