Managing Atopic Eczema
Eczema (atopic dermatitis) is a chronic inflammatory skin condition characterized by dry, itchy, and red skin. Effective management requires consistent daily care and knowing how to handle flare-ups.
The Core Strategy: Emollients
The foundation of eczema treatment is repairing the skin barrier. Emollients (medical moisturizers) should be applied liberally and frequently—often 3 to 4 times a day.
- Lotions: High water content, easy to apply, but least effective for severe dryness.
- Creams: A balance of oil and water. Good for daytime use.
- Ointments: High oil content (greasy). Best for extremely dry, thickened skin and nighttime use.
Fire Risk Warning
Clothing or bedding infused with paraffin-based emollients can be highly flammable. Keep away from open flames and wash fabrics at high temperatures.
Emollient Usage Table
| Age Group | Recommended Weekly Amount |
|---|---|
| Infants | 250g per week |
| Children | 250g - 500g per week |
| Adults | 500g - 600g per week |
Source: NICE Guidelines CG57 (2023 update).
Managing Flare-Ups (Topical Steroids)
When eczema flares up (becomes red, inflamed, and intensely itchy), emollients alone are not enough. Topical corticosteroids are required to reduce inflammation.
Many patients suffer from 'steroid phobia', under-treating their eczema out of fear of skin thinning. When used correctly for short bursts (typically 7-14 days), topical steroids are highly safe and effective.
How much to use? (The FTU)
We measure creams in Fingertip Units (FTU). One FTU is the amount of cream squeezed from the tube along the tip of an adult index finger to the first crease. This is enough to treat an area of skin twice the size of an adult hand flat.
Use our FTU CalculatorFrequently Asked Questions
Does diet cause eczema?
In a small subset of young children, specific food allergies (like cow's milk) can exacerbate eczema. However, for most adults, diet is not a primary trigger, and restrictive diets should only be undertaken under medical supervision.
How do I know if my eczema is infected?
Signs of bacterial infection (usually Staph aureus) include weeping, crusting (often golden-colored), sudden worsening, or failure to respond to usual treatments. Viral infections (like Eczema Herpeticum) present as painful, punched-out blisters and require urgent medical attention.