Eczema

Key points

• An ongoing itch that intensifies at night is the defining feature, with affected skin looking red or greyish depending on complexion.
• Flares commonly affect the elbow and knee folds, neck, wrists and ankles, and the cheeks and scalp in infants.
• Topical corticosteroid strength is matched to the skin affected, from mild agents for the face to potent short courses for thickened patches.

Recognising a flare

The hallmark is persistent itch, often worse at night. Affected skin may look red on lighter complexions or grey-brown on darker ones, and it tends to crack, weep, or crust during active flares. Common sites are the folds of the elbows and knees, the neck, wrists, and ankles. In infants, the cheeks and scalp are often involved. Triggers vary by person but frequently include sweat, certain fabrics, soap, dust mites, and sudden changes in temperature or humidity.

Topical treatments

Moisturising the skin barrier frequently is the cornerstone of ongoing management. During flares, topical corticosteroids reduce inflammation and itch. Milder steroids such as desonide and fluocinolone acetonide suit sensitive or facial skin, while moderately potent options like triamcinolone address thicker plaques on the body. Stronger agents including betamethasone and clobetasol are reserved for short courses on stubborn, lichenified areas. When a secondary bacterial infection develops alongside the rash, a combination product containing fusidic acid can address both. Browse the full range in our skin care category.

When to get medical advice

See a doctor if the rash becomes weepy, crusted, or spreading rapidly, if sleep is consistently disrupted, or if the skin shows signs of infection such as increasing redness, warmth, or pus. Children who fail to improve with standard care, or adults whose eczema covers large body areas, benefit from a structured review to rule out contact allergy or other diagnoses.

Further reading

• Eczema (contact dermatitis): Symptoms, causes, types & treatment
• Atopic eczema - NHS
• Eczema - symptoms, causes and treatment - Healthdirect