From one sufferer to another, consider this your need-to-know on the irritating skin condition, from what causes a flare-up to how it can be managed
I’ve suffered with eczema for as long as I can remember. Flare-ups are a year-round thing; in the summer the combination of heat and hay fever symptoms make it worse, while in winter the harsh weather exacerbates the dry, splitting skin.
And I’m by no means alone in being driven mad by the skin condition. According to Allergy UK, as many as 15 million people are living with it in the UK alone. But despite its prevalence a lot of us still aren’t really sure what causes it or how we can keep the symptoms at bay.
Eczema varies from person to person – what works for me may be completely different to what works for you – so to explain it thoroughly, we asked some of the country’s top dermatologists to shed some light on the skin condition.
What is eczema?
‘Also referred to as “dermatitis”, eczema is a chronic inflammatory skin condition that can make your skin red, dry and itchy,’ says Dr Walayat Hussain of Bupa Health Clinics. ‘There are a number of different types, and the type you have determines which treatment options are best for you.’
If you’re experiencing uncomfortable hot and rashy skin that then becomes dry and itchy, there’s a good chance that it’s eczema, but your GP will be able to confirm a diagnosis. It can appear pretty much anywhere on the body; it’s possible to get eczema on hands, feet, legs, arms, torso and eczema on the face.
Although eczema in babies is very common, many people will experience symptoms throughout adulthood too.
Are there different types and causes of eczema?
Despite usually being referred to as simply ‘eczema’ there are quite a few different types, each with its own specific set of causes and treatment options. Read on for a breakdown of each below.
Also known as pompholyx, dishydrotic eczema appears as tiny, fluid-filled blisters usually on your hands and feet. They look like raised pinpricks covering the top of hands or feet or in patches between the fingers and toes, and are incredibly itchy, becoming even more sore if they burst as your skin tries to heal.
While the exact causes are unknown, it’s thought dishydrotic eczema is triggered by stress or upon contact with allergens.
Also known as atopic dermatitis, this is the most common type of eczema, often found in people who also have asthma, hayfever and allergies. ‘This can be genetic and you may notice your skin gets irritated on the face, in front of the elbows and behind the knees,’ says Dr Hussain. ‘It usually flares up if you have allergies and come into contact with soaps, detergents or other types of chemicals.
‘Although there is no cure for atopic eczema, your GP or dermatologist may prescribe you with a specific type of moisturiser known as an emollient. These work by restoring water and oils to your skin to soothe and hydrate it, as well as helping to repair the damaged skin.’
This type appears when your skin becomes sensitised to something in the environment. ‘Unlike a peanut allergy, which occurs immediately upon exposure, contact dermatitis develops over a period of time as your body becomes sensitised to something you may have been using or wearing for years, such as nickel in jewellery,’ says Dr Hussain.
‘Contact dermatitis often affects your hands, so avoid this, consider what products you’re using that maybe irritating your skin and try shielding your hands from them. Your GP may refer you to a specialist Dermatologist who performs patch testing, which can help identify what you’re allergic to.’
This type appears as very itchy, flat red patches of inflamed skin, usually on the arms and or legs, and is most commonly found in middle aged or elderly people. ‘We don’t know what exactly causes discoid eczema, but in keeping with other types, your skin loses moisture and therefore struggles to provide an effective barrier against substances,’ says Dr Hussain. ‘This means usually harmless substances, like soap, can irritate your skin.
‘Although there’s no simple cure for this type of eczema, your dermatologist or pharmacist can recommend some medications to help ease the symptoms, along with daily moisturising.’ Read our guide to the best moisturiser for dry skin and choose a gentle formula for eczema-prone skin.
In seborrhoic eczema, inflammation usually occurs in areas of your skin that are hairier or more oily, i.e. where there are more sebaceous glands, such as your eyebrows, chest or scalp.
‘It’s believed that seborrhoeic dermatitis is caused by having too much yeast in your system or your immune system’s over-reaction to yeast,’ adds Dr Hussain. ‘Your dermatologist can recommend some creams and shampoos to help reduce the level of yeast you have which should help ease the symptoms.
Varicose eczema mainly affects people who have varicose veins, causing the skin around them to become itchy and inflamed, and can be managed by working on improving your circulation.
‘This can be done by keeping active and wearing compression socks every day, apply moisturiser to help with the dryness and talk to your pharmacist about which ointments would be best for you,’ advises Dr Hussain. ‘If this doesn’t work, your GP may refer you to a dermatologist or vascular specialist to explore other treatment options.
Treatment of eczema
There are many different options to manage eczema, and no ‘one-size-fits-all treatment plans. Your GP may prescribe topical steroid creams, such as hydrocortisone, which can stop inflammation.
