Eczema treatment

Eczema is a very common skin condition that causes itchy, dry, and cracked skin.

Eczema is more common in children, with 70 to 90% of eczema cases diagnosed in children younger than 5. Although 2 out of 3 children with eczema grow out of it by the time they become teenagers, some adults also have eczema.

It’s uncommon for eczema to happen for the first time in adults older than 20.

Types of eczema

There are many different types of eczema, but atopic eczema is the most common.

Atopic eczema is caused by inflammation in the skin and disruption of the skin’s natural barrier. We do not fully understand what causes this, but we know that certain things can increase the chances of having it, including:

• allergies, such as to dust mites or pollen
• changes in weather
• pollution
• diet
• infections
• genetics
• stress

Eczema symptoms

Eczema usually tends to flare up, which means symptoms can appear and then disappear, often caused by triggers. Flare-ups can last anything from a few days to weeks or even months.

During a flare-up, skin can become:

• dry
• red
• inflamed
• itchy
• scaly or thickened
• blistered
• weepy

Although eczema can appear anywhere, the most affected areas include the:

• elbows
• knees
• hands
• neck
• face
• scalp

You might need eczema treatment if your skin is:

• itchy
• dry
• cracked
• crusty
• scaly
• thickened

This may appear anywhere, but it’s more likely to be eczema if it appears in areas where there are skin creases, like the knees and elbows.

The severity of your symptoms will affect whether you need treatment and what type. If your symptoms are mild, a simple, over-the-counter emollient cream may be enough, but if your symptoms are more severe, you might require prescription treatment.

If you’ve had eczema before, as a child or adult, you may know the symptoms to look out for. If you’re an adult and you’ve never had eczema before, it’s a good idea to get your symptoms checked out by a doctor to make sure it is eczema, as it’s much less common to get it for the first time as an adult.

When you request eczema treatment with ZAVA, we’ll ask for some photos of the affected area along with some questions about your symptoms and current health. These are completely confidential and are used by our doctors to check whether you have eczema or another condition.

Eczema treatment most commonly works by reducing inflammation during flare-ups and keeping skin well hydrated at all times to avoid dryness. Other treatments can be used to deal with specific symptoms like itching, infection, or if you do not respond well to the usual treatment option.

There’s currently no cure for eczema, but treatments can help manage and improve your symptoms. Your eczema treatment plan may involve 1 or more types of treatment, along with trying to recognise and avoid triggers.

The type of eczema treatment you need is based on your symptoms and how much they are impacting your quality of life, which means how they’re affecting things like your sleep, work, social life, mood, and even your confidence.

Eczema is a chronic condition, which means it’s likely to come back repeatedly with flare-ups every so often. Treatment can help to reduce how regularly flare-ups happen and how severe they are, but it will not cure eczema completely.

The main treatments for eczema are emollient creams and steroid creams.

Emollients

Moisturisers, also known as emollients, are a common everyday treatment for eczema. They help to maintain the skin’s moisture barrier, stopping it from becoming dry and breaking down, which can lead to skin damage and infection.

Research suggests that emollients are an effective treatment for eczema. They can improve eczema symptoms, while also reducing the number of flare-ups and the need for topical corticosteroids (stronger, prescription treatments).

You should use your emollient as instructed by your doctor or pharmacist. Usually, this is at least every day after washing to stop your skin drying out, and you may even consider showering or bathing using an emollient wash instead of soap. You can find these in certain health shops or pharmacies.

ZAVA stocks emollients such as Aveeno and Cetraben. These can be prescribed in a bundle with corticosteroid creams, like hydrocortisone and Eumovate (clobetasone).

Steroid creams

Steroid creams contain corticosteroids that work to reduce inflammation in the skin and should only be used during flare-ups, not as an everyday treatment. They range from mild steroids, like hydrocortisone, to stronger steroids, like mometasone.

You’ll start using steroid cream when it’s prescribed during a flare-up and can expect symptoms to improve within a few days. After using the cream as prescribed for a few days, you should stop unless told otherwise.

The type of cream you’re prescribed will depend on how severe your symptoms are.

