Self-care

As well as medication, there are things you can do yourself at home to help ease symptoms. 

Scratching

Eczema is often itchy and scratching it can aggravate the skin, eventually causing it to thicken. Scratching your skin also increases the risk of your eczema becoming infected with bacteria. 

Read more about complications of atopic eczema.

There may be times when you or your child cannot help scratching. Keeping nails short will minimise damage to the skin. 

If your baby has atopic eczema, anti-scratch mittens may stop them scratching their skin. Tapping or pinching the skin until the itch has gone may also offer relief.

Avoiding triggers

Your GP will work with you to establish what might trigger the eczema flare-ups, although it may get better or worse for no obvious reason.

Once you know what triggers a flare-up, you can try to avoid them. For example:

• if certain fabrics irritate your skin, avoid wearing these and stick to natural materials such as cotton
• if heat aggravates your eczema, keep the rooms in your home cool
• avoid using soaps or detergents that may affect your skin

Although many people with eczema are allergic to house dust mites, it is not recommended that you try to get rid of them from your home. The process is time consuming and difficult to carry out effectively, and there is no clear evidence that it helps.

Similarly, although living in an area that has hard water is associated with slightly higher levels of eczema in younger children, installing a water softener does not seem to make any difference.

Diet

You should not make any significant dietary changes without first speaking to your GP. Some foods, such as milk, eggs and nuts, have been shown to trigger eczema symptoms. 

However, it may not be healthy to cut these from your diet without medical advice, especially in young children who need plenty of the calcium, calories and protein that are provided by these foods.

If your GP suspects you have a food allergy, you may be referred to a dietitian (a specialist in diet and nutrition).

If you are breastfeeding a baby with atopic eczema, get medical advice before making any changes to your regular diet.

Emollients

Emollients are substances that help soften your skin to keep it moist. They reduce water loss from the skin by covering it with a protective film. They are the most important treatment for dry skin associated with atopic eczema.

It is important to keep skin moisturised to prevent it becoming dry and cracked.

Choosing an emollient

There are several different emollients available, some of which you can buy over-the-counter without a prescription. Your GP or pharmacist can recommend a suitable one for you, although you may need to try a few before you find one that suits you.

You may also be prescribed different emollients for different uses, such as:

• an ointment for very dry skin 
• a cream or lotion for less dry skin
• an emollient to use on your face and hands 
• a different emollient to use on your body  
• an emollient to use instead of soap 
• an emollient to add to bath water or use in the shower

The difference between lotions, creams and ointments is the amount of oil and water they contain. Ointments contain the most oil so can be quite greasy, but they are the most effective at keeping moisture in the skin. Lotions contain the least oil so are not greasy, but can be less effective. Creams are in the middle.

If you have been using a particular emollient for some time, it may eventually become less effective or may start to irritate your skin. If this happens, speak to your GP as another product can be prescribed instead.

If the skin is inflamed, emollients should be used along with an anti-inflammatory treatment, such as topical corticosteroids.

How to use emollients

Use your emollient all the time, especially between flare-ups, even when you do not have symptoms. Keeping separate supplies of emollients at work or at school can be a good idea.

To apply the emollient:

• use a large amount
• smooth the emollient into the skin in the same direction that the hair grows
• do not rub the emollient in
• for very dry skin, apply emollient every two to three hours
• after a bath or shower, gently dry the skin and apply the emollient while the skin is still moist
• do not share emollients with other people
• do not put your fingers into an emollient pot – instead, use a spoon or pump dispenser as this reduces the risk of spreading infection

It is very important to keep using your emollients during a flare-up because this is when the skin needs the most moisture. During a flare-up, apply generous amounts frequently.