Eczema (dermatitis) management

Treatments to control eczema (dermatitis), a common long-term condition that makes the skin dry, itchy and inflamed.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Eczema (dermatitis) is a common, long-term condition causing dry, itchy, inflamed skin; it can be well controlled but not cured.
Moisturisers (emollients) used often, even when the skin looks clear, are the foundation of treatment, with steroid creams used on flares.
Used correctly on active eczema, topical steroids are an important and effective treatment; the main risks come from overuse on normal skin.
Severe or poorly controlled eczema can be referred to a dermatologist for additional treatments such as light therapy, tablets or newer injected medicines.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMedical treatment (moisturisers, steroid creams and sometimes specialist treatment)

AnaestheticNot applicable

How long it takesAn assessment appointment; treatment continues long term

Hospital stayOutpatient — no hospital stay

Time off workUsually none

When you'll see resultsFlares often settle within days to a couple of weeks of treatment; control is ongoing

On the NHS?Eczema is commonly treated on the NHS; specialist treatments need a dermatologist

A general guide. Your specialist will give you advice for your situation.

Best fit

Can control itch and inflammation and settle flares

Pause if

Strong topical steroids are not suitable for long-term use on normal skin or routinely on delicate areas like the face without guidance.

Main recovery point

With regular emollients and the right-strength steroid on active eczema, itch and redness usually start to settle within a few days.

Good aftercare

A clear written plan: which emollient, how often, and exactly how to use steroids on flares.

First few days of treating a flare

With regular emollients and the right-strength steroid on active eczema, itch and redness usually start to settle...

Up to a couple of weeks

Flares often come under control within this time. Steroid use is then stepped down while emollients continue.

Between flares

Keep using emollients regularly, even on clear skin, to keep the barrier healthy and reduce future flares.

If not improving

If a flare does not settle, keeps coming back, or looks infected, the plan should be reviewed and treatment...

Medical line illustration of dermatology rash acne inflammatory skin for Eczema (dermatitis) management. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is eczema (dermatitis) management?

Eczema, also called dermatitis, is a common condition where the skin becomes dry, itchy, red or inflamed. The most common type is atopic eczema, which often starts in childhood and tends to run in families alongside asthma and hay fever. It usually comes and goes, with calmer periods and flare-ups.

There is no cure for atopic eczema, but it can usually be well controlled. The aim of treatment is to keep the skin moisturised and the barrier healthy, settle flares quickly, control the itch, and avoid things that make it worse. Many children improve as they get older.

The foundation of treatment is regular use of moisturisers (emollients), with steroid creams or ointments used on flares. Some people need additional or specialist treatments, such as non-steroid creams, treatment for skin infections, light therapy or, for severe eczema, tablets or newer injected medicines started by a dermatologist.

This guide explains the options, how they are used, and what to discuss with your clinician. It is not a substitute for personal medical advice.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Emollients (moisturisers)

Creams, lotions, ointments and gels used frequently (often several times a day) to keep the skin moist and protect its barrier. They are the foundation of eczema care and should be continued even when the skin looks clear.

Topical corticosteroids (steroid creams)

Applied to active eczema to settle inflammation and itch, in different strengths from mild to potent. Used correctly on flares they are effective and safe; the main risk is from overusing strong steroids on normal skin.

Non-steroid creams (calcineurin inhibitors)

Creams such as tacrolimus or pimecrolimus can be used in some areas (for example the face) or to reduce steroid use, usually under guidance.

Treatment of infection and itch

Infected eczema may need antibiotics or antiseptic measures. Itch may be helped by good moisturising and, in some cases, antihistamines, though these are not always effective.

Specialist treatments for severe eczema

For severe or hard-to-control eczema, a dermatologist may use bandages or wet wraps, light therapy (phototherapy), tablets that calm the immune system, or newer injected medicines (biologics). These need specialist monitoring.

Everyday care vs treating a flare

Point	Between flares	During a flare
Main treatment	Frequent emollients	Emollients plus steroid cream
Aim	Keep skin moist	Settle itch and inflammation
Steroid use	Usually none	On active eczema, as advised
When to escalate	Not needed	If no better, or skin infected

Emollients continue all the time. Steroid creams are added to active eczema and stepped down as it settles. Persistent or infected flares should be reviewed.

