Eczema develops because of a combination of genetics, an overactive immune system and a weakened skin barrier.

People with eczema have skin that is less effective at retaining moisture and protecting against irritants, allergens and bacteria. This "leaky" skin barrier allows water to escape more easily, leading to dryness, while also allowing substances from the environment to penetrate the skin and trigger inflammation.

Eczema commonly occurs in people with an atopic tendency, meaning they or their family members may also have:

• Asthma

• Hay fever (allergic rhinitis)

• Food allergies

Although eczema often runs in families, it is not contagious and cannot be passed from one person to another.

Triggers vary from person to person, but common factors include:

• Dry skin

• Hot weather or excessive sweating

• Cold, dry climates

• Soaps, bubble baths and harsh detergents

• Wool or rough fabrics

• Dust mites

• Animal dander

• Pollens

• Skin infections

• Stress

• Certain fragrances or skincare products

Symptoms can range from mild to severe and may include:

• Dry, rough or flaky skin

• Intense itching

• Red, inflamed patches

• Thickened skin from repeated scratching

• Cracked or painful skin

• Weeping or crusting during severe flares

• Difficulty sleeping due to itch

The appearance and location of eczema often changes with age. Infants commonly develop eczema on the cheeks and outer limbs, while older children and adults frequently experience eczema in the skin folds such as the elbows, knees, neck and wrists. Hand eczema is also common in adults.

Eczema is usually diagnosed by a Specialist Dermatologist based on your medical history and a thorough skin examination. In some cases, additional investigations may be recommended to identify contributing factors or to exclude other skin conditions.

These may include:

• Patch testing to investigate allergic contact dermatitis

• Skin swabs if infection is suspected

• Occasionally, blood tests or skin biopsy where the diagnosis is uncertain

Food allergy testing is not routinely required for most people with eczema and is only recommended when there is a history suggesting an immediate allergic reaction or other specific concerns.

There is currently no cure for eczema, but with the right treatment most people can achieve excellent control of their symptoms.

Treatment is tailored to the severity of the eczema, the patient's age and the areas of skin involved.

Our treatment options include:

• Individualised skincare advice

• Moisturiser recommendations to repair the skin barrier

• Soap substitutes and gentle skin care routines

• Prescription corticosteroid creams and ointments

• Non-steroidal anti-inflammatory creams (including calcineurin inhibitors and PDE4 inhibitors)

• Treatment of secondary skin infections when required

• Wet dressings for severe flare-ups

• Patch testing where allergic contact dermatitis is suspected

• Narrowband UVB phototherapy

• Many systemic therapies for eczema are Dermatologist prescription only in Australia

• Oral medications for more severe eczema

• Advanced biologic therapies, including injectable medications such as Dupilumab

• Oral JAK inhibitor medications for appropriate patients

We work closely with each patient to develop a long-term management plan that reduces flare-ups while minimising the need for stronger treatments whenever possible.

Daily skin care is one of the most important parts of eczema management.

We recommend:

• Applying moisturiser at least twice daily, even when the skin appears clear

• Using fragrance-free, soap free cleansers instead of soap

• Taking short, lukewarm showers or baths

• Patting the skin dry rather than rubbing

• Applying prescribed eczema creams before moisturiser, as directed by your dermatologist

• Wearing soft, breathable cotton clothing where possible

• Keeping fingernails short to reduce skin damage from scratching

You should seek specialist assessment if:

• Your eczema is not improving with standard treatment

• Frequent flare-ups are affecting your quality of life

• The skin is becoming infected

• Sleep is regularly disrupted by itching

• You require repeated courses of topical steroids

• You are concerned about allergies or contact reactions

• You may be a candidate for phototherapy or advanced systemic treatments

Our Specialist Dermatologists have extensive experience treating eczema in both children and adults. We provide evidence-based care using the latest treatment options, from optimising skincare and topical therapies through to phototherapy, biologic medications and oral immunomodulating treatments for more severe disease.

Our goal is to help you achieve long-term eczema control, reduce itching and flare-ups, and restore healthy, comfortable skin.