‘You want to avoid irritating the inflamed skin as much as possible, so try swapping your soap for emollients or bath oils to wash with,’ says Dr Anjali Mahto, consultant dermatologist at London’s Cadogan Clinic and author of The Skincare Bible. ‘Limit the use of foaming shower gels to your armpits, skinfolds, hands and feet to help limit aggravation of the skin. In terms of facial products, try a gentle, fragrance-free cleanser such as La Roche-Posay Tolerane Dermo-Cleanser (£8.75, Lookfantastic).’
While there’s an element of trial and error in terms of which over-the-counter products will keep your symptoms at bay, Dermol 500 lotion is a really gentle moisturiser that also works as a soap substitute, used by eczema sufferers all over.
For periods of unbearable itching, try La Roche Posay Lipikar Stick AP+, £13, Boots. It looks like a roll on deodorant that you apply onto itchy eczema for almost instant relief, providing a nice distraction from scratching. The Lipikar Syndet Shower Body Gel, £10, Boots, is a good replacement for your usual shower gel during bad flare-ups.
Is eczema contagious?
The biggest misconception about eczema is that it’s contagious – but it absolutely is not. It’s only if eczema becomes infected, and is open and weeping, that the infection itself may be contagious, Dr Hussain tells us.
Are eczema and diet linked?
Many sufferers of medical conditions see a reduction in symptoms by carefully monitoring their diet, with dairy and acne being a prime example. So what’s the deal with diet and ezcema? ‘Although changes in your diet can’t cure your eczema, in some cases it may help alleviate the symptoms and minimise flare ups,’ says Dr Hussain.
‘Some cases of eczema are caused by an allergic reaction; the most common sources of allergic reactions from food are from milk, eggs, peanuts, fish, soy, wheat, gluten and citrus, so you may find it helpful to try cutting back on some of those foods to see if it helps with your symptoms.
‘Otherwise, a simple prick test can help identify exactly what you’re allergic to, so you can avoid those foods. It is however important that you discuss potential food allergies with your GP, dermatologist or allergy specialist to ensure you get the best advice which is relevant to you and best for your skin.’
If you have an eczema like rash around your mouth, nose and eyes, it could actually be perioral dermatitis, which requires different treatment options. ‘Periorificial dermatitis is a common facial skin problem characterised by groups of itchy or tender small red papules,’ explains Dr Anjali.
‘It is given this name because the papules occur around the eyes, the nostrils, the mouth and on occasions, the genitals. The more restrictive term, perioral dermatitis, is often used when the eruption is confined to the skin in the lower half of the face, particularly around the mouth. Periocular dermatitis may be used to describe the rash affecting the eyelids.’
Your doctor or dermatologist will be able to confirm a diagnosis, so it’s important to check in with them to confirm.
What causes perioral dermatitis?
‘The exact cause of periorificial dermatitis is not totally understood but research has shown it may be related to epidermal barrier dysfunction, activation of the innate immune system, altered cutaneous microflora or follicular fusiform bacteria,’ says Dr Anjali.
Good news here: ‘Although it my take several weeks before there is a noticeable improvement, periorificial dermatitis does respond well to treatment,’ explains Dr Mahto. ‘The best way to treat periorificial dermatitis is stop using all face creams including topical steroids, cosmetics and sunscreens.
‘Also, do consider a slower withdrawal from topical/steroid/face creams if there is a severe flare after steroid cessation. I would recommend replacing it by a less potent or less occlusive cream or apply it less frequently until it is no longer required. If the rash is present, wash your face only with warm water alone. Only use a non-soap or liquid cleanser when the rash is cleared up.’
Note that the purpose of this feature is to inform, not replace one-to-one medical consultations. For advice tailored specifically to you, always discuss your health with a doctor.
Keep scrolling for the best skincare products for eczema-prone skin below to help you get through heatwave season.
This super formula has everything you need to get your skin barrier back on track. As well as being jam-packed with ceramides, essential in restoring and maintaining the skin barrier, the clever skincare technology gradually releases hyaluronic acid throughout the day for round the clock hydration. It comes in a massive tub, generous size tube or travel size, and is suitable for face and body, so carry it with you wherever you go to repleish moisutre whenever you need.
Cica is known for its healing properties, so it's no wonder this La Roche-Posay cream is so soothing when faced with an angry flare-up. It can be applied to your face, body and lips, so no matter where your eczema is wreaking havoc, you can rely on this to calm the affected area.
If you struggle with itchy blisters or cracked skin on your hands, this French pharmacy hand cream is a must to have in your bag or on your desk.
When washing your face it's important not to strip the skin barrier of all its goodness, especially in the case of eczema-prone skin. CeraVe's Hydrating Cleanser is a non foaming wash that's soap and fragrance-free, and packed with ceramides and hyaluronic acid to support your skin barrier. It's gentle and simple but super effective, and we love the handy pump dispenser.
A great range for eczema-prone skin, Avène's Tolerance products are specifically formulated with the most sensitive skincare types in mind. This lightweight fluid is a great moisturiser to have in your everyday skincare routine.