Preparing for your treatment

Be ready to describe where the eczema is, how itchy it is, how it affects sleep and daily life, and what seems to trigger flares.
Bring a list of treatments already tried, including moisturisers and steroid strengths, and how you used them.
Note any known irritants or allergies, such as soaps, fragrances or certain materials.
Mention any history of skin infections, asthma or hay fever.
For a child, a parent or carer should attend and can describe sleep, scratching and school impact.
Ask how much steroid to use, how often, and for how long, so you are not under- or over-treating.
Avoid soaps and bubble baths that dry the skin before your appointment if you can.

What happens

At the appointment, the clinician looks at your skin, asks about itch, sleep, triggers and impact, and checks for signs of infection. For a child, they will ask the parent or carer about scratching, sleep and daily life.

They then set out a treatment plan, usually built around frequent emollients with a suitable-strength steroid cream for flares, and advice on avoiding irritants. They should explain how much to apply, how often, and when to step treatment up or down.

You will usually be asked to follow the plan and return if it is not working. If eczema is severe, keeps getting infected, or does not respond, you may be referred to a dermatologist for additional treatments and monitoring.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Strong topical steroids are not suitable for long-term use on normal skin or routinely on delicate areas like the face without guidance.
Some specialist tablets and injected medicines are not suitable in pregnancy, certain infections, or without monitoring.
Treating a flare as ordinary eczema is wrong if it is actually infected, which needs different treatment.
Heavy treatment is not needed for very mild dryness that responds to moisturisers alone.

Delay or rearrange if…

Eczema looks infected and needs treating before, or alongside, escalation.
A widespread viral skin infection is suspected, which needs urgent assessment first.
Pregnancy is possible and a treatment unsafe in pregnancy is being considered.
Baseline checks for systemic treatment have not been done.
You cannot get help if a severe flare or infection develops.

Alternatives to discuss

Stepping up or down between emollients alone and emollients plus steroids, depending on the skin.
Non-steroid creams (calcineurin inhibitors) to reduce steroid use or for delicate areas.
Light therapy (phototherapy) for suitable people with widespread eczema.
Immune-calming tablets or newer injected medicines for severe eczema, under a specialist.
Avoiding irritants and managing triggers as part of any plan.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Can control itch and inflammation and settle flares
Keeps the skin barrier healthier with regular moisturising
Improves sleep, comfort and quality of life
Reduces scratching and the risk of skin infection
Offers a stepped approach matched to severity
Specialist treatments can help even severe, long-standing eczema

Risks & complications

More common

Eczema returning or flaring, as there is no cure
Stinging or irritation when applying creams to broken skin
Needing to apply emollients many times a day, which takes effort
Skin becoming infected during a flare
Trial and error to find emollients and treatments that suit you

Less common

Thinning of the skin from overusing strong steroids on the same area over a long time
Spread of infection (such as bacterial or, rarely, widespread viral infection) during a flare
An allergy or reaction to an ingredient in a cream
Eczema not responding to standard treatment, needing specialist input

Rare but serious

Side effects from tablets that calm the immune system, needing blood-test monitoring
Reactions to newer injected medicines (biologics), needing specialist supervision
A serious widespread skin infection that needs urgent treatment

The main worries are under-treating flares (so eczema and itch persist) and, less commonly, overusing strong steroids on normal skin (which can thin it). Used correctly on active eczema, steroids are safe and effective, so ask exactly how much to use, where, and for how long. Watch for signs of skin infection, which is common in eczema and can flare it badly. Specialist tablets and injected medicines have their own monitoring needs.

Published figures to discuss

Eczema severity, triggers and response to treatment vary widely between people and over time, so single success percentages can mislead. Side-effect risks depend on which treatment is used and how. The points below describe realistic uncertainties rather than precise figures, because robust comparable rates for individuals are limited; specialist treatments have their own monitoring requirements.

