Eczema (Atopic Dermatitis)

Non-Pharmacological Management

• Emollients applied at least twice daily, preferring ointments over lotions

• Soap-free or low-irritant cleansers for bathing to minimise dryness

• Lukewarm baths with bath oils or salt to hydrate skin and reduce inflammation

• Bleach baths at a 0.005% dilution two times weekly if recurrent infections occur

• Wet dressings during severe flares to reduce itching and promote skin healing

• Loose cotton clothing to prevent sweating and irritation, avoiding wool or synthetic fabrics

• Maintain a cool indoor environment with adequate humidity to prevent excessive skin dryness

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Triggers

• Irritants such as pet fur, dust mites, mould, detergents, fragranced products

• Food allergens in infants, especially if gastrointestinal symptoms or urticaria are present

• Climatic extremes including hot, humid weather or cold, dry air

• Staphylococcus aureus infection or herpes simplex (eczema herpeticum) exacerbating flares

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When to Refer

• Unclear or atypical presentation not responding to standard measures

• Significant impact on quality of life or severe psychosocial consequences

• Recurrent or severe infections requiring systemic antibiotics or antivirals

• Consideration of systemic therapies or phototherapy for refractory disease

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Notes

• Educate about consistent emollient use and avoidance of identified triggers

• Treat early signs of secondary infection (weeping, crusting) to prevent worsening

• Topical corticosteroids or topical calcineurin inhibitors are used to control inflammation during flares