Eczema (Atopic Dermatitis) in London: Symptoms, Triggers & Diagnosis

Understanding eczema (atopic dermatitis)

Eczema is driven by two main factors: a weakened skin barrier (which allows moisture to escape and irritants to enter) and an overactive inflammatory response. This creates the “itch–scratch cycle” — itching leads to scratching, which further damages the barrier and increases inflammation. Eczema often starts in childhood, but it can persist into adulthood or develop later in life.

Eczema symptoms

• Itching (often worse at night) and sleep disturbance
• Dryness, roughness, scaling or cracking
• Redness or inflamed patches (may appear darker, grey-brown or violaceous in skin of colour)
• Weeping/crusting during acute flares
• Skin thickening (lichenification) if inflammation is long-standing

Common types of eczema

• Atopic eczema (atopic dermatitis): The most common type, often affecting flexures, face, neck, and hands.
• Contact dermatitis: Triggered by irritants or allergens such as fragrance, preservatives, metals or rubber. See contact dermatitis.
• Discoid eczema: Coin-shaped patches that can be persistent. See discoid eczema.
• Hand eczema: Often linked to wet work, detergents and occupational exposure.
• Seborrhoeic dermatitis overlap: Flaking and redness on scalp/face. See seborrhoeic dermatitis.

Causes and triggers of eczema

Many people have an inherited tendency toward eczema, but flare-ups are often driven by triggers. Common triggers include:

• Soaps, bubble baths, fragranced skincare and harsh cleansers
• Detergents, disinfectants and repeated handwashing
• Heat, sweating and friction
• Dry air and seasonal change (common in London winters with indoor heating)
• Stress, anxiety and lack of sleep
• Allergens such as dust mites, pollen or pet dander
• Skin infection (eczema may worsen if infected)

Eczema diagnosis

Eczema is usually diagnosed clinically by a dermatologist based on the pattern, distribution and history. If eczema repeatedly affects the eyelids, hands, face, or seems linked to products, a contact allergy may be contributing. In selected cases, we may recommend patch testing to identify potential allergens and guide avoidance.

Eczema self-care that helps (evidence-based basics)

• Moisturise daily: Use a fragrance-free emollient regularly, especially after washing.
• Gentle cleansing: Avoid harsh soaps; use mild, non-fragranced cleansers.
• Short, lukewarm showers: Pat dry and moisturise within a few minutes (“soak and seal”).
• Reduce scratching: Keep nails short; use cool compresses when itchy.
• Clothing: Choose soft, breathable fabrics; avoid wool on active areas.
• Hands: Use protective gloves for wet work; apply barrier cream when needed.

Eczema treatment options (overview)

Treatment depends on the severity, the areas involved (e.g., face, eyelids, hands), your age, and how eczema affects daily life. Many people do well with a structured routine and flare plan, but persistent eczema may need escalation. For a full consultant-led pathway, visit our Eczema Treatment page.

• Barrier repair: Emollients and protective routines.
• Anti-inflammatory topicals: Used appropriately for the site and severity.
• Trigger control: Allergen/irritant avoidance when identified (including patch test-guided changes).
• Escalation pathways: Options for more persistent or severe eczema under specialist supervision.

Eczema in children

Children’s eczema often affects cheeks and flexures and can significantly impact sleep and family life. A clear, simple routine plus a structured flare plan usually helps. If eczema is severe, recurrently infected, or not responding, specialist assessment can clarify diagnosis and guide escalation safely.

Eczema in skin of colour

In darker skin tones, eczema may look less red and more grey-brown or violaceous, and post-inflammatory pigmentation can persist after flares. Management should be pigment-aware and set realistic timelines for colour changes to fade.

Related conditions

Depending on the appearance and location, eczema can overlap with or be confused with other conditions such as dermatitis, dry skin, and psoriasis. If you are unsure which applies, a dermatologist assessment helps confirm the diagnosis.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 12 September 2025