Treatment depends on the nature, severity and location of the affected skin. The BNF approach to managing eczema includes self-care and medication recommendations:30

·       avoid/manage contributory factors including domestic/occupational irritants (eg detergents, solvents), known or suspected allergens

·       use emollients liberally at least twice daily, and supplement these with bath or shower emollients if necessary

·       apply topical corticosteroids, with potency appropriate for the severity and site of the eczema (mild steroids for face and flexures, potent steroids for adults with discoid or lichenified eczema, or eczema on the scalp, trunk or limbs) – treatment should be reviewed regularly

·       topical corticosteroids should be used for two consecutive days each week for prophylaxis in patients regularly experiencing flare ups two or three times a month

·       bandages, including those impregnated with ichthammol and zinc oxide (which also help reduce itching) can be used over topical steroids or emollients

·       consider an antihistamine to reduce itching.

Topical pimecrolimus is licensed for mild to moderate atopic eczema and topical tacrolimus is licensed for moderate to severe atopic eczema. However, this should be initiated by prescribers experienced in their use.31

Weeping or exudative eczema may need a topical steroid, as well as managing for any infection. Potassium permanganate solution 100ppm can also be used in exudating eczema as an antiseptic and astringent.30