Ask an expert – about eczema 

It was the 40th national Eczema Week from 12 – 20 September so we hosted a web chat with one of our experts, consultant dermatologist Dr Jennifer Crawley.  Eczema is fairly common in the UK – one in five children and one in twelve adults are affected. Dr Crawley is a specialist in treating skin conditions, including skin cancer, at University College Hospital in London and also leads the children’s dermatology service at UCLH.  

You can read a transcript the web chat below.

1:37 - Dr Jennifer Crawley: 
Good afternoon and welcome to our web chat. We will begin at 2pm but you can submit your questions now in preparation for the chat. Please note: your questions will not appear in the main chat window until after 2pm.

Dr Jennifer Crawley will be joining us to take your questions on ‘Eczema’ and will try to answer as many questions as possible within the hour long web chat.
Wednesday September 16, 2015 1:37 Dr Jennifer Crawley

1:57 [Comment From Eunice: ] 
Hello My daughter has acute eczema all over and we are waiting to see a dermatologist. She is 24 years old and it is making her life a misery. What washing powder/liquid do you recommend? At the moment they are using Bold but I am not sure this is a sensitive one. They live in a hard water area. With many thanks
1:58 Dr Jennifer Crawley: 
Hello Eunice, many thanks for your question. In general people with eczema should avoid soaps/shower gels etc as they can be drying and irritant to the skin so a soap substitute is always recommended. Your GP can prescribe these. It is always best to use a non-biological washing power. This won’t make the eczema better but it will certainly prevent the worsening of her symptoms. And remember to moisturise lots!
2:01 [Comment From Debbie: ] 
hi i have an 8 year old daughter with severe eczema, shes been under numerous doctors and specialist, shes tried immunesuppressants and light treatment along with different steriod creams. we were told she has fillagarrin gene mutation, and that its come from me and her dad . any information or help to do with this gene i would be greatful .weve been told her skin will never clear up
2:03 Dr Jennifer Crawley: 
Hello Debbie, thanks for your question. I’m sorry to hear about your daughter. It can be very upsetting for both her and you as her Mum. The filaggrin gene is a protein that regulates the surface layer of the skin and keeps the skin barrier intact. A mutation in this gene is thought to be implicated in people with eczema. When the skin barrier isn’t so good this can lead to problems with dryness and inflammation of the skin. It is important that your daughter’s skin is kept well hydrated with a regular emollient in order to maximise the skin barrier function. There is a lot of research taking place at the moment into filaggrin gene mutations so it’s an exciting time!
2:06 [Comment From Guest: ] 
My son (38 yrs) suffers from eczema since childhood. It was under control throughout his schooling years, but there was a severe outbreak three years ago whilst he was working in Singapore and has seen a dermatologist there and been under medication, which he stopped since coming back to UK. There is less flare up due to coooler weather but the hard water here is not helping. Is there any supplement he can take or diertary requirements to help in preventing future outbreaks of rashes?
2:06 Dr Jennifer Crawley: 
Thanks for that guest, it’s a common question I get asked. Unfortunately there is no know dietary supplement that can treat eczema. It is important that he has a good varied and balanced diet and importantly he uses a soap substitute and emollient regularly to help prevent flare ups. Keeping cool is important too.
2:07 [Comment From Dan: ] 
Hello Dr Crawley, I've read that Aloe Vera is not only good for burns but also for eczema. Is this true? Thank you.
2:08 Dr Jennifer Crawley: 
Good question Dan. Aloe Vera is good as it hydrates the skin and is soothing to the skin. It’s not something that I routinely recommend for the treatment of eczema as there are lots of other topical emollients that are much more beneficial.
2:14 [Comment From Emma: ] 
I have quite bad eczema and have been prescribed steroids for it which I am reluctant to use. I read steroids are bad for your skin
2:17 Dr Jennifer Crawley: 
