Eczema (atopic eczema): symptoms, treatment, triggers and whether it is contagious

The NHS says there is currently no cure for atopic eczema, although symptoms tend to get better as you get older, and there are treatments that can help manage it. The main treatments are emollients and topical corticosteroids. Depending on how severe your eczema is, you may also be able to try special dressings or medicines, and a GP can prescribe some treatments or refer you to a skin specialist (a dermatologist).

The British Association of Dermatologists (BAD) says treatment depends on how severe the eczema is, and describes the following options.

The NHS lists things that can help with atopic eczema. It also says a pharmacist can give advice and recommend some treatments if you have small areas of eczema that are dry and slightly itchy; if it is more severe, it is best to see a GP.

• Avoid things that make eczema worse, such as soap, washing detergent, some fabrics or pets.

• Apply emollients as often as possible, at least 2 times a day, and continue even if your eczema improves.

• Wash with an emollient instead of soap.

• Keep cool, because being hot can make eczema more itchy.

• Keep nails short, and put anti-scratch mittens on babies.

• Try not to scratch; gently rubbing the area with a finger is suggested instead.

• Use a spoon or pump dispenser for emollient pots rather than your fingers, and do not share emollients.

• Do not use aqueous cream, as the NHS says it can irritate the skin and make eczema worse.

• Do not smoke or go near naked flames if you use an emollient, because emollients on fabrics such as dressings, clothing and bedding can catch fire more easily.

The NHS says atopic eczema can appear in different areas of the body but is common on the elbows, knees and hands, and in babies and toddlers also on the face. BAD says it most commonly appears in the creases of the elbows, knees, wrists and neck.

The main symptom is itching, which BAD says can be so strong that it affects sleep. The NHS says it can make your skin:

• Itchy.

• Dry, cracked, crusty, scaly or thickened.

• Red, white, purple or grey, or lighter or darker than the skin around it, depending on your skin tone.

• Blistered or bleeding.

The NHS describes atopic eczema as a common skin condition that causes itchy skin. It cannot be cured, but treatment can help manage the symptoms. BAD explains that the word atopic describes conditions linked to strong reactions of the immune system, including asthma, eczema and hay fever.

The NHS says there are also other types of eczema, including contact dermatitis, discoid eczema, pompholyx (dyshidrotic eczema) and varicose eczema. This page mainly covers atopic eczema, the most common type.

No. The NHS says atopic eczema is not contagious, so you cannot catch or spread it. BAD says the same: it is not contagious and you cannot catch it from someone else.

There is one related point. BAD says skin affected by eczema can pick up infections, and an infection with the cold sore virus (herpes simplex) in eczema skin can cause a painful, widespread flare with weeping small sores, called eczema herpeticum, which can be very serious if not treated quickly. It advises avoiding skin contact with active cold sores.

The NHS says it is not always known what causes atopic eczema, but you are more likely to have it if one or both parents have atopic eczema, or you or a close family member has asthma or hay fever. BAD adds that a gene called filaggrin helps keep the skin barrier strong, and that a weaker skin barrier makes it easier for bacteria, viruses and irritants to enter.

The NHS says atopic eczema can be made worse by the following things.

• Contact with an allergen or irritant such as soap, washing detergent, pets, some fabrics, pollen, house-dust mites or certain foods.

• Heat or changes in temperature.

• Skin infections, such as a staph infection.

• Stress.

• Hormonal changes, such as during pregnancy.

The NHS says symptoms usually start in babies and young children and tend to get better as they get older. BAD says about 1 in 5 children in the UK develop eczema, and that most children see improvement as they get older, with 4 out of 5 clear of it by their teens. It also says around 1 in 3 children with atopic eczema will go on to develop asthma or hay fever.

For babies, the NHS suggests keeping nails short and using anti-scratch mittens to prevent skin damage. BAD notes that teething in babies can be a trigger and that wet wraps may upset babies and young children because they can become too cold. For children under 5 with signs of infected eczema, the NHS says to call 111.

The NHS says not to change your diet unless a doctor tells you to, including if you are breastfeeding a baby with eczema. BAD says food allergens can trigger eczema in some people. If you suspect a food is a trigger, speak to a GP rather than cutting foods out yourself.

BAD also says there is currently no proven way to stop eczema developing, and that there is no strong evidence that breastfeeding prevents it, nor clear proof that eating organic food or taking fish oil during pregnancy lowers the risk in children.

The NHS lists hormonal changes, such as those during pregnancy, among the things that can make atopic eczema worse. Continue with emollients and avoiding irritants as usual, and speak to a GP, pharmacist or midwife before starting or changing any prescribed or over-the-counter eczema treatment, so it can be checked as suitable for you.

The NHS says to see a GP if you or your child have symptoms of atopic eczema, or if treatments are not helping.

Ask for an urgent GP appointment or get help from NHS 111 if you or your child have eczema and any of the following. The NHS says these can be signs that your eczema is infected or you have a more serious condition called eczema herpeticum, and you may need treatment such as antibiotics.

• It is blistered, crusty, leaking fluid or has spots filled with pus.

• It is painful, swollen or feels warm.

• It suddenly gets worse or gets bigger.

• You have a high temperature or feel generally unwell.

BAD says a healthcare professional can usually recognise atopic eczema just by looking at the skin, and that blood tests and skin tests are usually unnecessary.

On the NHS, most eczema is managed through a pharmacist or GP, with emollients and steroid creams, and referral to a dermatologist if it is severe or not responding. The NHS also points to National Eczema Society and Eczema Care Online for information.

Some people choose a private dermatology consultation for quicker access to specialist review or assessment for stronger treatments. In either setting, keep using emollients every day and tell your GP about any treatment you are given.