Eczema Treatment in Ireland: From OTC Creams to Prescription Options

Eczema (also known as dermatitis) is one of the most common skin conditions in Ireland, affecting approximately 1 in 5 children and 1 in 10 adults. It causes dry, itchy, inflamed skin that can significantly impact quality of life, sleep, and daily activities. While there is no cure for eczema, it is highly manageable with the right combination of skincare, trigger avoidance, and medical treatment.

This guide covers identifying your type of eczema, the treatments available over the counter and on prescription, and the situations that need a doctor's input.

What Is Eczema?

Eczema is a chronic inflammatory skin condition characterised by dry, itchy, and irritated skin. The term "eczema" actually covers a group of related conditions, all of which involve inflammation of the skin. The most common form is atopic eczema (also called atopic dermatitis), which is linked to the immune system and often runs in families alongside asthma and hay fever, a combination sometimes referred to as the "atopic triad."

In eczema, the skin barrier does not function as effectively as it should. This means moisture escapes more easily, leading to dryness, and irritants and allergens can penetrate the skin more readily, triggering inflammation and itching.

Types of Eczema

Understanding which type of eczema you have is important for effective treatment. The main types include:

Atopic Eczema (Atopic Dermatitis)

This is by far the most common form, accounting for the vast majority of eczema cases. It typically begins in childhood, often before the age of five, and many children grow out of it by their teenage years. However, it can persist into adulthood or return later in life.

Key features:

• Dry, itchy, inflamed skin
• Commonly affects the creases of elbows, behind the knees, wrists, and neck
• In infants, often appears on the face and scalp
• Tends to flare up and then settle in cycles
• Often runs in families with a history of eczema, asthma, or hay fever

Contact Dermatitis

Contact dermatitis occurs when the skin reacts to a substance it comes into contact with. There are two subtypes:

Irritant contact dermatitis is caused by direct damage to the skin from irritants such as detergents, soaps, solvents, or frequent hand washing. It is the most common type of contact dermatitis and is particularly prevalent in healthcare workers, hairdressers, and those in cleaning occupations.

Allergic contact dermatitis is an immune-mediated reaction to a specific allergen, such as nickel (in jewellery), fragrances, preservatives, latex, or certain plants. Patch testing by a dermatologist can identify the specific allergen.

Seborrhoeic Dermatitis

This type affects areas of the body with many oil-producing (sebaceous) glands, particularly the scalp, face, and chest. In infants, it is commonly known as "cradle cap."

Key features:

• Greasy, yellowish scales on the scalp and face
• Red, flaky patches around the nose, eyebrows, and behind the ears
• Associated with an overgrowth of a yeast called Malassezia
• Generally responds well to antifungal treatments

Discoid (Nummular) Eczema

Discoid eczema presents as distinctive circular or oval patches of inflamed skin.

Key features:

• Well-defined, coin-shaped patches
• Very itchy and may ooze or crust
• Most commonly appears on the lower legs, forearms, and trunk
• More common in adults, particularly men
• Can be triggered by dry skin, insect bites, or skin injuries
• Sometimes mistaken for ringworm due to its circular shape

Other Types

• Varicose eczema: Affects the lower legs, associated with poor circulation and varicose veins
• Pompholyx (dyshidrotic eczema): Causes small, intensely itchy blisters on the hands and feet
• Asteatotic eczema: Very dry, cracked skin, typically in older adults during winter

Common Eczema Triggers

Eczema flare-ups are often triggered by specific factors. Identifying and avoiding your personal triggers is a key part of management.

Environmental Triggers

• Weather changes: Cold, dry winter air is a major trigger in Ireland. Central heating further dries the air indoors
• Heat and sweating: Hot weather, exercise, and overheating can trigger itching
• Low humidity: Ireland's damp climate can actually be beneficial for some, but heated indoor environments are very drying
• Pollution and cigarette smoke: Can irritate sensitive skin

Irritants

• Soaps and detergents: Standard soaps, shower gels, and bubble baths strip natural oils from the skin
• Laundry detergents: Biological detergents and fabric conditioners contain enzymes and fragrances that irritate eczema-prone skin
• Household cleaning products: Direct contact with cleaning chemicals can trigger flares
• Wool and synthetic fabrics: Rough or non-breathable clothing can cause irritation

Allergens

• Dust mites: A very common trigger, particularly in bedding and carpets
• Pet dander: Proteins from animal skin, saliva, and urine can trigger eczema
• Pollen: Seasonal pollen can worsen eczema, especially in those with the atopic triad
• Mould: Damp environments with mould growth can exacerbate symptoms

Dietary Factors

While food allergies are not the primary cause of eczema, they can trigger flare-ups in some individuals, particularly young children:

• Cow's milk: The most common food trigger in children with eczema
• Eggs: Another frequent trigger in young children
• Nuts and wheat: Can contribute to flare-ups in sensitised individuals
• Soy and fish: Less common but possible triggers

Important: Do not eliminate foods from your or your child's diet without medical guidance, as unnecessary dietary restrictions can lead to nutritional deficiencies.

