Treatment - Eczema

There's no cure for eczema. But there are treatments. These can help to manage your symptoms.

Children who have eczema find their symptoms get better when they get older.

Talk to your pharmacist or GP

If you have eczema, talk to a pharmacist for advice on treatment with emollients and soap substitutes. Talk to your GP if this treatment is not working for you.

Your GP can tell you if any medicines are covered by your medical card or under the drugs payment scheme.

Eczema treatment

The main treatments for eczema are:

• soap substitutes and emollients (moisturisers)
• topical corticosteroids (ointments that you put on your skin)
• topical tacrolimus (ointments that you put on your skin)

Other treatments include:

• antihistamines
• bandages or special body suits
• stronger treatments you can get from a dermatologist (skin specialist)

Emollients and soap substitutes

You can use emollients to help with eczema. They are moisturising treatments you put on your skin. You can get emollients as creams, ointments, lotions and sprays.

You can use some of these instead of normal soap. You can also get an emollient wash or soap substitute to wash with.

Emollients cover your skin with a film. This protects your skin and helps you lose less water from your skin. Use them every day to stop your skin from getting dry.

When you have an eczema flare-up, put a lot of emollient on your skin and put it on more often.

But emollients on their own are not enough to treat a flare-up. You will need a steroid cream. Talk to your GP about this.

Emollients and soap substitutes

Steroid ointment

If your skin is sore and inflamed, your GP may prescribe a topical corticosteroid (a steroid ointment). This is a treatment you put on your skin. It can bring down the inflammation in a few days.

Topical corticosteroids come in different strengths. Which one your GP tells you to use will depend on the type of eczema you have and the areas of skin affected.

They can be:

• very mild (such as hydrocortisone)
• moderate (such as clobetasone butyrate)
• even stronger (such as mometasone)

Your GP should prescribe the weakest treatment that will work for your symptoms. If you need to use corticosteroids a lot, talk to your GP. They can check the treatment is working and you're using the right amount. You can also talk to them about side effects.

Steroid ointments and how to use them

Tacrolimus ointment

Tacrolimus ointment (topical tacrolimus) is a treatment for atopic eczema.

Your dermatologist may prescribe it to reduce inflammation. It works best on your face and neck. It can be used on adults and children age 2 and over who have atopic eczema.

You put the ointment on your skin in a thin layer. It will work better if you put it on an hour after using an emollient. Your dermatologist will tell you how often to use it.

You may have burning sensation and itching - this usually improves within 1 week.

Common side effects include:

• redness
• feeling of warmth
• pain
• increased skin sensitivity (especially to hot and cold)
• skin tingling
• rash and facial flushing or skin irritation after drinking alcohol

Contact your dermatologist if you notice your skin crusting or small blisters. This could be a sign of infection.

Wear sunscreen as tacrolimus can make you burn more easily in the sun.

Do not use sunbeds or receive ultraviolet phototherapy whilst using tacrolimus ointment.

Antihistamines

Antihistamines are a type of medicine that can help with itching.

They come in two types:

• non-drowsy (non-sedating) - your GP may suggest these for severe itching
• drowsy (sedating) - your GP may suggest these if itching from a flare-up makes it hard to sleep

You can be drowsy the next day after taking sedating antihistamines.

If your child is taking these it may be helpful to let your child's school know. They may not be as awake as normal in school if they have taken a sedating antihistamine the night before.

Antihistamines

Bandages and wet wraps

Your GP may prescribe special medicated bandages, clothing or wet wraps. You wear these over areas of skin affected by eczema.

You can put these on over emollients. You can also use with topical corticosteroids. This will stop you scratching. They allow the skin underneath to heal, and stop the skin drying out.

Steroid tablets

Corticosteroid tablets are rarely used to treat eczema. But your GP may prescribe them for bad flare ups. If you need a lot of courses of steroids, your GP may refer you for more specialist treatment.

Corticosteroid tablets

Treatments from a skin specialist

Your GP may refer you to a dermatologist. This is a specialist in treating skin conditions.

They may do this when:

• they are not sure what type of eczema you have
• normal treatment is not working for you
• your eczema is affecting your daily life
• it is not clear what's causing it

A dermatologist may be able to offer you:

• a review of your treatments to make sure they're right for you
• very strong topical corticosteroids
• bandages or wet wraps
• phototherapy, such as ultraviolet (UV) light to bring down inflammation
• immunosuppressant tablets to stop your immune system from fighting against your body - these include azathioprine, ciclosporin and methotrexate
• dupilumab, a medicine for adults with medium to bad eczema when other treatments have not worked
• jak inhibitors - tablets
• support to help you use your treatments the right way
• a referral for psychological support if you feel you need it

Your dermatologist may do a patch test. They may do this if they think you are coming into contact with something that is driving your allergy. This could be perfume, aftershave and anything with a fragrance or nickel which can be found in some jewellery.

Complementary therapies

There's a lot of information about complementary therapies such as herbal remedies to treat eczema.

There is little proof to show these work.

If you're thinking about using a complementary therapy, talk to your GP first. Your GP will tell you if it is safe for you to use.

Keep up the treatments your GP has prescribed.