I used to think eczema was just dry, itchy skin that showed up when the heating came on – a seasonal nuisance that disappeared with a good moisturiser. Then I met people who live with it every single day, and realised it’s not just about dryness; it’s an ongoing battle to stay calm when your skin has other plans.
Eczema, or atopic dermatitis, affects 3 per cent of adults in Ireland, according to Allergy Ireland, and 20 per cent of children. It often starts in childhood but can stubbornly stick around long after. It can be raised, red, itchy, tight, dry and generally inflamed. During flares or particularly dry weather, it can crack, ooze, and feel sore and painful.
“People often think eczema is caused by poor hygiene, or that it’s contagious,” says Dr Bernard Ho, consultant in dermatology at St George’s University Hospitals in London. “In reality, it’s a genetically linked inflammatory skin condition – not an infectious disease or a sign of being ‘dirty’. It’s related to immune and barrier dysfunction.”
Eczema is rarely triggered by one single thing. Genetics play a part, yes, but it’s only one piece of the puzzle. “Eczema tends to flare when the immune system overreacts to things that wouldn’t normally be an issue,” explains Dr Ho. “It’s not just about what touches your skin; stress, hormones and even weather changes can all be triggers.”
There are many types of eczema. Atopic dermatitis is the most familiar form, but there are others, including contact dermatitis, which happens when your skin encounters an irritant or allergen, such as mould, dust mites or pollen. There’s also dyshidrotic eczema, which can present as tiny, itchy blisters on the hands and feet, nummular eczema, which shows up as coin-shaped patches on the skin, and seborrheic dermatitis, which appears on the scalp and face.
Dr Ho says eczema is often confused with psoriasis. “Eczema usually appears as itchy, red patches in the skin creases, sometimes oozing or thickened. Psoriasis, on the other hand, tends to form well-defined, thick plaques with silvery scales, often on the elbows and knees, and is less itchy.”
If there’s one golden rule when treating eczema, it’s moisture, and lots of it.
“A simple routine is best,” advises Dr Ho. “Apply a gentle, fragrance-free moisturiser regularly. Bioderma Atoderm Intensive Baume (€22 for 500ml from Life Pharmacy) is effective for severe dryness. Avoid common irritants, like fragrances, sodium lauryl sulfate, alcohol-based products, and some essential oils. Using mild, fragrance-free products can make a noticeable difference.”
And while moisture is vital, cleansing also plays an important role in managing eczema. Gentle, soap-free, pH-balanced washes such as Bioderma Atoderm Shower Oil (€19.50 for 1L from millies.ie) help keep the skin calm. When showering, long, hot dips might sound heavenly, but they’re not your skin’s friend – keep them short and warm to avoid irritation.
When flares strike, over-the-counter hydrocortisone creams can help, but stubborn eczema may need prescription options like topical corticosteroids or biologic therapies. “Topical corticosteroids remain highly effective when used correctly,” says Dr Ho. “But long-term, unsupervised use can cause thinning or stretch marks, so regular reviews with your doctor are essential.”
The good news? “Biologic therapies, which target specific immune pathways, have revolutionised care for moderate-to-severe eczema,” he says. “They’re offering real relief for people who haven’t responded to traditional treatments.”
While consultant dermatologists often see the most severe cases, GPs are usually on the front line of eczema care, managing everything from mild flare-ups to chronic conditions.
Dr Laura Lenihan, GP and founder of Dr Laura Clinic in Galway, sees eczema across all ages in her practice - “babies, toddlers, and women of all stages of life. I’m seeing a lot of women in their 20s right now, and flare-ups are definitely common.”
“Most of the cases I see are atopic,” she adds. “Eczema on the eyelids is particularly tricky - it can be hard to pinpoint the exact cause, and potential allergens like nail products often play a role.”
When managing flares, Lenihan’s philosophy is to keep things uncomplicated. “I always recommend keeping it simple. If you’ve been prescribed a medicated cream, use that once daily, and your moisturiser once daily. Consistency is what makes the difference.”
Her go-to product lineup focuses on barrier support and hydration. “I also recommend Bioderma Atoderm Shower Oil - it’s the only thing I suggest using in the shower. After that, I really rate the Aveeno Body Oil Spray (€10.49 from Boots) or Aveeno After Shower Mist Moisturiser (€10.49) to lock in hydration.
“To seal everything in, I recommend La Roche-Posay Lipikar Baume Ap+M (€25.50 from Boots),” she adds. “For small areas that need extra care, La Roche-Posay Cicaplast Baume (€19.50 from Boots) is brilliant, and if your hands are super dry, the Cicaplast Hand cream (€10 from Boots) - with its higher glycerin content - is fantastic.”
When choosing everyday make-up and skincare, look for alcohol-free, hypoallergenic products that contain soothing ingredients such as glycerin, ceramides, cica and panthenol.
Great base options that meet these criteria include Ilia Beauty Super Serum Skin Tint SPF30 (€50 from Space NK) and Hourglass Veil Hydrating Skin Tint (€54 from Brown Thomas).
For every day moisturisers and sunscreens, a gentle, barrier-repairing cream is essential, and always follow with a broad-spectrum sunscreen – preferably one containing zinc oxide, an anti-inflammatory that can soothe and reduce itching, such as EltaMD Clear SPF46 (€59 from Institute of Dermatologists) and Heliocare 360° Mineral Tolerance Fluid SPF50 50ml (€36 from lookfantastic.com).
And when it comes to removing it all at the end of the day, the gentler the better. Cream or milk-based cleansers with barrier-repairing ingredients, and non-irritating micellar waters will be your best friends. Great options include Avène Extremely Gentle Cleanser (€18 from millies.ie) and Bioderma Sensibio Cleansing Micellar Water (€14 for 250ml from Boots).
If you’re doing all the right things, and eczema is still keeping you up at night, spreading, or just not improving, it’s important to see a GP or dermatologist. Any oozing, crusting or pain can signal infection and needs attention.
[ Eczema season guide: What is the skin condition and how to support your childOpens in new window ]
For parents caring for kids with eczema, Dr Ho’s advice is this: “Favour gentle, fragrance-free products and use prescribed topical steroids as recommended for children. Keeping nails short, avoiding overheating, using cotton clothes, and considering wet-wrap therapy for severe flares are key strategies. Consultation for food allergies is more important when eczema is severe or persistent in children.”
