Atopic dermatitis, commonly referred to as eczema, is a chronic inflammatory skin condition characterised by dry, sensitive skin, redness and itch. It often begins in childhood but can persist into adulthood or develop later in life.
Eczema tends to fluctuate, with periods of flare and improvement. It is associated with a weakened skin barrier and an overactive immune response. Commonly affected areas include the face, neck, hands, inner elbows and behind the knees.
Although there is no permanent cure, eczema can usually be managed very effectively with the right combination of treatments and skin care.
At Atlas Dermatology, management is individualised, taking into account the severity of symptoms, triggers, lifestyle factors and previous treatments.
Treatment options
Skin care and moisturising
Restoring the skin barrier is a cornerstone of treatment.
- Regular use of fragrance-free moisturisers
- Ointments or thicker creams for very dry skin
- Gentle, soap-free cleansers
- Avoiding known irritants and over-washing
Consistent skin care can significantly reduce flare frequency and severity.
Topical treatments
Anti-inflammatory creams are used during flares to control redness and itch.
- Topical corticosteroids of varying strengths
- Topical calcineurin inhibitors (non-steroid options for sensitive areas such as the face and eyelids)
- Topical phosphodiesterase inhibitors in selected cases
These treatments are safe when used appropriately and under guidance.
Phototherapy
For more widespread or persistent eczema, medical phototherapy can be helpful.
- Narrowband UVB is most commonly used
- Reduces inflammation and itch
- Usually delivered several times per week over a defined course
Systemic treatments
For moderate to severe eczema that does not respond adequately to topical therapy:
- Oral immunosuppressive medications such as ciclosporin, methotrexate or azathioprine
- Short courses of oral corticosteroids in selected situations
These treatments require careful monitoring and are tailored to the individual.
Biologic and targeted therapies
Newer targeted treatments have significantly improved outcomes for many patients with moderate to severe eczema.
- Biologic therapies such as dupilumab
- Oral Janus kinase (JAK) inhibitors such as upatacitinib in selected patients
These treatments act on specific pathways in the immune system and can provide substantial and sustained improvement.
Management of itch
Itch is often the most distressing symptom and may require a combination approach:
- Optimised skin care and anti-inflammatory treatment
- Antihistamines in selected cases
- Addressing sleep disturbance and triggers General measures
- Identifying and avoiding triggers such as irritants, allergens, heat, stress and certain fabrics
- Wearing soft, breathable clothingKeeping showers short and lukewarm
- Maintaining a consistent skin care routine
Frequently Asked Questions
Is eczema contagious?
No. Eczema cannot be passed from person to person.
Can eczema be cured?
Eczema is a long-term condition, but it can usually be controlled very well. Many patients experience long periods with minimal or no symptoms.
Why does eczema flare?
Flares can be triggered by dryness, irritants, allergens, stress, infections, heat and environmental factors. Often there is a combination of triggers.
Is it safe to use steroid creams?
Yes, when used correctly. Topical corticosteroids are a mainstay of treatment and are safe under medical guidance. The key is using the right strength, in the right area, for the appropriate duration.
What are biologics and when are they used?
Biologics are targeted treatments used for moderate to severe eczema when other treatments are insufficient or unsuitable. They can significantly reduce symptoms and improve quality of life.
When should I see a dermatologist?
You should seek specialist care if eczema is persistent, severe, affecting sensitive areas such as the face or hands, interfering with sleep or daily life, or not responding to standard treatments. A tailored treatment plan can make a significant difference.