Eczema (Atopic Dermatitis) in Ireland — Treatment Guide

What eczema is

Atopic eczema is a chronic, relapsing inflammatory skin condition. It runs in families with hay fever and asthma. Skin barrier dysfunction lets irritants and allergens through, triggering inflammation and itch.

The foundation: emollients

Frequent and generous emollient application is the single most important treatment. Use 250–500 g per week for an adult, every body wash followed by emollient, and at the first hint of dryness. Choose ointment for very dry skin; cream for daytime convenience.

Topical corticosteroids — by potency

• Mild (hydrocortisone 1%) — face, flexures, infants
• Moderate (clobetasone, betnovate-RD) — body in adults, short bursts
• Potent (betamethasone valerate) — body flares, palms, soles

Use the right potency for the right site, twice daily for 7–14 days, then taper. Steroid phobia is common but unjustified at appropriate dose and duration.

When to step up

If a moderate-potency course does not control symptoms, or if you are needing it almost continuously: switch to a topical calcineurin inhibitor (tacrolimus, pimecrolimus) for face/sensitive areas; or add antihistamines, antibiotics for bacterial superinfection, or wet-wrap therapy.

Severe eczema

Eczema that fails standard topical therapy may benefit from systemic treatment (methotrexate, ciclosporin) or biologic therapy (dupilumab) — these are dermatology-supervised. We refer where indicated.

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