The Evidence on Eczema, Without the Hype
It is managed rather than cured, and the single most common reason treatment fails is using far too little emollient and too little steroid.
Key takeaways
- Mainstay of treatment: emollients, used generously and often
- Typical emollient quantity: far more than most people use; hundreds of grams a week
- Most useful single change: Use emollient several times a day, including when the skin looks clear.
- Commonest mistake: Soap and detergent-based washes.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
What it is
A chronic inflammatory skin condition causing dry, itchy, inflamed skin. It sits within Skin Health. The figures come from the bodies named at the foot of this page.
The numbers, in one place
| Measure | Figure |
|---|---|
| Mainstay of treatment | emollients, used generously and often |
| Typical emollient quantity | far more than most people use; hundreds of grams a week |
| Topical steroids | matched in strength to severity and site, used in short courses |
| Fingertip unit | the standard measure for applying topical steroid |
What helps
These are worth doing. None of them needs to happen all at once.
- Use emollient several times a day, including when the skin looks clear
- Apply emollient in the direction of hair growth, without rubbing in hard
- Use the steroid strength you were prescribed rather than under-treating
- Identify and reduce triggers such as soap, heat and specific fabrics
What to avoid
The usual wrong turns. Some are more tempting than others.
- Soap and detergent-based washes
- Under-using topical steroids through fear of them
- Aqueous cream as a leave-on emollient, which commonly irritates
Where to go next
- A Q and A on Eczema
- Eczema at a Glance
- Eczema — the reference entry
- Acne: What Published Guidance Supports
- What the Guidance Really Says About Psoriasis
When to speak to a doctor
See a GP urgently for rapidly worsening eczema with fever, painful clustered blisters or punched-out sores, which can indicate eczema herpeticum — a medical emergency. Also seek advice for weeping, crusting or yellow discharge suggesting bacterial infection, or for eczema that is not responding to treatment.
Where this comes from
- NICE — Eczema - atopic clinical knowledge summary
- National Eczema Society — treatment
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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