Should I use this page, or skip it?
Use this page for dry, itchy patches that flare and settle, and for NHS first steps: emollients every day, steroid creams for flares as directed, and spotting infection. Skip it and get urgent GP or 111 help if skin is weeping, crusted or feverish. Call 999 if someone is very unwell or struggling to breathe.
This page is about atopic eczema, the common long-term type. It is not a cream brand list. It will not replace a clinician looking at the skin. It will tell you what to keep doing when the skin looks clear, and which changes mean you should not wait.
If a new soap, glove, necklace or job seems to have started a rash in one place, also read contact dermatitis. If pollen is the main story, see hay fever.
What is atopic eczema, in plain English?
Atopic eczema is a common itchy skin condition. The skin barrier does not hold water well, so skin becomes dry, cracked and inflamed. Itch drives scratching and poor sleep. It usually starts in babies and young children and often eases with age, but adults can still have it, especially on the hands.
It comes in flares: worse for a stretch, then better. It is not contagious. Also called atopic dermatitis, it often sits in the same family as hay fever and asthma. Triggers can include soap, detergent, some fabrics, pets, pollen, house-dust mites, heat, temperature changes, skin infection, stress, and hormonal change such as pregnancy. Triggers differ between people.
You do not need a blood test to start treatment. Diagnosis is usually from the history and what the skin looks and feels like.
How does eczema look, including on darker skin?
Look for itch plus dryness, not for a single colour. On lighter skin, flares often look pink or red. On darker skin, the same inflammation may look purple, grey, brown, or lighter or darker than the skin around it. Redness is easy to miss. Dryness, scale, cracking, thickening, and the person being kept awake by itch still count.
| What you notice | More likely | First sensible step |
|---|---|---|
| Dry, itchy patches in elbows, knees, hands, or a baby’s face | Atopic eczema | Pharmacist for small mild patches; GP if more widespread |
| Purple, grey or darker patches that itch, on brown or black skin | Eczema that is easy to under-treat if you wait for redness | Treat itch and dryness; show a clinician if unsure |
| Rash only where a product, metal or glove touches | Contact dermatitis | Stop the likely trigger; pharmacist or GP |
| Weeping, yellow crust, pus, heat, fever | Possible infection | Urgent GP or 111 — do not keep “just moisturising” |
Common sites are the insides of elbows, backs of knees, hands, and in babies the face. It can appear anywhere. Blistering or bleeding can happen in a bad flare. That still needs a plan, and it needs infection to be ruled out if there is pus, crust or fever.
What should I use every day, even when the skin looks clear?
Emollients are the foundation. They are medical moisturisers — creams, ointments, lotions or gels — used to trap water and protect the barrier. The NHS says to apply them as often as possible, at least twice a day, and to keep going when the eczema improves. Stopping because the skin “looks fine” is how the next flare starts.
Wash with an emollient instead of ordinary soap. Do not use aqueous cream as a leave-on moisturiser; the NHS says it can irritate eczema. Do not put fingers into a pot — use a spoon or a pump, and do not share pots. Keep nails short. For babies, anti-scratch mittens can reduce damage. Heat makes itch worse, so keep cool where you can.
Emollients on fabrics can make clothes, dressings and bedding catch fire more easily. Do not smoke or go near naked flames if you use them. They are not flammable on the skin itself, but residue on fabric is the risk.
Do not change your diet unless a doctor tells you to, including if you are breastfeeding a baby with eczema.
How should I use steroid creams in a flare?
Topical steroids calm inflamed skin during a flare. They are not moisturiser, and they are not a punishment for “failing” at emollients. A pharmacist can help with small, mildly itchy areas. More severe, widespread, facial, or childhood eczema belongs with a GP, who will match the strength to the site.
Use them as directed: the right product, on the affected skin, for the advised time. Keep using emollients as well. Face, skin folds, and babies need extra care and usually milder preparations. Do not borrow a strong tube from someone else, and do not keep a potent steroid going for weeks without review.