Steroid cream should be applied at least 30 minutes after your emollient has been applied, allowing the emollient time to soak in. Only use the amount of cream that you’re told to use, as using too much can increase the risk of skin reactions.

If your symptoms do not improve in 3 to 7 days, speak to your GP or prescribing doctor. They may prescribe a stronger steroid cream or suggest an alternative treatment, like steroid tablets or tacrolimus ointment (an immunosuppressant).

Depending on how severe your eczema is, it may be enough to use emollients alone. However, more serious symptoms may require you to use steroid creams too.

Steroid creams should not be used all the time due to the risk of side effects.

You can purchase many emollients online, or from a high street pharmacy or supermarket without a prescription. You may also be able to get some emollients on an NHS prescription at a reduced cost, but the type and choice of emollient is likely to be more limited.

Can I buy eczema treatment online?

Yes, some eczema treatments can be obtained online from ZAVA.

If you’re not sure about which treatment is best for you, simply fill in our online medical questionnaire and our doctors will review your answers and suggest the most appropriate treatment. Your medication will then be dispatched quickly and delivered via Royal Mail.

At ZAVA, we can provide steroid medication and moisturising emollient treatment packs. These contain:

• a steroid medication – either clobetasone (Eumovate) or hydrocortisone, as either a cream or an ointment
• a moisturising emollient – either Aveeno or Cetraben

Our quick and easy online doctor service provides a convenient way of getting your eczema medication without waiting for an appointment with your GP. During the questionnaire, we’ll request some confidential photos of your skin to make sure you’re getting the best treatment for your symptoms.

Can I get eczema treatment over the counter?

Yes, some steroid creams for eczema are available over the counter from a pharmacy or can be bought from an online pharmacy, but these creams only contain mild steroids. Stronger steroid creams require a prescription from your GP or an online doctor service.

Can I get eczema treatment on the NHS?

Yes, eczema treatments are available on the NHS, but you will need to make an appointment with your GP first. They will assess your symptoms and prescribe treatments like topical corticosteroids, emollients, and if required, refer you to a dermatologist for more specialised care.

Many people use eczema treatments without any problems, but some people experience some side effects.

Emollients

You can sometimes get a skin reaction when you use emollients, which can include:

• a burning or stinging sensation, which may not improve, even after several days of treatment – this is normally caused by your skin reacting to an ingredient in the emollient
• folliculitis – when your hair follicles become blocked or inflamed, which can cause boils or a rash on the face and can make acne worse

Thick emollients are more likely to cause folliculitis. Try to apply your emollients in the direction of hair growth rather than against it to avoid this.

Emollient creams are usually designed with sensitive skin in mind, but sometimes people can become allergic to the ingredients, which means their skin inflammation gets worse. If you’re worried that you may be sensitive to a particular emollient, a doctor can advise you on the alternatives.

Emollients are flammable, so make sure to keep them away from flames and avoid smoking after applying them.

Steroid creams

Side effects from mild steroid creams are uncommon, but are more likely with stronger steroids used for a long time. You may notice some stinging when applying steroid creams to your skin, but this should pass within a minute or so.

If used for prolonged periods of time, steroid creams can lead to:

• skin thinning (especially in areas where skin is already thin, like the face)
• skin colour changes
• acne
• increased hair growth

Some people notice their skin gets worse after stopping steroids. This is usually when they have been used for a long time, and these symptoms tend to get better over time.

If steroid cream is absorbed into the bloodstream, this can lead to side effects that affect other areas of the body, like:

• reduced growth in children
• high blood pressure
• thinning of the bones
• fluid buildup
• weight gain

Although these side effects are rare, if you notice any of them, you should speak to a doctor.

A full list of side effects for the specific emollient cream or steroid cream you’re taking can be found on the medication packaging.

Eczema treatment may not be right for everyone – certain conditions or certain medications can interact with these treatments and make them less effective, or potentially unsafe.

Certain eczema creams should not be used if you:

• are under 18
• are pregnant
• have specific medical conditions
• are allergic to any of the ingredients in your eczema cream

A doctor may be able to suggest an alternative cream if you find your current treatment causes flare-ups, irritates your skin, or you’re unable to use it.