Eczema

Eczema (atopic dermatitis) is a chronic condition that makes skin dry, itchy, and inflamed. It often starts in infancy, runs in families with asthma or allergic rhinitis, and flares with weather, stress, and irritants. It is not contagious.

Typical pattern

• Intensely itchy, dry, red, scaly patches.
• Infants: face, scalp, outer arms/legs.
• Children and adults: creases of elbows, behind knees, neck, wrists, ankles. Dark skin may look brown-grey rather than pink.
• Scratching leads to thickening ("lichenification") and infection.

Common triggers in India

• Winter dryness, North Indian smog; hot humid summers trigger sweat-driven flares.
• Harsh soaps, detergents, antiseptic body washes, long hot showers.
• Wool, synthetic fabrics, strong fragrances.
• House-dust mites, pet dander, pollen (with allergic rhinitis).
• Food triggers are uncommon in older children and adults — don't restrict the diet without a doctor's advice.

What actually helps (in order)

• Moisturise heavily, twice a day, every day — this is the single most important treatment. Use a thick, fragrance-free moisturiser within 3 minutes of bathing. In India, plain petroleum jelly, coconut oil, or a ceramide-based cream works.
• Short, lukewarm showers — no hot water, no scrubbing, mild soap only where needed.
• Topical corticosteroid cream during flares — prescribed by strength appropriate to the body part and age. Use as directed; don't under-treat by fearing steroids, and don't overuse.
• Non-steroid topical options (calcineurin inhibitor and PDE4 inhibitor creams) for sensitive areas like face and skin folds.
• New systemic treatments (dupilumab, JAK inhibitors) are available in India for severe eczema — under a dermatologist.
• Treat infected flare-ups early — wet, oozing, yellow-crusted patches need antibiotics.

Avoid

• Over-the-counter "skin creams" with clobetasol for the face or long-term use — causes dependency and worsens eczema.
• Unregulated "ayurvedic" eczema powders — several have caused steroid dependence or skin burns.
• Constantly scratching — keep nails short; cool compresses or antihistamines help the itch.

When to see a doctor

• Persistent itch that disrupts sleep or school.
• Infected skin — pus, fever, increasing redness, crusting.
• Eczema on the face in a baby that's not responding to moisturiser.
• Generalised eczema with fever and blisters (eczema herpeticum — urgent).