Figure	Reported range	How to interpret it	Source / confidence
Flares and relapse	Common because eczema is often chronic and relapsing	A realistic goal is durable control, fewer flares and better sleep, not a guaranteed permanent cure.	Guide sourcesClinical context
Skin thinning or stretch marks from topical steroids	Uncommon when used correctly; risk rises with high potency, thin skin sites and prolonged unsupervised use	Steroid fear can be harmful if it leads to undertreatment. Good plans specify potency, body site, duration and stepping down.	Atopic eczema in primary care: evidence update — PMCncbi.nlm.nih.govSource-linked context
Secondary infection, including eczema herpeticum	Recognised; eczema herpeticum is uncommon but urgent	Rapidly worsening painful eczema, clustered blisters, fever or feeling unwell should trigger urgent medical review.	Atopic eczema in primary care: evidence update — PMCncbi.nlm.nih.govSource-linked context
Systemic or advanced-treatment side effects	Treatment-specific	Phototherapy, ciclosporin, methotrexate, biologics and JAK inhibitors each need their own monitoring, vaccination and infection-risk discussion.	Atopic eczema in primary care: evidence update — PMCncbi.nlm.nih.govSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no procedure to recover from. 'Afterwards' here means how your skin responds: flares usually settle within days to a couple of weeks of proper treatment, while overall control is ongoing.

First few days of treating a flare

With regular emollients and the right-strength steroid on active eczema, itch and redness usually start to settle within a few days.

Up to a couple of weeks

Flares often come under control within this time. Steroid use is then stepped down while emollients continue.

Between flares

Keep using emollients regularly, even on clear skin, to keep the barrier healthy and reduce future flares.

If not improving

If a flare does not settle, keeps coming back, or looks infected, the plan should be reviewed and treatment adjusted or escalated.

On specialist treatment

Light therapy, immune-calming tablets or injected medicines work over weeks, with regular specialist review and any necessary blood tests.

What's normal — and not a worry

Itch and redness settling over days with proper treatment
Skin staying dry and needing ongoing moisturising
Occasional flares despite good control
Some trial and error to find products that suit you
A possible short flare after stopping a steroid too soon

Aftercare

Use emollients frequently and generously, even when the skin looks clear.
Apply steroid cream to active eczema as directed, and step it down as the skin settles rather than stopping abruptly.
Avoid soaps, bubble baths and fragranced products; use an emollient wash instead.
Avoid scratching where possible; keep nails short, especially for children.
Watch for signs of infection (weeping, crusting, increasing redness, pain or feeling unwell) and seek advice.
Identify and avoid your own triggers and irritants where you can.
Attend reviews so treatment can be adjusted, and keep specialist monitoring appointments.
Do not stop or swap prescribed treatments without advice.

Before your treatment

A supply of your emollient, used several times a day
An emollient wash instead of soap
Your steroid cream, with clear instructions on how much and how long
A written step-up/step-down plan for flares
Short nails (especially for children) to limit scratching damage
Contact details for your clinician or dermatology team

⚠ Get urgent help if…

Eczema becoming weepy, crusted, pus-filled or rapidly worsening (possible bacterial infection)
Many small blisters, painful clustered sores, or feeling unwell with a flare (possible widespread viral infection — seek urgent advice)
A fever or feeling generally unwell alongside a flare
A flare that does not settle despite proper treatment
Skin becoming thin, fragile or marked where strong steroids have been used a lot
Signs of an allergic reaction to a cream, such as marked swelling or breathing difficulty
For children: poor sleep, distress or eczema badly affecting daily life despite treatment

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is comfortable, less itchy skin with flares that are infrequent and quickly controlled, and good sleep and daily life. Many children's eczema improves as they grow up.

Because atopic eczema cannot be cured, treatment controls it rather than removing it for good, and flares can still happen. Results depend on using emollients consistently and treating flares promptly. If standard treatment is not enough, specialist options can help even severe eczema, though they need monitoring and do not work for everyone.

How long it lasts

Atopic eczema is a long-term, fluctuating condition. It often improves with age, and many children grow out of the worst of it, but it can persist into adult life or return after periods of clear skin. Ongoing moisturising and prompt treatment of flares keep it controlled. Specialist treatments may be used for months or longer with review. Your clinician can give a realistic picture for you or your child.

