Eczema Treatment

What is Eczema?

Eczema describes a spectrum of skin conditions that share common symptoms such as:

• Dry, scaly, or cracked skin

• Itching (often severe or chronic)

• Redness and inflammation

• Weeping, crusting, or secondary infection

• Thickened skin from repeated scratching (lichenification)

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Eczema is not contagious but can be persistent, relapsing, and significantly impact sleep, mood, and daily function.

 

Effective management requires correct diagnosis, trigger identification, and a tailored treatment plan from a qualified dermatologist.

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Types of Eczema

1. Atopic Dermatitis

Atopic dermatitis is the most common form of eczema, often beginning in early childhood but also affecting adults. It is part of the atopic triad, commonly seen alongside asthma and hayfever.

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Key Features:

• Chronic, relapsing course with flares

• Flexural eczema in children and adults (elbows, knees, neck)

• Facial and scalp involvement in infants

• Widespread dryness and inflammation in severe cases

• May present differently in skin of colour (e.g. grey-brown patches or subtle redness)

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Contributing Factors:

• Genetic predisposition affecting the skin barrier

• Immune system hypersensitivity and environmental allergen response

• Exposure to irritants, stress, sweat, and infection

• Disruption of the normal skin microbiome

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Atopic dermatitis may lead to complications such as recurrent bacterial infections, sleep disturbance, and significant psychosocial burden.

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2. Contact Dermatitis

Contact dermatitis is caused by direct interaction between the skin and an external substance, and is classified into:

a) Irritant Contact Dermatitis

• Caused by repeated exposure to water, soaps, detergents, hand sanitisers, or other chemicals

• Common in people with frequent handwashing or wet work (e.g. healthcare workers, cleaners)

• Results in dry, cracked, and painful skin, especially on the hands

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b) Allergic Contact Dermatitis

• A delayed hypersensitivity reaction to substances such as fragrances, metals (e.g. nickel), rubber components, or preservatives

• Often requires patch testing to confirm the allergen

• Appears as red, itchy, inflamed skin in the area of contact

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Chronic or untreated cases can resemble other skin conditions, highlighting the need for specialist input and accurate diagnosis.

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3. Discoid Eczema (Nummular Dermatitis)

Discoid eczema is a distinct type of eczema that appears as coin-shaped plaques on the arms, legs, or trunk. It is more common in adults and often flares in cold or dry climates.

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Clinical Signs:

• Round or oval patches that are itchy, scaly, or weepy

• May become secondarily infected

• Surrounding skin is often dry

• Can be confused with fungal infection or psoriasis

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Effective treatment focuses on restoring moisture, reducing inflammation, and preventing recurrence.

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Common Eczema Triggers

Understanding and avoiding triggers is essential to managing eczema. These may include:

• Soap, detergent, shampoo, or fragranced skin products

• Wool, synthetic fabrics, or tight clothing

• Dust mites, mould, pollen, or pet dander

• Heat, sweating, cold air, or low humidity

• Psychological stress or illness

• Skin trauma or scratching

• Microbial imbalance (e.g. increased skin bacteria)

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Diagnosis of Eczema

Our dermatologists at Domain Dermatology conduct a comprehensive telehealth assessment to identify the type and cause of your eczema. This includes:

• Thorough history taking (onset, pattern, triggers, family history, treatment history)

• Image and/or video review of your skin

• Assessment for differential diagnoses (e.g. psoriasis, scabies, fungal infections)

• Patch testing referral for suspected allergic contact dermatitis

• Microbiological swabs or other investigations if needed

Diagnosis is guided by your skin type, medical history, environmental exposures, and impact on quality of life.

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Treatment of Eczema

There is no single cure for eczema, but most patients achieve good control with the right skin care, treatment plan, and ongoing support. At Domain Dermatology, we offer a layered approach to treatment:

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1. Skin Barrier Repair and Maintenance

• Regular use of soap-free cleansers and fragrance-free moisturisers

• Gentle bathing and pat-drying

• Protective clothing and environmental control

• Education on flare prevention and lifestyle modifications

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2. Anti-Inflammatory Treatments

• Topical corticosteroids: Prescribed based on severity, site, and age group

• Non-steroidal topical immunomodulators: Often used for sensitive areas or long-term control

• Wet dressings or occlusive therapy: For intense flares or hard-to-treat areas

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3. Infection Control

• Use of topical antiseptics and appropriate treatments for secondary infection

• Hygiene advice and flare management planning

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4. Systemic and Specialist Therapies

• Phototherapy (light therapy) for extensive or treatment-resistant eczema

• Oral immunomodulating agents may be considered in severe or chronic cases under dermatological supervision

• Biologic therapies: Targeted immune-modulating treatments reserved for moderate-to-severe atopic dermatitis where other options have not succeeded

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We tailor each treatment plan to your needs, preferences, and skin response, with a focus on long-term safety and skin recovery.

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Why Choose Domain Dermatology?

At Domain Dermatology, you will receive:

• Expert dermatologist care through telehealth — accessible anywhere in Australia

• Rapid assessment and targeted management of all eczema types

• Advice on appropriate skincare, lifestyle modifications, and preventative strategies

• Referrals for investigations such as patch testing if required

• Ongoing support and follow-up care to keep your skin healthy

We are passionate about helping patients with eczema reclaim confidence, comfort, and control over their skin.

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Book a Dermatology Telehealth Appointment Today

If you are struggling with persistent, itchy, or inflamed skin, early diagnosis and specialist care can make a lasting difference.

 

Book a telehealth appointment with Domain Dermatology and receive personalised, evidence-based eczema treatment — no matter where you live in Australia.