Treatment for atopic eczema, emollients (moisturisers)

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People with eczema have a tendency for their skin to become dry. Dry skin tends to 'flare-up' and become inflamed into patches of eczema. Emollients are lotions, creams, ointments and bath/shower additives which prevent the skin from becoming dry. They 'oil' the skin, keep it supple and moist and help to protect the skin from irritants. This helps to prevent itch and reduces the frequency of eczema flare-ups.

The regular use of emollients is the most important part of the day-to-day treatment for eczema. Your doctor, nurse or pharmacist can advise on the various types and brands available, and the ones which may be best suit you.

You should apply emollients as often as you need. This may be twice a day, or several times a day if your skin becomes very dry. Some points about emollients include:

As a rule, thicker, greasy ointments work better and for longer than thinner creams, but they are messier to use. Some people dont mind using thick ointments, but some people prefer creams (but apply them more often.)
Apply liberally to all areas of skin. You cannot overdose or overuse emollients. They are not active drugs and do not get absorbed through the skin.
Use emollients every day. A common mistake is to stop using emollients when the skin appears good. Patches of inflammation, which may have been prevented, may then quickly flare-up again.
If you are also using a steroid cream or ointment, wait 30-60 minutes after you have applied the steroid before applying emollients. This avoids 'diluting' the steroid which may make it less effective.

Many people with eczema use a range of different emollients. For example, a typical routine for an 'average' person with eczema might be:

When you have a bath or shower, add an emollient oil to the bathwater or as you shower. This will give your skin a general background 'oiling'.
Use a thick emollient ointment as a soap substitute for cleaning. You can also rub this into particularly dry areas of skin.
After a bath or shower it is best to dry by patting with a towel rather than by rubbing.
Then apply a less thick emollient cream or ointment to any remaining dry areas of skin.
Between baths or showers, use an emollient cream, ointment or lotion as often as necessary.
Use an emollient ointment at bedtime.

Note: moisturisers used for eczema tend to be 'bland' and non-perfumed. Occasionally, some people become sensitised to an ingredient in a moisturiser. This can make the skin worse rather than better. If you suspect this, see your doctor for advice. There are many different types of moisturisers with various ingredients. A switch to a different type will usually sort this uncommon problem.

Warning: Bath additive emollients will coat the bath and make it greasy and slippery. It is best to use a mat and/or grab rails to reduce the risk of slipping. Warn anybody else who may use the bath that it will be slippery.