Other Triggers

• Stress and anxiety: Emotional stress is a well-documented trigger that can initiate or worsen flare-ups
• Hormonal changes: Menstrual cycle, pregnancy, and menopause can affect eczema
• Infections: Bacterial (particularly Staphylococcus aureus), viral, and fungal skin infections can trigger flares
• Scratching: Creates an itch-scratch cycle that damages the skin barrier and worsens inflammation

Over-the-Counter (OTC) Treatments

For mild eczema, over-the-counter treatments available from Irish pharmacies can be very effective. The cornerstone of all eczema management is regular moisturising.

Emollients (Moisturisers)

Emollients are the single most important treatment for eczema. They restore moisture to the skin, repair the skin barrier, and reduce the frequency and severity of flare-ups.

Types of emollients:

• Lotions: Lightest, good for mild dryness and hairy areas. Absorb quickly but provide least protection
• Creams: Medium consistency, suitable for everyday use. A good balance of hydration and comfort
• Ointments: Thickest and most effective for very dry skin. Greasy texture but provides the best barrier. Examples include 50:50 white soft paraffin/liquid paraffin
• Soap substitutes: Emollient wash products that cleanse without stripping oils (e.g., Dermol, Elave)

Products available in Ireland: Elave, Diprobase, Epaderm, Dermol, Silcock's Base, Cetraben, Doublebase, Aveeno

Tips for use:

• Apply emollients at least twice daily, more often if needed
• Apply within 3 minutes of bathing to lock in moisture
• Use generous amounts, approximately 500g per week for adults during flares
• Smooth in the direction of hair growth, do not rub vigorously
• Use soap substitutes instead of regular soap, shower gel, or bubble bath
• Keep a tub at every sink and by the bed

Mild Topical Corticosteroids

Over-the-counter hydrocortisone cream (0.5% or 1%) is available without prescription for mild eczema flare-ups.

How it works:

• Reduces inflammation and redness
• Relieves itching
• Helps settle flare-ups quickly

Tips for use:

• Apply a thin layer to affected areas only, not to unaffected skin
• Use once or twice daily for up to 7 days
• Leave a gap between applying emollient and steroid — your GP, nurse or pharmacist can advise on timing and order
• Do not use on the face, groin, or armpits without GP advice
• Stop when the flare settles and return to emollients alone

Products available in Ireland: HC45, Dermacort, Eurax HC

Antihistamines

While antihistamines do not treat eczema itself, sedating antihistamines can help with sleep when itching is severe at night.

• Chlorphenamine (Piriton): Sedating, can help with nighttime itching
• Cetirizine or loratadine: Non-sedating, may help if eczema coexists with hay fever

Note: Antihistamines are generally not recommended as a primary eczema treatment as they do not address the underlying inflammation.

Bath Additives and Colloidal Oatmeal

• Oilatum or Balneum bath oils: Add moisture during bathing
• Colloidal oatmeal products (Aveeno): Soothe itchy, irritated skin
• Keep bath water lukewarm, not hot
• Limit baths to 10-15 minutes
• Pat skin dry gently, do not rub

When to See a GP

While mild eczema can often be managed with OTC treatments and good skincare habits, there are clear signs that you should consult a doctor.

You Should See a GP If:

Your eczema is not controlled with OTC treatments If regular emollients and mild hydrocortisone are not keeping your eczema under control after 2-3 weeks, you likely need stronger prescription treatments.

You have widespread or severe eczema Large areas of red, inflamed, weeping, or crusted skin require prescription-strength treatment.

Your eczema is affecting your sleep Persistent nighttime itching that disrupts sleep needs medical attention, as poor sleep worsens eczema and overall health.

You suspect a skin infection Signs of infected eczema include increased redness, warmth, swelling, yellow or green crusting, pus, or fever. Infected eczema requires prompt treatment with antibiotics.

A rapidly worsening, painful, blistering rash — especially with fever or feeling unwell — needs same-day medical assessment. A cold-sore virus can occasionally infect eczema (eczema herpeticum), which looks like clusters of small blisters or punched-out sores spreading quickly; it is most serious in children and is treated as an emergency.

Eczema is affecting your mental health or daily life If eczema is causing anxiety, depression, embarrassment, or affecting your ability to work or socialise, speak to a GP.

Your child has eczema and you need guidance Children's eczema requires careful management with age-appropriate treatments and monitoring.

