A – Avoid soaps
This includes all soaps, shower gels, bubble bath, shampoo (particularly shampooing hair in the bath), washing up liquid and anything else that makes bubbles.
Instead of soap, you should use a soap substitute. You can use any moisturiser as a soap substitute, or a special glycerin soap like Pure glycerine soap.
B – Barrier restoration
In eczema, the skin barrier is not functioning normally, and moisturising the skin will help to improve the barrier function. You should apply moisturiser as often as you can – if the eczema is bad, this may be 4 or 5 times a day; if it is good, then once or twice a day is fine. People with eczema will have fewer problems if they use a moisturiser every day, even when the skin is good.
Always apply moisturiser by smoothing it on, in the direction of the hairs (to avoid blocking up the hair follicles), and you do not need to rub it in completely. If it looks white, just wait a few minutes and it will soon melt into the skin.
There is no need to use bath oils (which just make things slippery), so long as you always apply moisturiser immediately after getting out of the bath.
C – Control inflammation
This is usually done with steroid creams or ointments. We use lower strengths on the face and in the flexures (skin creases) than on other body areas. Steroid creams are very safe, so long as you follow the instructions and only use them on the areas stated.
Many people worry about using steroids on their skin or their children’s skin. We know that if we do not treat the inflammation, the eczema gets worse and the barrier function gets worse, even with plenty of moisturisers. If we do not use topical steroids then we may end up making the eczema worse in the long run. If you are concerned about the use of topical steroids, please speak to your dermatologist about it.
You should not apply moisturiser and steroid at the same time – you need to wait half an hour for one to soak in before you use the other. If the eczema is bad then we would suggest using the steroid first; as it calms down then you can switch to using the moisturiser first.
Even on clear skin you should always apply the moisturiser.