Related tests, treatments or support

Eczema treatments are layered rather than used alone: emollients all the time, steroid creams on flares, and sometimes non-steroid creams, infection treatment or specialist therapies added on top. Managing related conditions such as asthma or hay fever, and avoiding irritants, supports overall control. Your clinician will explain how the treatments fit together.

Follow-up & long-term care

You will usually be reviewed to check whether the plan is controlling flares and to adjust treatments and steroid strengths. Persistent, severe or repeatedly infected eczema may be referred to a dermatologist. Specialist treatments such as immune-calming tablets or injected medicines involve regular review and, where needed, blood tests. You should know who to contact if a flare will not settle or looks infected.

Keep using emollients regularly, even when the skin is clear.
Use an emollient wash and avoid soaps and fragranced products.
Treat flares early with the agreed step-up plan.
Avoid known triggers and irritants where practical.
Attend specialist monitoring appointments and blood tests if on systemic treatment.
Return if control is slipping or flares are becoming more frequent or infected.

Repeat, follow-on and what comes next

Treatment is regularly stepped up and down as eczema flares and settles.
Emollients and steroid strengths are often adjusted to find what works.
Eczema can relapse after good control and need treatment again.
Specialist treatments may be switched or stopped depending on response and side effects.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

A clear written plan: which emollient, how often, and exactly how to use steroids on flares.
Clear guidance on recognising and treating infection, with a contact route.
A defined review point and easy access if a flare will not settle.
Proper monitoring (including blood tests) for any systemic treatment.
Honest, long-term expectations focused on control rather than cure.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

The severity of eczema and how much treatment it needs
Whether care is emollients and steroid creams or specialist treatments
The clinician's fee (GP or dermatologist) and number of appointments
The cost of emollients, creams and any specialist medicines
Monitoring blood tests for immune-calming tablets or injected medicines
Light therapy sessions, if used
Follow-up and long-term review

Make sure your written quote includes

The consultation and review fees
The cost of creams, emollients and any specialist medicines
The cost and number of any light-therapy sessions
Whether monitoring blood tests are included for systemic treatment
What is covered if treatment needs to be changed or escalated
What happens, and who to contact, if eczema flares or becomes infected
How care links back to your GP and NHS records

On the NHS? Eczema is commonly treated on the NHS, with GP-led care and referral to a dermatologist for severe or hard-to-control disease and specialist treatments; private care is used mainly for speed or choice of specialist.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

Exactly how much steroid should I use, where, and for how long?
Which emollient suits me, and how often should I apply it?
How do I tell a normal flare from an infected one, and what do I do?
When should I be referred to a dermatologist?
If standard treatments are not enough, what specialist options are there and what do they involve?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my treatment, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this treatment not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Can eczema be cured?

No. Atopic eczema cannot be cured, but it can usually be well controlled with regular moisturising and treatment of flares. Many children improve as they get older.

Are steroid creams safe?

Used correctly on active eczema, topical steroids are an effective and safe treatment. The main risk, skin thinning, comes from overusing strong steroids on normal skin, so follow the advice on how much and how long.

Why do I need to keep moisturising when my skin looks fine?

Eczema-prone skin has a weak barrier even when it looks clear. Using emollients regularly keeps the skin moist and helps prevent the next flare, so they are continued all the time.

How quickly should a flare settle?

With regular emollients and the right-strength steroid on active eczema, itch and redness often start to settle within a few days and a flare is usually controlled within a couple of weeks.

Can I get eczema treatment on the NHS?

Yes. Eczema is commonly treated on the NHS by GPs, with referral to a dermatologist for severe or hard-to-control eczema and specialist treatments. Private care is used mainly for speed or choice.

When should I worry about infection?

If eczema becomes weepy, crusted, pus-filled, painful or rapidly worse, or you feel unwell, it may be infected and needs prompt advice. Painful clustered blisters with feeling unwell need urgent assessment.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Atopic eczema (treatment) NICE CKS — Eczema (atopic) British Association of Dermatologists — Atopic eczema (patient leaflet) Atopic eczema in primary care: evidence update — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.