You need treatment for the face or sensitive areas Eczema on the face, eyelids, neck, or genital area needs GP guidance as these areas require specific treatments.

Prescription Treatments

When OTC options are insufficient, a range of prescription treatments is available through your GP.

Moderate to Potent Topical Corticosteroids

Prescription steroid creams and ointments are more powerful than OTC hydrocortisone and are the mainstay of eczema flare treatment.

Potency scale (from mild to very potent):

• Mild: Hydrocortisone 1% (OTC)
• Moderate: Clobetasone butyrate, betamethasone valerate 0.025%
• Potent: Betamethasone valerate 0.1%, mometasone furoate, fluticasone propionate
• Very potent: Clobetasol propionate — reserved for severe, resistant eczema under specialist supervision

Tips for use:

• Use the lowest effective potency for the shortest time needed
• Apply a thin layer to affected areas once or twice daily during flares
• "Fingertip unit" dosing: one fingertip unit covers an area of skin roughly the size of two adult palms
• Do not use potent steroids on the face or skin folds without specific GP instructions
• Taper gradually rather than stopping abruptly after prolonged use
• "Weekend therapy" (applying twice weekly to prone areas) can prevent frequent flares

Calcineurin Inhibitors

These non-steroidal prescription creams are particularly useful for sensitive areas where steroids should be used cautiously.

Tacrolimus

• Effective for moderate to severe eczema
• Can be suitable for use on delicate areas such as the face and eyelids, where long-term steroid use is a concern — under a doctor's guidance
• May cause temporary burning or stinging when first applied
• How often to apply, and for how long, is set by the prescribing doctor

Pimecrolimus

• A cream for mild to moderate eczema
• Similar to tacrolimus but less potent
• Well-suited for facial and sensitive area eczema
• Generally better tolerated than tacrolimus

Oral Medications

For severe eczema not controlled by topical treatments, oral medications may be prescribed.

Oral corticosteroids (Prednisolone)

• Short courses (1-2 weeks) for severe flare-ups
• Rapid relief of inflammation
• Not suitable for long-term use due to side effects
• Eczema often rebounds when stopped

Immunosuppressants For adults with severe, chronic eczema, specialist-initiated immunosuppressants may be considered:

• Azathioprine: Takes 4-6 weeks to work, requires blood monitoring
• Ciclosporin: Faster acting, used for short courses
• Methotrexate: Weekly dosing, requires regular blood tests
• These are typically initiated by dermatologists and require monitoring

Newer Targeted Therapies

Dupilumab

• A biologic injection for moderate-to-severe atopic eczema
• Targets specific immune pathways (IL-4 and IL-13)
• May be considered by a dermatologist for eczema that has not responded to other treatments — access is specialist-led and subject to reimbursement criteria, so it is a hospital-clinic conversation rather than a GP prescription
• Significant improvement seen in many patients who have not responded to other treatments

Wet Wraps

For acute flare-ups, particularly in children, wet wrap therapy can provide rapid relief — but learn the technique from a GP or nurse first, especially where steroid creams are involved, rather than improvising from a description. In outline: emollient (or a steroid preparation as directed) is applied, covered with a damp layer of bandage or clothing, then a dry layer on top, and left for several hours or overnight to hydrate the skin and reduce itching.

Phototherapy (UV Light Therapy)

Narrowband UVB phototherapy may be recommended for widespread eczema not responding to topical treatments:

• Available at dermatology departments in Irish hospitals
• Typically requires 2-3 sessions per week for 8-12 weeks
• Can provide significant improvement for some patients
• Not suitable for everyone, requires assessment by a dermatologist

How Online Consultations Work for Eczema

Online GP consultations are well-suited for eczema management. Many aspects of eczema care can be handled effectively via video call.

What You Can Do Before Your Appointment

Upload photos of your skin:

• Take clear, well-lit photos of affected areas
• Include close-up shots showing texture and scale
• Photograph all affected body areas
• Take photos during a flare-up when symptoms are active
• These help your GP assess severity and type accurately

During Your Video Consultation

Your GP will:

• Review your photos and discuss your symptoms
• Ask about triggers, previous treatments, and family history
• Assess the type and severity of your eczema
• Discuss lifestyle factors and skincare routine
• Recommend appropriate treatment, including prescriptions if needed
• Provide a personalised eczema management plan

What Can Be Prescribed Online

An online GP can prescribe:

• Emollients and soap substitutes (some are prescribable on the GMS scheme)
• Topical corticosteroids appropriate for remote management — the most potent preparations are generally reserved for specialist or in-person supervision
• Calcineurin inhibitors (tacrolimus, pimecrolimus)
• Antihistamines for sleep and itch relief
• Antibiotics for infected eczema
• Referral to dermatology if specialist input is needed

When an In-Person Visit Is Needed

You should see a GP or dermatologist in person if:

• You have signs of widespread skin infection (fever, spreading redness)
• Patch testing is needed for suspected contact dermatitis
• You need phototherapy or biologic treatments
• Your condition is rapidly worsening despite treatment

Daily Management Tips

Effective eczema management is about consistent daily care, not just treating flare-ups.