If itch is still severe, a GP may discuss other options, including a short antihistamine trial for sleep, dressings, or referral to dermatology. Those are clinician decisions. Infected eczema may need a different treatment, not a stronger steroid used in the dark.
When is eczema an infection, and when do I need a GP?
See a GP if eczema is not improving, or it is affecting sleep or daily life. Get urgent GP or 111 help if skin is blistered, crusty, leaking, pus-filled, painful, hot, suddenly worse, or you have a fever. Those can be signs of infection.
Those features can mean bacterial infection, or a more serious viral infection called eczema herpeticum. NICE advises urgent hospital assessment if rapidly worsening, painful eczema with clustered blisters and punched-out sores is suspected. Do not wait for a routine slot in that situation.
A GP can also help if sleep is wrecked, school or work is suffering, or you think a food or contact allergy is involved. Referral to dermatology is for uncertain diagnosis, poor control, repeated infection, or when extra treatments are needed. Eczema can affect mood; that is a reason to say so, not a reason to be fobbed off.
Who is this page not for?
This page is not for a child who is floppy, feverish and very unwell — that is urgent paediatric care. It is not a full protocol for eczema herpeticum. It is not a substitute for contact dermatitis advice if a chemical or allergen at work is the clear trigger.
It will not tell you to stop a prescribed steroid cream because of something you read about “thin skin” without speaking to the prescriber. Used as directed, these creams are standard care. Stopping them and leaving a flare untreated can damage the skin more than a short, supervised course.
Common questions about eczema
- What causes atopic eczema?
- The exact cause is not always known. It is linked to a skin barrier that lets moisture out and irritants in, plus family tendency. You are more likely to have it if a parent has eczema, or if you or a close relative have asthma or hay fever. It is not something you catch.
- Should I moisturise when the skin looks clear?
- Yes. The NHS says to apply emollients as often as possible, at least twice a day, and to continue even when eczema improves. Stopping moisturiser when the skin looks better is a common reason flares return. Use a spoon or pump, not fingers dipped in a pot.
- Are steroid creams safe for eczema?
- Used as directed, topical steroids are a standard NHS treatment for inflamed flares. A GP or pharmacist matches the strength to the area and how bad the flare is. Problems are more likely if a strong steroid is used for too long, or on the face or skin folds, without advice. They are not a daily substitute for emollients.
- How does eczema look on darker skin?
- Itch and dryness still matter most. Inflamed patches may look purple, grey, brown, or lighter or darker than the surrounding skin, rather than bright red. Redness can be easy to miss. If you are unsure, describe the itch, dryness and any weeping to a clinician rather than waiting for a textbook red rash.
- When is eczema infected?
- Get urgent GP or 111 advice if skin is blistered, crusty, leaking fluid or has pus, if it is painful, swollen or warm, if it suddenly worsens, or if you have a fever or feel unwell. Rapidly worsening painful eczema with clustered blisters needs urgent assessment. Do not wait for a routine review.
- Is eczema the same as contact dermatitis?
- No. Atopic eczema is a long-term tendency to dry, itchy skin that flares. Contact dermatitis is a reaction where the skin has touched an irritant or allergen, such as soap, nickel or fragrance. The two can overlap, especially on the hands. See the contact dermatitis page if a new product or job seems to be the trigger.
- Should I change my diet to treat eczema?
- Not unless a doctor advises it. The NHS says not to change your diet, including if you are breastfeeding a baby with eczema, unless you are told to. Food is only sometimes a trigger, and cutting food groups on a forum can do harm. A GP can refer you if a food allergy needs proper assessment.
- Can I catch eczema from someone else?
- No. Atopic eczema is not contagious. You cannot spread it by touching, sharing a towel, or sitting next to someone. Infected eczema still needs medical advice for the person who has it, but it is not a reason to isolate a child from school in the way a contagious rash might be.