Eczema (Dermatitis) – Assessment and Treatment by a Dermatologist
A specialist in dermatology identifies the type of eczema and develops a treatment plan for children and adults.
Eczema (dermatitis) is an inflammatory skin condition that causes itching, redness, dryness and scaling. Eczema is not contagious and occurs in several forms – the most common are atopic eczema, contact dermatitis and hand eczema. At Charlottenlund Privathospital, eczema in children and adults is assessed and treated by Susanne Birkballe, specialist in dermatology. The assessment determines which type of eczema is present and whether an allergy is involved, for example through patch testing. Based on the diagnosis, a plan is made for skincare, topical treatment and, if needed, tablet treatment.
What does eczema look like?
Itching is the most typical and often the most troublesome symptom. The skin becomes red, dry and scaly, and during a flare-up small blisters, oozing and crusts may develop. If eczema has been present for a long time, the skin often becomes thickened and leathery from scratching, and painful cracks can develop, particularly on the hands.
The location of the eczema can provide clues about the type. In adults, atopic eczema often affects the bends of the elbows, backs of the knees, neck and face, while contact dermatitis usually occurs where the skin has been exposed to a particular substance.
Eczema can be confused with psoriasis, fungal infections and scabies, and if itching affects many areas of the body at the same time, there may be other causes of an itchy rash.
Eczema caused by the skin’s own vulnerability
- Atopic eczema – usually starts in childhood and is often associated with a family history of asthma and hay fever. In children, it is called childhood eczema.
- Seborrhoeic eczema – redness and greasy scales on the scalp, around the nose and on the eyebrows.
- Discoid eczema – round, clearly defined patches, often on the arms and legs.
Eczema caused by something the skin is exposed to
- Irritant contact dermatitis – caused by water, soap and cleaning products that damage the skin.
- Allergic contact dermatitis – caused by a substance you are allergic to, such as nickel or perfume.
- Hand eczema – a mix of several causes and one of the most common forms in adults.
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- Dyshidrotic eczema – small, itchy blisters on the palms and sides of the fingers.
Atopic eczema affects up to 20% of children and around 3% of adults. Childhood eczema has its own page, as do hand eczema and contact dermatitis. Hand eczema is common: around 10% of adults experience it within a year.
Atopic eczema in adults
Atopic eczema improves with age in many children, but some continue to have it into adulthood, and in others it first develops as an adult. In adults, eczema often affects the face, neck, hands and bends of the elbows, and the skin may become thickened after years of itching and scratching.
The itching can interfere with sleep and work. Stress, dry winter air, sweat and wool can trigger flare-ups, and many people also have asthma, hay fever or allergies.
Treatment is based on daily use of moisturiser and topical treatment during flare-ups. If this is not sufficient, the dermatologist may start tablet treatment. Certain treatments are only provided in a hospital setting, in which case the patient is referred onwards.
When should you see a dermatologist about eczema?
You should see a dermatologist if the eczema does not improve with moisturiser and the treatment prescribed by your GP, or if it keeps returning.
You should also seek specialist assessment if the itching affects your sleep, if the eczema spreads, or if cracks, oozing or crusts develop, as these may be signs of infection.
If you are unsure what the rash is, or suspect that the eczema is caused by something at work or by products you use, assessment by a dermatologist can help identify the cause.
How does a dermatologist assess eczema?
The diagnosis is usually made based on the consultation and examination of the skin. The dermatologist asks when the eczema started, whether there is asthma or hay fever in the family, and which products, materials and work-related exposures the skin comes into contact with.
At Charlottenlund Privathospital, the assessment is carried out by Susanne Birkballe, specialist in dermatology. If allergy to a particular substance is suspected, patch testing is performed.
If needed, a swab may be taken for bacteria or fungal infection, blood tests may be performed, or a small tissue sample may be taken if the diagnosis is uncertain. Results from a tissue sample are typically available within 5–10 working days.
How is eczema treated?
Moisturiser is the foundation of all eczema treatment. It should be applied every day, including when the skin is clear, because it strengthens the skin barrier and helps prevent new flare-ups.
During a flare-up, inflammation is treated with topical medication for a period of time, and the dermatologist provides a plan for how often and for how long it should be used.
It is equally important to avoid factors that worsen the eczema, such as fragranced products, prolonged exposure to water and soap, wool directly against the skin, and any substances identified through patch testing as allergens.
For severe eczema, tablet treatment may be appropriate. If sweating makes the eczema worse, hyperhidrosis may also play a role.
Referrals and payment
Many health insurance policies cover consultations with a dermatologist, but insurers typically require a referral from your GP and prior authorisation. No referral is needed if you are paying for treatment yourself. Prices are listed in our price list. Consultations take place at our main clinic in Charlottenlund
Frequently asked questions
Can eczema be cured?
Eczema cannot always be cured, but it can usually be kept under good control with daily moisturiser, topical treatment during flare-ups, and by avoiding things that make it worse. In many children, eczema goes away with age.
Is eczema contagious?
No. Eczema is not contagious. However, weeping eczema with crusts may indicate an infection that needs treatment.
What is the difference between eczema and childhood eczema?
Eczema is a general term for several skin conditions. Childhood eczema is atopic eczema in children—the most common type of eczema in childhood.
Can adults get atopic eczema?
Yes. Atopic eczema can continue from childhood or start in adulthood. Around 3% of adults have atopic eczema.
Can stress affect eczema?
Yes. For many people, stress can trigger eczema flare-ups and make itching worse.
Which cream should you use for eczema?
Daily use of fragrance-free moisturiser is the basis of treatment for all types of eczema. Flare-ups often require topical treatment, and the dermatologist will assess which treatment is right for the type and severity of the eczema.