Dry, itchy skin and eczema
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The short answer
What actually helps eczema and dry, itchy skin?
Using emollients generously every day, washing with a soap substitute and treating flares early with topical steroids used as directed. Eczema that does not settle needs a GP, who has stronger creams and can refer you to a dermatologist.
Evidence: Good How we grade evidence
Eczema is not just dry skin. It is a barrier that leaks water and lets irritants in, plus an immune system that overreacts to them. That is why it itches, and why the itching is the part that needs breaking.
What is atopic eczema?
Atopic eczema is a common, long-term skin condition that causes itchy skin, because the outer layer of skin does not hold together properly. That is often because of differences in the filaggrin gene, which helps keep the skin barrier strong. Water escapes, irritants get in, and the immune system responds with inflammation. Skin can look red or, depending on your skin tone, purple, grey, or lighter or darker than the skin around it, and it feels tight, rough and intensely itchy. Scratching damages the skin barrier further, which is the cycle worth interrupting. Contact dermatitis is a separate thing: a reaction to something touching the skin, either an irritant such as detergent or a true allergy such as nickel or an ingredient in a cosmetic.
What triggers an eczema flare-up?
The common triggers for eczema are soap and washing detergent, some fabrics, house dust mites, heat and changes in temperature, and stress. Long hot showers, wool, sweat, central heating and cold weather are frequent culprits too. Fragrance is a common problem in skincare, and so are essential oils, despite the marketing: the BAD lists fragrances among the common causes of allergic contact dermatitis.
How should you look after your skin if you have eczema?
Emollients are the backbone of eczema care, and they are not optional extras. The NHS advice is to apply them as often as possible, at least twice a day, and to keep going even when the skin improves. Use a cream or ointment generously, and again straight after a lukewarm shower while the skin is still damp. A Cochrane review of 77 trials found that people who used moisturisers had fewer flares and needed less steroid cream. The best emollient is the one you are happy to use regularly, and the cheap ones work. Switch to a soap-free wash, pat rather than rub dry, and keep the routine short and fragrance-free while skin is flaring. Actives such as acids and retinoids are best paused entirely during a flare. A MyAgenix read builds a short, fragrance-free routine around your emollient rather than on top of it.
What eczema treatments can a pharmacist or GP offer?
A pharmacist can supply mild topical steroids and advise on emollients, and a GP can prescribe stronger treatments. Most mild hydrocortisone creams can be bought from pharmacies. A GP can prescribe stronger steroids matched to the body part, non-steroid creams such as tacrolimus or pimecrolimus for delicate areas, antihistamines to help sleep, and antibiotics if skin becomes infected. For eczema that is not controlled, dermatology can offer phototherapy and newer targeted medicines such as dupilumab or JAK inhibitors. Steroid phobia is common and usually unhelpful: used as directed, topical steroids carry a much smaller chance of side effects, and using too little or stopping too soon can make eczema harder to control.
When should you see a doctor about eczema?
See a doctor urgently if eczema is weeping, crusting, blistering or suddenly painful, or you feel unwell with a high temperature, as the NHS says these can be signs of infection. Also see a GP if itching is disturbing sleep, if it is not settling with emollients and a short steroid course, or if you suspect a specific allergy, which patch testing at a dermatology clinic can identify.
Questions people ask
Is eczema contagious?
No. You cannot catch eczema from someone or pass it on. It often runs in families, especially alongside asthma and hay fever, but it spreads only in the sense that a flare can cover more skin. Infected eczema is a different matter and needs a doctor.
Is aqueous cream good for eczema?
No. The NHS advises against using aqueous cream on eczema because it can irritate the skin and make eczema worse. Choose a plain emollient cream or ointment instead, and use it as a soap substitute too.
Should you cut foods out of your diet if you have eczema?
Not without medical advice. Food allergies can trigger eczema in some people, but cutting out foods on your own risks missing out on nutrition without helping your skin. The NHS advises changing your diet only if a doctor tells you to, including when breastfeeding a baby with eczema.
Do children grow out of eczema?
Many do. Eczema usually starts in early childhood, and most children find it improves a lot as they get older. Some people keep dry, sensitive skin into adulthood, so a regular emollient and avoiding soaps and detergents stay useful.
Sources
- a common, long-term skin condition that causes itchy skin (nhs.uk)
- the filaggrin gene, which helps keep the skin barrier strong (skinhealthinfo.org.uk)
- Contact dermatitis (nhs.uk)
- fragrances among the common causes of allergic contact dermatitis (skinhealthinfo.org.uk)
- A Cochrane review of 77 trials (pubmed.ncbi.nlm.nih.gov)
- pat rather than rub dry (nhs.uk)
- Most mild hydrocortisone creams can be bought from pharmacies (nhs.uk)
- used as directed, topical steroids carry a much smaller chance of side effects (skinhealthinfo.org.uk)
General information about skin, not medical advice. MyAgenix offers cosmetic guidance to help you choose products. It does not diagnose or treat any condition. For anything on this page that needs treating, see a pharmacist, your GP or a dermatologist.