Eczema. Everything you need to know

At-home care plays a critical role in eczema maintenance.

• Avoid drying agents and products that irritate your skin, such as certain soaps, detergents and skincare products.
• Use mild temperature water for showers and baths.
• Moisturise your skin liberally and often, particularly after bathing. Moisturisers can be applied to wet skin straight after a bath or shower.
• Use creams rather than lotions as moisturisers for better hydration.
• Avoid excessive heat when possible. Turn the heating down at home. Avoid electric blankets in winter.
• Wear soft clothing that does not cause friction against your skin.
• Wear clothing made of breathable materials.
• Take measures to reduce your exposure to household dust mites and other allergens.
• During a flare up, keep your fingernails short to reduce trauma from scratching.
• Only apply prescription creams to the affected area, not on healthy skin.

Depending on the type and severity of your eczema, a specialist dermatologist may recommend combining practical lifestyle changes like those above with medical treatment.

Prescription options for managing eczema include steroid creams and non-steroidal anti-inflammatory creams applied topically to the affected skin.

For moderate to severe cases of eczema that do not respond to topical treatments, phototherapy or oral medication may be used. Phototherapy is an in-office treatment that involves exposing the skin to controlled amounts of ultraviolet (UV) light to reduce the body’s inflammatory response. Oral medications and injection treatment for eczema suppress the immune system, reducing its ability to send an inflammatory response to the skin.

You should continue to exercise, but manage your sweat carefully. Sweat contains salt, which can irritate already inflamed skin. To minimise flare-ups during exercise:

• Wear Loose, Cotton Clothing to allow your skin to breathe.
• Exercise in a Cool Environment if possible.
• Shower immediately after exercising using a gentle, non-soap cleanser, and perform the “soak and seal” method (pat dry, immediately apply medication/moisturiser) to soothe the skin.

Both cause red, scaly patches, but they are distinct conditions:

• Eczema (Atopic Dermatitis): Causes intense, deep itchiness; patches are often poorly defined, and frequently appear in the creases (behind the knees, inside the elbows). It is a skin barrier and immune dysfunction.
• Psoriasis: Causes milder itch, often with a burning sensation; patches are typically very thick, sharply defined, and covered with silvery scales, appearing on the outside of joints (knees, elbows, scalp). It is a true autoimmune condition where skin cells grow too quickly.

The itch-scratch cycle is the core problem in eczema. The rash causes an intense itch; scratching the skin damages the barrier further, which releases more inflammatory chemicals, causing more itch. Breaking this cycle is key to healing. You can stop it by immediately applying your prescribed topical steroid or a thick, cold layer of moisturiser to calm the skin, rather than scratching.

Bleach baths (using a very small amount of regular household bleach diluted in a large tub of water) are an effective way to reduce bacteria (specifically Staphylococcus aureus) on the skin. Eczema-affected skin is prone to harbouring this bacterium, which can worsen inflammation and itching. A diluted bleach bath helps reduce this load, calming infection-prone or constantly irritated skin.

They serve two different purposes:

• Moisturisers (Emollients): Provide long-term maintenance. They hydrate the skin and repair the physical barrier to prevent future flares. They should be used daily, even when the skin is clear.
• Topical Steroids: Are a targeted medication used only for active flares. They rapidly calm the intense inflammation, redness, and itch. They should be used only as prescribed by your dermatologist, then stopped once the flare is controlled.

Eczema is a chronic, non-infectious condition caused by a combination of genetics and an over-reactive immune system. Currently, there is no permanent cure, but there are highly effective treatments (including the ones discussed on this page) that can successfully manage symptoms, heal the skin, and prevent flare-ups for long periods.

Our specialist dermatologist will walk you through a tailored treatment plan and care routine that addresses your specific needs. When it comes to daily care, moisturising is the cornerstone of eczema management. Eczema skin has a damaged barrier, which allows moisture out and irritants in. High-quality, fragrance-free moisturisers (ointments are best for very dry skin) should be applied liberally and frequently, ideally within three minutes of bathing or showering, to “seal in” the water and protect the skin barrier. Our dermatologists can recommend moisturisers. Contact us today on 03 8582 8688

For most adults, food does not cause eczema. For a small percentage of young children with severe eczema, a food allergy (like cow’s milk or egg) may be a trigger that worsens the condition. If a food allergy is suspected, a dermatologist or allergy specialist will perform tests to confirm if the food is genuinely impacting the skin. Removing foods unnecessarily can lead to nutritional gaps.