Eczema (atopic dermatitis) is a chronic inflammatory skin condition affecting up to 20% of children and 3% of adults worldwide. European dermatology takes a systematic approach to management, combining pharmaceutical treatment with skin barrier repair and trigger avoidance.
Understanding Eczema Triggers
Eczema flares are provoked by a combination of factors. Common triggers include dry air and low humidity, harsh soaps and detergents, certain fabrics (especially wool), stress, food allergens (particularly in children), house dust mites, pollen, and pet dander. Identifying and minimizing your personal triggers is a crucial part of management.
The Skin Barrier Approach
European dermatologists emphasize that eczema is fundamentally a skin barrier disorder. The outermost skin layer (stratum corneum) functions like a brick wall — in eczema, the mortar between the bricks is defective, allowing moisture to escape and irritants to penetrate.
Emollient therapy is considered the foundation of eczema management, not just an add-on. Generous, frequent application of emollients reduces flare frequency and severity, decreases the need for topical steroids, restores the skin barrier function, and reduces itching.
Vitamin A and D ointments like Infadolan support skin barrier repair in areas of chronic eczema, providing deep moisturization and promoting healthy skin cell turnover.
OTC Treatment Options
Hydrocortisone cream (1%): The mildest topical corticosteroid, suitable for mild flares on face and body. Use for short periods (up to 7 days on the face, 14 days on the body) to control inflammation.
Antihistamines: Products like Fenistil drops can help manage itching, particularly at night when eczema itch tends to worsen. The mild sedating effect of some antihistamines can actually be beneficial for sleep disruption.
Colloidal oatmeal: Found in many European eczema care products, colloidal oatmeal soothes irritation and supports the skin barrier.
Bathing Best Practices
- Short, lukewarm baths or showers (not hot)
- Use soap-free, fragrance-free cleansers
- Pat skin dry gently — never rub
- Apply emollient within 3 minutes of bathing to lock in moisture
- Add bath oils for extra hydration during flares
The Wet Wrap Technique
For severe flares, European dermatologists often recommend wet wrapping: apply a thick layer of emollient, cover with a damp layer of cotton or bandage, and top with a dry layer. Worn for several hours or overnight, this dramatically increases emollient absorption and provides rapid relief from itching and inflammation.
When to Escalate Treatment
See a dermatologist if OTC treatments aren't controlling flares, if eczema is affecting sleep or daily activities, if the skin appears infected (weeping, crusting, increased warmth), or if you need topical steroids more than intermittently.