Eczema and skincare — what works, what does not, and why the barrier comes first.

Eczema — clinically, atopic dermatitis — affects approximately one in ten people. It presents as patches of dry, intensely itchy, inflamed skin that flare and remit in cycles. For many people it is a childhood condition that resolves; for others it persists into or begins in adulthood. Managing it well requires understanding both what it is and what the role of skincare actually is within a broader treatment picture.

What eczema is

Atopic dermatitis is a chronic inflammatory skin condition with two converging problems. The first is a defective skin barrier. People with eczema often have mutations in the gene that encodes filaggrin — a structural protein responsible for forming the tight junction layer that keeps the barrier intact and retains water. A filaggrin-deficient barrier loses water faster (elevated TEWL), allows allergens and irritants to penetrate more easily, and disrupts the skin's lipid composition. The barrier is impaired even between flares, not only during them.

The second problem is immune dysregulation. Eczema-prone skin has an overactive Th2 immune response — the branch of the immune system associated with allergic reactions. Environmental triggers (pollen, dust mites, animal dander, certain foods in severe cases) and skin-surface disruptions activate this pathway, producing the inflammatory cascade that causes the redness, swelling, and itch of a flare.

Both problems are present simultaneously, which is why eczema management requires both ongoing maintenance (addressing the barrier) and flare treatment (addressing the inflammation).

The role of skincare in eczema management

Skincare is the maintenance layer. It cannot resolve an active inflammatory flare — that requires medical treatment — but it can reduce flare frequency, severity, and duration by supporting the barrier function that eczema compromises.

The two goals of an eczema skincare routine are: keep the barrier reinforced between flares, and avoid triggering the immune response with products that contain irritants or allergens. These goals are often in conflict with conventional skincare priorities like efficacy or texture, which is why standard skincare recommendations do not always translate to eczema-prone skin.

The routine

Cleansing: Use a non-soap, non-foaming cleanser with a pH close to the skin's natural acid mantle (4.5–5.5). Traditional soaps have a pH of 8–10 — alkaline — which disrupts the acid mantle and depletes the lipid barrier, both of which worsen eczema. Sodium lauryl sulfate (SLS) and sodium laureth sulfate (SLES), the primary detergents in many foaming cleansers, are among the most significant contact irritants for eczema skin and should be avoided in leave-on products and minimised in rinse-off products. Wash with lukewarm, not hot, water — heat dilates capillaries and increases histamine release, which intensifies itch.

The soak and seal method: Apply moisturiser within three minutes of bathing, while the skin is still slightly damp. This is not merely a recommendation — it is the most evidence-backed technique for barrier support in eczema. The moisturiser seals in the water that has absorbed during bathing before it can evaporate. Waiting until skin is fully dry means the barrier has already lost the surface hydration the application was intended to lock in.

Moisturiser selection: For eczema, the most effective formulations are emollient-heavy: they restore the lipid barrier directly. The most well-supported ingredients are ceramides (particularly ceramide NP, ceramide AP, and ceramide EOP in combination — the three dominant ceramide species in the stratum corneum), cholesterol, and free fatty acids. Products that combine all three in approximately physiological ratios provide the most targeted structural support. Colloidal oatmeal (Avena sativa kernel flour) is an FDA-recognised active ingredient for eczema with multiple mechanisms — anti-inflammatory, barrier-reinforcing, antipruritic. Shea butter, squalane, and glycerin are effective emollients and humectants with low sensitisation potential.

Heavy emollient ointments (white petrolatum, paraffin) have the most evidence behind them for severe eczema; they are occlusive rather than barrier-corrective, but occlusion works. Many people find them impractical for daytime use — a ceramide-based cream is a reasonable compromise.

Frequency: Moisturise at minimum twice daily. For eczema, the research supports more frequent application rather than less — every bathroom visit is a reasonable approach. Consistent daily moisturising reduces flare frequency more than reactive moisturising only when the skin feels dry.

Flare management

During an active flare — characterised by redness, swelling, oozing, crusting, or intense itch — skincare cannot resolve the inflammation. Topical corticosteroids (hydrocortisone at 1% OTC, or prescription-strength options via a GP or dermatologist) are the first-line medical treatment for flares. They suppress the Th2 inflammatory response and reduce itch, redness, and swelling rapidly. The concern about topical steroid overuse is real — thinning, tachyphylaxis, and perioral dermatitis with inappropriate long-term use — but they remain the most effective acute treatment available.

Topical calcineurin inhibitors (tacrolimus, pimecrolimus) are non-steroidal alternatives for moderate eczema, effective on facial and skin-fold areas where long-term steroid use carries more risk. Dupilumab, a biologic targeting the Th2 pathway, is a highly effective prescription option for moderate-to-severe atopic dermatitis that does not respond adequately to topical treatment.

Wet wrap therapy — applying a topical treatment followed by damp gauze or tubular bandages under dry bandaging — is used for severe flares, particularly in children. It enhances penetration of topical treatment and provides a physical barrier against scratching.

None of this is skincare. It is medicine. The role of skincare is to reduce the conditions that trigger flares, not to treat them.

What to avoid

Fragrance is the most common contact allergen in skincare and a primary trigger for eczema flares. This includes "natural" fragrances — lavender, eucalyptus, rose — which are frequently more sensitising than synthetic fragrance compounds on eczema-prone skin.

Drying alcohols (ethanol, isopropyl alcohol, denatured alcohol) disrupt the lipid barrier and should be avoided in leave-on products for eczema skin.

Preservatives: Some preservatives — methylisothiazolinone (MI), methylchloroisothiazolinone (MCI), formaldehyde releasers — have high sensitisation rates and are disproportionately problematic for eczema-prone skin. The EU has restricted MI in leave-on products for this reason.

Overactive skincare: Retinoids, high-concentration AHAs, and physical scrubs are inappropriate on active or fragile eczema skin. They cause irritation that compounds the barrier disruption eczema already creates. When eczema is well-controlled and the skin is stable, gentle actives (low-concentration lactic acid, niacinamide) may be tolerable. During a flare, strip the routine to cleanser and emollient only.

The trigger question

Managing eczema well almost always involves identifying individual triggers and moderating exposure to them. Common environmental triggers include: house dust mites, pet dander, certain pollens, synthetic textiles (wool and rough fibres against skin), washing detergents and fabric softeners (fragrance and enzymes), and temperature extremes. Stress activates the hypothalamic-pituitary-adrenal axis and modulates the Th2 response — it is not a myth that eczema flares under stress. Some people with severe eczema have identified food triggers; this is more common in children and requires allergy testing rather than elimination guessing.

A dermatologist is part of the picture

For eczema that is not controlled by moisturising and OTC hydrocortisone, a dermatologist assessment is the appropriate next step — not escalating the skincare routine. Prescription treatments (prescription-strength topical steroids, topical calcineurin inhibitors, dupilumab, newer JAK inhibitors) have evidence behind them that no skincare formulation can match for moderate-to-severe disease. Referral is not a failure; it is the right tool for the right job.

The Lux & Glo position

We make a niacinamide serum, a cleansing oil, and a moisturiser. These are appropriate for maintenance use on eczema-prone skin in remission — niacinamide is a well-tolerated anti-inflammatory and barrier-supportive ingredient; our cleansing oil is a fragrance-free, barrier-respecting format; a ceramide-containing moisturiser is the backbone of any eczema maintenance routine.

What we do not do is claim to treat eczema. A skincare routine is the maintenance layer — genuinely important, but distinct from the medical treatment that active disease requires.

Tending the skin consistently, with the right formulations and without the ingredients that trigger it, is what makes a good stretch last longer.