Great question Emma and something I get asked time and time again so you aren’t alone! Topical steroids (cream/ointment based) do have some side effects and people are wary in using them. However, eczema responds very well to topical steroid treatment and these are crucial in managing eczema and keeping it under control. Steroids come in varying strengths from mild, moderate and severe. As long as you use them as directed by your doctor they are a good and effective treatment for eczema. Not using them can prolong your symptoms and make it more difficult to control in the longer term.
2:23 [Comment From Laura: ] 
Hi Dr Crawley, my 7month old has severe eczema and I'm wondering could his formula be causing it to flareup? What is the best formula for eczema babies? At the moment we are giving him aptamil. Thanks
2:24 Dr Jennifer Crawley: 
Thanks Laura. This is a very common question that I get asked by parents in my Paediatric clinic. In some babies milk protein allergy can play a role in the flaring of eczema symptoms. In such cases the history is crucial-that ie is the eczema made worse every time your baby has cow’s milk protein. If this is the case then it is important that you see your GP who can advise alternate formulas. If you are giving your baby aptamil and the eczema is under control there is no need to switch to an alternative. I hope that helps Laura.
2:27 [Comment From Dan: ] 
Thank you. Are there lots of emollients and soap substitutes out there on the market, and is the definition anything which attracts moisture? Whereas a humectant is something that keeps moisture in? Is there a difference?
2:28 Dr Jennifer Crawley: 
You are correct Dan, there is a lot of choice available and the important thing is that you find one that works well for you. An emollient is any topical product that hydrates the skin and keeps it moisturised for as long as possible. People respond to different emollients hence there are so many available.
2:30 [Comment From Julian: ] 
Hi Dr Crawley, when you suggest using other topical emolients, which one is more effective? He is using Eucerin for sensitive skin, PH5 Lotion F for dry skin after shower. Does he need to change to a better lotion?
2:31 Dr Jennifer Crawley: 
In general Julian the greasier the emollient the better. Eucerin is good for eczema but it’s important to re-apply often.
2:38 [Comment From Guest: ] 
My 14 year old son does most of his scratching at night and has terrible scars on his arms and legs. We've tried onesies and gloves but he's at an age that he doesn't want to be different. Are there any off the shelf creams that he can use, such as E45? Do perfumed deodorants have a negative affect?
2:40 [Comment From Julian: ] 
Hi Dr Crawley, thanks for your advice for my son Nigel. My granddaughter is 2.5 yrs old. She had mild eczema as a baby, but recently it became worse after holidaying in South of France in August. Could it be the heat? She has been taking Alpro (soya milk) as substitute for cows milk. The rashes tend to be on the inner elbow and wrist and to prevent her from scratching at night, she has to wear pj top with glovelike sleeves. Does using calamine lotion as a cooling and temporary relief help. Right now the parents are using over the counter E45 cream.
2:40 Dr Jennifer Crawley: 
Thanks for that Guest and Julian. Perfumed deodorants and perfumes in general can be a little irritating to patients with eczema. Quite often I will prescribe tubifast garments to wear at night time in younger children, as this can be helpful with stopping the itch-scratch cycle. For older children I would recommend making sure that the skin is well moisturised at night to prevent it drying out and be-coming itchy. As I eluded to before there are numerous emollients available and it’s important to find one that your son is comfortable and happy to use. E45 can be helpful but there are others available too!
2:42 [Comment From jackie: ] 
Thank you Dr Crawley, it's helpful to have updated advice as he was last seen when he was a baby!
2:42 Dr Jennifer Crawley: 
You are very welcome Jackie
2:47 [Comment From David: ] 
If I have eczema do I have to be careful in the sun
2:47 Dr Jennifer Crawley: 
Hello David, yes definitely. Everybody should be careful in the sun even if they don’t have eczema. It is so important for all of us to apply a sunscreen regularly with a good UVB coverage (SPF) and UVA. People with eczema should make sure they use a skin sensitive sunscreen and re-apply it often.


2:54 Dr Jennifer Crawley: 

Here are some useful links

2:55 Dr Jennifer Crawley: 
Thank you for joining us today in our live web chat. We hope you found the chat useful and some of your questions have been answered.

2:57 [Comment From Dan: ] 
Thanks for an enlightening and friendly session, Dr Crawley.
2:58 Dr Jennifer Crawley: 
You are most welcome Dan, glad it was useful

 Useful links