Skincare Routine

• Moisturise, moisturise, moisturise: Apply emollients at least twice daily, ideally after every hand wash and within minutes of bathing
• Use soap substitutes for all washing: Replace all soaps, shower gels, and hand washes with emollient-based alternatives
• Keep baths and showers short and lukewarm: Hot water strips oils from the skin
• Pat dry gently: Never rub skin with a towel

Clothing and Laundry

• Wear soft, breathable fabrics: Cotton and silk are generally best tolerated
• Avoid wool and rough synthetics: These can irritate skin directly
• Use non-biological laundry detergent: Avoid fabric conditioners and use an extra rinse cycle
• Dress in layers: Prevents overheating, which triggers itching

Home Environment

• Keep rooms cool: Overheating worsens eczema. Use a thermostat and avoid placing beds near radiators
• Use a humidifier in winter: Central heating dries indoor air significantly
• Reduce dust mites: Wash bedding weekly at 60 degrees, use anti-allergy bedding covers, vacuum regularly
• Manage pets: If pet dander is a trigger, keep pets out of bedrooms and wash hands after contact

Itch Management

• Keep nails short: Reduces skin damage from scratching
• Apply cold compresses: A damp, cool cloth can relieve intense itch
• Tap or press instead of scratching: Helps break the itch-scratch cycle
• Wear cotton gloves at night: Especially helpful for children who scratch in sleep
• Distraction techniques: Particularly useful for children during itchy episodes

Stress Management

• Recognise the eczema-stress cycle: Stress triggers flares, and flares cause stress
• Practice relaxation techniques: Deep breathing, mindfulness, or meditation
• Regular exercise: Beneficial for stress reduction, but shower and moisturise afterwards
• Seek support: Talk to your GP about stress management or counselling if eczema is affecting your mental health

Frequently Asked Questions

Is eczema contagious?

No. Eczema is not contagious and cannot be passed from person to person. It is caused by a combination of genetic and environmental factors affecting the skin barrier and immune system.

Will my child grow out of eczema?

Many children do improve significantly or grow out of eczema by their teenage years. Approximately 60-70% of children with atopic eczema will see significant improvement by adolescence. However, some may experience intermittent flare-ups throughout life.

Are steroid creams safe?

When used correctly, topical steroids are safe and effective. Side effects are rare with appropriate use, including using the right strength for the right area and not exceeding recommended durations. Your GP will advise on the safest approach for your situation.

Can diet cure eczema?

There is no diet that cures eczema. While food allergies can trigger flare-ups in some people (particularly young children), elimination diets should only be undertaken with medical supervision. For most adults, dietary changes have minimal impact on eczema.

What is the best emollient for eczema?

The best emollient is the one you will use regularly and generously. Thicker preparations (ointments) are generally more effective for very dry skin, while creams are more cosmetically acceptable for daily use. Your pharmacist or GP can help you find the right product.

How often should I moisturise?

At minimum, apply emollient twice daily (morning and evening). During flare-ups, you may need to apply 3-4 times daily or more. Always reapply after washing hands, bathing, or swimming.

Can I swim with eczema?

Yes, but take precautions. Apply a thick layer of emollient before swimming to protect the skin from chlorine. Shower immediately after swimming, using a soap substitute, and reapply emollient generously. Some people find saltwater (sea swimming) beneficial, while others find it irritating.

When should I ask for a dermatology referral?

Ask your GP for a referral if your eczema is severe or not responding to standard treatments, if you need patch testing for suspected contact dermatitis, or if specialist treatments like phototherapy or biologics might be beneficial.

Take Control of Your Eczema

Living with eczema can be challenging, but with the right treatment plan, trigger avoidance, and consistent daily care, most people can achieve good control of their symptoms. The key is finding the right combination of treatments that works for you and sticking with your routine even when your skin is clear.

Do not suffer in silence. If your eczema is not well controlled, help is available. Modern treatments are more effective than ever, and an Irish-registered GP can create a personalised management plan tailored to your needs.

Ready to get your eczema under control?

Book a consultation with an Irish-registered GP at GetYourGP today, or learn more about our dermatology services. You can also read our guide to acne treatment in Ireland for more skin health information.

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This article was reviewed by Dr. Fasi Ullah, a General Practitioner registered with the Irish Medical Council. The information provided is for educational purposes and does not replace personalised medical advice.