Opinion article
Eczema (atopic dermatitis): why skin gets dry and itchy
Eczema, or atopic dermatitis, is a chronic inflammatory skin condition that combines two problems: a skin barrier that lets water escape and irritants in more easily, and an immune system that overreacts. It’s common in children, but it can start or persist into adulthood.
How it shows up
Dry skin, intense itching (often the most disabling symptom), redness, and, during flares, cracked or weeping skin. It tends to affect the creases of the elbows and knees, the neck, and, in young children, the face as well.
Common triggers
- Harsh soaps, very hot water, and dry air.
- Rough fabrics, such as wool, in direct contact with the skin.
- Stress and changes in temperature or humidity.
- Specific allergens, which vary from person to person.
Treatment
- Emollients: the backbone of treatment, applied generously and several times a day, even between flares.
- Topical corticosteroids: to control inflammatory flares, used for as long as directed by your doctor, without fear but also without overuse.
- Topical calcineurin inhibitors: an alternative to steroids on sensitive areas such as the face.
- Systemic treatments: for moderate to severe cases, there are now biologic options (such as dupilumab) targeting the specific inflammatory pathway behind eczema.
Short showers, with warm rather than hot water, followed by moisturiser applied within three minutes, help lock in water far more than any product used alone.
This article is for information only and does not replace a medical consultation.
Sources
- Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of Care for the Management of Atopic Dermatitis. Journal of the American Academy of Dermatology. 2014
- National Eczema Association