Eczema – Consultant Dermatologist Diagnosis & Personalised Treatment in London

Understanding eczema

Eczema, also known as atopic dermatitis, is one of the most common inflammatory skin conditions worldwide. It is characterised by recurring flares of itchy, red, and dry skin. The condition can begin in early childhood but may persist into adulthood or even start later in life. The severity of eczema varies, with some people experiencing only mild dryness and itching, while others endure widespread inflammation that disrupts sleep, work, and wellbeing.

Skin barrier dysfunction and immune system imbalance are key factors in eczema. The skin fails to retain enough moisture and becomes more permeable to irritants, allergens, and microbes, leading to chronic inflammation.

Causes and triggers

Eczema does not have a single cause but arises from a combination of genetic, environmental, and immunological factors. Triggers vary from person to person but common ones include:

• Dry climate and weather changes
• Soaps, detergents, and fragrances
• Allergens such as pollen, dust mites, or pet dander
• Infections that worsen inflammation
• Stress and emotional factors
• Certain foods (in children especially)

Symptoms and clinical features

Symptoms of eczema can vary but generally include:

• Intense itching, often worse at night
• Dry, cracked, or thickened skin
• Red, inflamed patches, especially in skin folds
• Oozing or crusting during acute flares
• Lichenification (thickened, leathery skin from scratching)

In children, eczema commonly affects the face, scalp, and flexures, while in adults it often appears on the hands, neck, and eyelids.

Diagnosis

Diagnosis is usually clinical, based on the characteristic appearance and history of symptoms. Blood tests are rarely needed, though allergy testing may be useful in some cases.

Treatment and management

Eczema is a long-term condition, but effective management can significantly reduce symptoms and improve quality of life. Treatments include:

• Moisturisers (emollients): Used daily to strengthen the skin barrier and reduce dryness.
• Topical corticosteroids: Applied to inflamed areas to quickly reduce flare-ups.
• Non-steroidal creams: Calcineurin inhibitors or PDE4 inhibitors for delicate areas like the face.
• Antihistamines: Sometimes used to control itching, particularly at night.
• Phototherapy: Ultraviolet light therapy in controlled settings for moderate to severe eczema.
• Systemic treatments: Oral or injectable immunomodulating medicines for resistant or widespread cases.

Lifestyle and self-care

Alongside medical treatment, daily care makes a major difference. Avoiding known triggers, using fragrance-free products, taking short lukewarm showers, and applying moisturiser immediately afterwards are recommended. Wearing breathable fabrics and managing stress can also help reduce flares.

Special considerations for skin of colour

In darker skin tones, eczema may appear as grey, purple, or brown patches rather than red. This can delay diagnosis. Post-inflammatory hyperpigmentation is also more common and can persist after flares settle. Dermatologists experienced in treating all skin types are best placed to provide tailored care.

Complications

Without proper management, eczema may lead to bacterial, viral, or fungal skin infections. Repeated scratching can cause scarring and thickening of the skin. Psychosocial impacts, such as anxiety or low self-esteem, are also common.

Why choose Skinhorizon?

At Skinhorizon, our consultant dermatologists provide comprehensive, personalised care for eczema. We combine advanced medical treatments with holistic skin support, helping patients achieve lasting relief while protecting long-term skin health.

Your first visit — what to expect

1. History: Review of symptoms, triggers, and personal/family history of allergies.
2. Examination: Assessment of affected areas, severity, and signs of infection.
3. Discussion: Education about eczema, lifestyle advice, and trigger management.
4. Treatment plan: Prescription of creams, phototherapy, or advanced options where appropriate.
5. Follow-up: Ongoing monitoring to ensure treatment success and adjust as needed.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 20 August 2025