Eczema — managing flare-ups with treatment
Reviewed by the My London Pharmacy clinical team, Yousef Yaghoubi, Pharmacist
·29 July 2026
·7 min read
Quick answer
Eczema is a common condition where the skin becomes dry, itchy and inflamed, often in flare-ups. Managing it well combines regular moisturising with emollients, avoiding personal triggers, and using topical steroids of the right strength during flares. A clinician can help you build a routine and choose suitable treatments.
Understanding eczema
Eczema, also called atopic dermatitis, is a long-term condition in which the skin becomes dry, itchy, red and inflamed. It is very common in the UK, often starting in childhood, though it can appear or persist at any age. Eczema tends to come and go, with settled periods interrupted by flare-ups when symptoms worsen.
The underlying issue is a weakened skin barrier. Skin that cannot hold on to moisture becomes dry and more sensitive to irritants and allergens, which triggers the immune system and leads to inflammation and itching. Scratching then damages the barrier further, creating a cycle that treatment aims to break. Eczema is not contagious, and while there is no simple cure, it can usually be well controlled. Many children find their eczema improves as they grow older, though it can persist into adult life or reappear after years of clear skin, sometimes triggered by hormonal changes, stress or a new irritant. Understanding that eczema fluctuates naturally, with better and worse spells, helps set realistic expectations and takes some of the frustration out of the occasional flare.
Common triggers
Flare-ups are often set off by things that irritate the skin or provoke the immune system. Identifying your own triggers is one of the most useful things you can do. Common ones include:
- Soaps, detergents and bubble baths that strip natural oils
- Wool or synthetic fabrics against the skin
- Heat, sweating and sudden temperature changes
- Stress, which can worsen many people's eczema
- Certain allergens such as house dust mites, pet dander or pollen
Keeping a simple diary of when flares happen can help you spot patterns. Once you know your triggers, avoiding or reducing them makes flares less frequent and easier to manage.
The foundation: daily emollient care
Moisturisers, known as emollients, are the cornerstone of eczema care and should be used every day, even when the skin looks clear. They work by replacing lost moisture and rebuilding the skin barrier, which reduces dryness, itching and the frequency of flares. Applying emollient generously and often, several times a day if needed, makes a real difference.
Use an unperfumed emollient as a soap substitute rather than ordinary soap, which can dry the skin further. Apply it in smooth downward strokes in the direction of hair growth rather than rubbing it in vigorously. Keeping this routine going during good periods is what keeps eczema settled, so it is worth making it a habit rather than only reaching for it during a flare.
It can take some trial to find an emollient that suits you, as they range from light lotions to thicker creams and greasy ointments. Heavier ointments hold moisture in for longer and often suit very dry skin, while lighter creams feel more comfortable during the day. Many people use a combination, keeping a tub by the sink and another by the bed. Applying emollient shortly after a bath or shower, while the skin is still slightly damp, helps lock moisture in. A useful rule is to use far more than feels necessary; most people underuse emollients, and generous, frequent application is what makes the biggest difference.
Treating flares with topical steroids
When a flare-up brings redness and itching that emollients alone cannot settle, a topical corticosteroid is the usual treatment. These come in different strengths, and matching the strength to the severity and the area of skin is important. A mild option such as Hydrocortisone is often used for the face and for milder flares, while a moderate steroid like Eumovate suits more stubborn patches on the body.
Stronger, potent steroids such as Betnovate or Elocon may be considered for thicker, more resistant areas of eczema, used for short courses under guidance. Applied correctly, in a thin layer once or twice a day for a defined period, topical steroids are a safe and effective way to bring a flare under control. NICE guidance supports using the lowest strength that works, stepping up only when needed and stepping back down as the skin settles.
When eczema becomes infected
Broken, weeping or crusted skin can become infected, most often with bacteria. Signs include increasing redness, oozing, yellow crusting, pain or a sudden worsening that does not respond to your usual treatment. Infected eczema needs prompt attention because it can spread and delay healing.
In these cases a clinician may recommend a combined preparation such as Fucibet, which pairs a steroid with an antibiotic to treat inflammation and infection together. Seeking advice early, rather than continuing with steroids alone, helps the skin recover more quickly and comfortably.
Using topical steroids with confidence
Many people feel anxious about topical steroids, and it helps to understand how to use them well. The amount is measured using the fingertip unit: the amount squeezed from the tube onto the tip of an adult finger, which is roughly enough to cover an area the size of two flat adult hands. Applying the right quantity, in a thin layer to the affected skin only, once or twice a day as directed, keeps treatment both effective and safe.
A common pattern is to use the steroid until the flare has settled, then stop and return to emollients alone. Emollient and steroid can both be part of the same day; simply leave a short gap between applying them so each has time to absorb. Used in this way, for the short courses that flares require, topical steroids have a strong safety record. The problems people worry about, such as thinning skin, are mainly associated with using potent steroids for long, uninterrupted periods on delicate areas, which is exactly what a considered, step-up-step-down approach avoids. If you find you are needing a steroid very frequently, that is a signal to review your routine rather than simply to keep applying more.
Living well with eczema
Good long-term control comes from combining daily emollients, avoiding your triggers, and treating flares promptly with the right-strength treatment. Keeping fingernails short and using cotton clothing can reduce the damage from scratching. Some people find that managing stress and keeping the home cool and well ventilated also helps.
Eczema fluctuates, and occasional flares do not mean you are doing anything wrong. Having a clear plan for what to use, and when, gives you confidence to respond quickly. If your eczema is frequently flaring despite a good routine, a review can help refine your approach.
When to seek advice
Speak to a pharmacist or clinician if your eczema is not improving with regular emollients, if flares are frequent or severe, if the skin looks infected, or if the condition is disturbing your sleep or daily life. Eczema affecting a child, the face, or large areas is also worth reviewing.
A clinical consultation can help you build an effective routine and recommend suitable treatments based on your skin and history. All treatment is subject to suitability, and a clinician can advise on the safest options for your circumstances.
Eczema affects people of all ages, and the priorities can differ across life stages. In babies and young children the focus is often on gentle, generous emollient use and careful choice of steroid strength for delicate skin, while in adults long-standing eczema on the hands or in relation to work may need extra attention to protection and triggers. Whatever your situation, the aim is the same: fewer and milder flares, comfortable skin, and a clear plan you feel confident using day to day. If your eczema changes in character, spreads, or stops responding to what usually works, a review is worthwhile, as occasionally other skin conditions can be mistaken for eczema and benefit from a different approach.
Frequently asked questions
Are topical steroids safe to use on eczema?
Yes, when used correctly for the recommended strength and duration they are safe and effective. Using the lowest strength that controls the flare, applied thinly and for a defined period, keeps the risk of side effects low.
How often should I moisturise?
Apply emollient at least twice a day, and more often if your skin is very dry, including on days when the skin looks clear. Regular use is what keeps the skin barrier strong and reduces flares.
Can eczema be cured?
There is no simple cure, but eczema can usually be well controlled with the right routine. Many children find it improves as they grow older.
Why does my eczema get worse in winter?
Cold air and indoor heating both dry the skin, weakening the barrier and triggering flares. Using more emollient and avoiding very hot baths can help during colder months.
Is eczema contagious?
No, eczema itself cannot be passed from person to person. However, if the skin becomes infected, that infection may need specific treatment.