Eczema and Dry Skin: The Difference and How to Care

What is the difference between atopic eczema and dry skin?

Dry skin feels rough or flaky and may itch a little. It usually improves within days of moisturising and changing a few habits, and often affects the legs, arms and hands. It can get worse with age, with hard water in some homes, and with fasting and low fluid intake.

Atopic eczema usually starts in childhood. The itch is intense and can disturb sleep, with red or darker patches and sometimes weeping or cracking. In babies it tends to appear on the face and cheeks; in older children and adults, in the creases of the elbows, knees and neck. There is often a family history of asthma, hay fever or eczema.

What triggers eczema and makes dryness worse?

Triggers differ between people, and knowing yours helps reduce flares. Common ones include:

• Long, hot showers.
• Harsh soaps, scented detergents and fabric softeners.
• Wool and rough fabrics against the skin.
• Dry air from air-conditioning for long hours.
• Sweat and summer heat.
• Stress and poor sleep.
• Frequent hand washing and sanitiser use without moisturising afterwards.

How do you moisturise the right way?

Regular moisturising is the foundation of care for both conditions, and how you apply it matters as much as which product you choose:

• Shower in lukewarm water for 5 to 10 minutes with a gentle, fragrance-free wash.
• Pat the skin dry with a towel; do not rub.
• Apply moisturiser within 3 minutes of getting out, while the skin is still slightly damp.
• Choose a thick cream or ointment; it works better than a light lotion on dry skin.
• Moisturise at least twice a day, and after every hand wash.
• Smooth it on in the direction of hair growth to lower the chance of inflamed follicles.

What should you do during an eczema flare?

When itching and redness flare, keep moisturising rather than stopping, keep nails short, use cool compresses to ease the itch and wear loose cotton clothing. Keeping your moisturiser somewhere cool can make it more soothing on itchy skin. Try not to scratch, as scratching increases inflammation and opens the door to infection.

If a flare does not settle within a few days, or you notice weeping, yellow crusts or pain, see a doctor, as the skin may be infected and need specific treatment.

When are steroid creams prescribed, and why should a doctor guide them?

Topical corticosteroids are a mainstay of treatment for eczema flares and are safe when used correctly. The doctor chooses the strength according to the patient's age and the location and severity of the eczema: the face, skin folds and children's skin need milder types than the hands and feet. The doctor also sets how long to use it and how to stop.

Using strong creams without supervision, for long periods, or buying unlabelled mixtures that contain steroids can thin the skin and cause marks and pigmentation. On the other hand, excessive fear and stopping treatment too early prolongs the flare. Your doctor may also prescribe other treatments for frequent or severe eczema.

How do you care for eczema in children?

Eczema is common in babies and children, and many improve as they grow. Use short baths in lukewarm water, a fragrance-free moisturiser several times a day and soft cotton clothes, and keep your child's nails short.

Do not use adult creams or home remedies on a child's skin, and do not cut foods out of their diet without medical advice, as unnecessary restriction can affect growth. If your child is a baby, or the eczema covers large areas, see the doctor before using any medicated cream, so they can choose the right type and strength for their age.