25/07/2025
Eczema:
Eczema ( also called atopic dermatitis) is a common skin condition that causes itchy, dry and inflamed skin, eczema often begins in infancy and can persist into adulthood.
Eczema is not contagious, but can be very uncomfortable and frustrating to manage.
What causes eczema?
1. Weakened skin barrier – the skin cells don’t” fit together properly and allows skin lose moisture and let allergens and irritants in.
2. Overactive immune response – your skin becomes more easily inflamed than others
3. Genetics- family history of asthma, eczema or allergic rhinitis “hay fever” increases your risk of eczema
4. Environmental- harsh soaps, colder weather, dust mites, stress can all worsen your symptoms
Symptoms:
1. Dry, sensitive skin
2. Itching – intense and often worse at night
3. Red, inflamed patches ( crusting or oozing in severe cases)
4. Thickened, scaly skin ( usually due to prolonged scratching)
Treatment:
1. Avoid triggers:
Identify your triggers – wool clothing, strong perfumes or cleaners, detergents, stress, etc.
Recommend cotton underwear, clothing and bed linen.
Chlorine in swimming pools may irritate and dry out the skin. Avoid prolonged swimming or moisturise immediately afterwards.
For washing of clothes, nonbiological washing powders should be used, and fabric softeners should be avoided completely.
Avoid long and hot baths/showers. If soaking in a bath, apply emollients within 3 minutes after patting the skin dry.
Bubble baths, household antiseptics and medicated soaps are best avoided or minimised.
2. Protect the skin barrier:
Moisturise frequently(MOST IMPORTANT TREATMENT)
o Creates an oily layer on top of the skin that prevents the skin from drying out.
o Emollients are safe; they don’t pe*****te the skin, but rather protect the skin.
o Can be applied 6-8 times per day
o Thick, fragrance-free ointments and creams
Baths should be lukewarm rather than too hot (minimise moisture loss)
Avoid harsh soaps – soaps dry out the skin, so gentle cleaners containing moisturiser are advised. Emollients can also be used as soap, e.g. Aquas cream
3. Reduce itching and inflammation:
Antihistamines: Tablets or syrups can help with itching, especially at night. Antihistamine ointments are usually not effective and can irritate the skin more.
Cool compresses: soothing the irritated skin
Topical cortisone: Steroids/cortisone help by reducing the inflammation; they are the most effective treatment for rapid relief and are usually used during flare-ups.Different strengths of topical cortisones can be used. During flares, stronger ointments can be used, and as the flare resolves, weaker cortisone ointments can be used and slowly reduced until it can be stopped, and only emollients are continued.
Important to use emollient and cortisone at the same time, first apply steroid directly to skin then emollient layer on top.
Please use cortisone creams as advised by a medical professional.
Do I need antibiotics?
If you suffer from eczema your skin is more prone to infections, these can be caused by bacteria, fungi and viruses such as herpes and the common wart.
If your eczema rash develops crusting, oozing and redness of the skin, this might be due to infection ( see photos below)
Antibiotic creams and occasionally oral antibiotics are then used to treat infected eczema.
Recommended emollients available in SA:
- Epi-max Cream / Epi-max Plus – cost-effective, fragrance-free, suitable for face & body.
- Cetaphil Restoraderm / Cetaphil Moisturizing Cream – good for sensitive skin, non-greasy.
- Aquaphor Healing Ointment (Eucerin) – very thick, great for extremely dry, cracked areas.
- SBR repair - restore skin barrier, good for dry,cracked skin, elbows, hand and feet.
Eczema is a chronic condition, but with the right care it can be controlled.
For more information please visit the Allergy Foundation of South Africa website : https://www.allergyfoundation.co.za/allergy-information/atopic-eczema/
Greetings Dr. Jo-hannè Linde 🩺
Disclaimer The information provided in this post is for general information purposes only. It should not be considered as medical advice, diagnosis or a substitute for consultation with your designated healthcare professional. Always seek the advice of your physician with any questions you may have regarding a medical condition
