Eczema

Eczema is a common chronic (ongoing) skin condition that affects both children and adults. Eczema is also known as atopic dermatitis.

If you have eczema, your skin becomes dry and easily irritated. This makes your skin more open to irritants and allergens (substances that cause allergies).

Allergens can trigger the release of chemicals in your skin, making it itchy. Scratching makes your skin more itchy, and so the cycle repeats. This is known as the ‘itch-scratch cycle’.

Most people develop eczema for the first time when they are babies or during childhood. Your symptoms usually improve by the time you are 8 years of age.   

Your guide to eczema

The most common type of eczema involves areas of red, dry, itchy skin. Eczema often affects the skin:

• in the creases of your elbows
• behind your knees
• on your wrists and ankles
• on your face and scalp (usually seen in babies)

There are some differences in the pattern of eczema and the areas of skin affected based on your skin colour. People of colour may get:

Eczema can be caused by your genes and by triggers in your environment. It can sometimes run in your family. 

It is common for people with eczema and their family members also to have other allergic conditions, including:

• hay fever
• asthma
• dust mite and food allergies

What triggers eczema?

A trigger is anything that might make your eczema symptoms worse. Some common examples include:

• changes in the weather and humidity
• overheating
• physical or emotional stress
• skin infections
• sweating
• allergens and irritants

Allergens and irritants can include:

• grass and/or pollen
• dust
• animals (animal dander)
• some fragrances, creams and shampoos
• some soaps and detergents
• rough, woollen or prickly clothing
• chlorine in pools

Triggers vary from person to person. Not all these things will affect every person with eczema. Identifying your personal triggers will help you manage your eczema.

You should see your doctor if you or your child has itchy, dry skin.

See your doctor if your eczema is:

• not improving with usual treatment
• getting worse
• affecting your sleep or daily activities

It is also important to get medical advice if you are unsure if the rash is eczema, as other skin conditions can look similar.

Seek medical care if you have signs of infection or other complications. 

If your child has eczema, see a doctor urgently if they develop a rapidly worsening rash with blisters or fever, or if they appear unwell.

Your doctor can diagnose eczema by:

• asking you about your symptoms and triggers 
• asking you about your general health and your family’s medical history
• examining your skin 

Usually, your doctor will not need to refer you for tests to diagnose eczema. 

If you have infections that keep coming back or don’t get better with treatment, your doctor may take a swab of your skin to check which treatment is needed.

They may also refer you to a dermatologist (skin specialist).

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Treatment for eczema may include a combination of:

• self-care to look after your skin
• identifying and avoiding triggers 
• creams and ointments to treat flare-ups

Treatment can improve or even clear your symptoms. 

There is no cure for eczema.

Self-care at home

Self-care to look after your skin includes:

• bathing daily with warm water (avoid hot water as this can make dry skin worse)
• using soap-free cleansers 
• applying fragrance-free and irritant-free moisturisers directly onto your skin after bathing 
• identifying and avoiding any triggers 
• applying a cold compress on itchy skin

There is no strong evidence that fish oil and primrose oil supplements treat eczema.

Medicines to treat eczema flare-ups

Your doctor may prescribe steroid or non-steroid ointments and creams to help clear up your skin. Your doctor will recommend different creams or ointments depending on where your skin is affected.

Be careful to use the cream or ointment exactly as your doctor recommends. Side effects of steroid creams and ointments are rare if you use them as prescribed.

There are other skin treatments for people who cannot use steroids. You can ask your doctor about these.

If you have disturbed sleep from itching, your doctor may recommend antihistamine medicines.

Depending on how severe your eczema is, it can take 7 to 14 days for your skin to become clear. 

Skin moisturisers

You can help protect your skin by applying a moisturiser at least 2 times each day. Use the moisturiser even when your eczema is under control (between flare-ups).

Thick moisturisers or ointments are best. Try to avoid any chemical additives or perfumes in moisturisers, as these may trigger your eczema.

Specialist treatments for severe eczema

If you have severe eczema that is not improving, your doctor may refer you to a dermatologist. 

Your dermatologist may treat your eczema with:

• oral immunosuppressants (medicines that lessen your immune system activity)
• biological therapy
• ultraviolet B therapy
• admission to hospital for treatment with wet dressings 

Wet dressings can help cool, protect and rehydrate your skin. Your doctor may suggest that you use these dressings at night.

Sometimes, your affected skin can become infected. If you have eczema, your skin is more likely to get infections from both bacteria and viruses.

If your doctor thinks you have a skin infection, they may take a swab for testing.

Depending on the cause of the infection and how severe it is, treatment may include:

• antibiotics or antiviral medicine
• special bleach baths or soaks

In young babies, eczema can be associated with poor feeding and slow weight gain (Opens in new tab) (sometimes known as failure to thrive). 

If you know what triggers your eczema, your doctor can work with you to develop an eczema action plan (Opens in new tab) to help prevent flare-ups. This is a personal guide for how to manage your eczema and prevent it from flaring up.

Some tips to help prevent a flare-up include:

• Moisturise daily — even when your skin is healthy.
• Try to avoid your triggers.
• Try to avoid overheating and make sure your baths and showers are not too hot.
• Have a bath or shower straight after swimming, especially if swimming in a chlorinated pool. 

The Australasian Society of Clinical Immunology and Allergy (Opens in new tab) answers some frequently asked questions people have about eczema (Opens in new tab).

Learn more about eczema (Opens in new tab) on the Eczema Association of Australasia website. 

Support for people with eczema is available at Eczema Support Australia (Opens in new tab).

Languages other than English

Eczema Support Australia has translated some of their fact sheets (Opens in new tab) into many community languages. 

Information for Aboriginal and/or Torres Strait Islander peoples

Eczema Support Australia has resources about eczema (Opens in new tab) for Aboriginal and/or Torres Strait Islander peoples.