Eczema

What is Eczema?

Eczema is a common skin condition that can affect all age groups. Eczema affects up to 1 in 5 children and 1 in 10 adults in Ireland. There are many different types of eczema but the most common type is “atopic” eczema which means the body is very sensitive to irritants once they enter the skin. 

Atopic eczema is a non-contagious, chronic (long-term) inflammatory skin condition. If you have atopic eczema, your skin barrier function (which prevents water loss and protects against allergens and irritants) is impaired or weakened. This makes the skin dry out and become more vulnerable to infections by bacteria and viruses.

While the exact cause is not known, certain factors are thought to be important in its development, these include an inherited (genetic) predisposition to have a weakened skin barrier, as well as altered inflammatory and allergy responses. Atopic eczema most frequently begins in childhood but may also develop for the first time in adulthood. Atopic eczema can run in families and frequently occurs alongside other atopic conditions, including hay fever and asthma.

Although there is no cure for eczema yet, treatments are available to manage the condition.

Common triggers for eczema include: irritants, allergens, stress and infection. The most common irritants include soap, bubble bath, shampoo, laundry detergents, fragrances, clothing that feels ‘itchy’ next to the skin (e.g. wool), changes in temperature, or allergens like animal dander, the house dust mite or pollen, but sometimes no cause can be identified. Atopic skin is vulnerable to infection and infection makes eczema worse. 

The main symptoms of eczema include dry, itchy, inflamed, red or irritated skin patches. These patches can occur in many different parts of the body such as the face, arms and elbow creases, the back of the knees and hands. Sometimes areas of the skin can become blistered or ooze fluid. If eczema is present for a long time, the skin can become hardened or thickened. The itch associated with eczema can be very intense and impact sleep, but also cause infection due to frequent scratching.

The goal of managing eczema is to improve the protective barrier function of the skin and to reduce the inflammation that causes symptoms. The main way of managing eczema is to use products that trap moisture in the skin (also known as emollients) which improve the protective function of the skin. When eczema flares up, ointments/creams that contain topical steroids are used to calm inflammation.

There are a number of things you can do to try and manage your eczema without medication. These include:

• Use an unfragranced moisturiser as much as possible, such as silcock’s base and emulsifying ointments. These  are excellent but need to be used 4 -6 times daily, in an acute flare. 
• Use sensitive skin detergents in your washing machine
• Wear cotton clothes as much as possible
• Avoid soaps, shower gels and bubble baths COMPLETELY. 
• Stay well hydrated
• Regularly moisturise your skin

If medication is required, you may need different steroid ointments/creams in order to control your symptoms. Ointments are preferred as they soak in better and last longer. The different types of steroid ointments/creams available through this service include:

• Hydrocortisone ointment/cream
• Alphaderm ointment/cream
• Locoid Lipocream
• Eumovate steroid ointment/cream
• Betnovate steroid ointment/cream
• Xyzal antihistamine tablets for itch.

Please note: Protopic (tacrolimus) cream is not available through this service. Products containing tretinoin in any strength or dosage are also not available from this service. Products containing tretinoin are unlicensed in Ireland and are not available through this service. 

Eczema is a long-term condition that can flare up from time to time even when following the correct advice. Using the service is for people who have stable or controlled eczema who regularly see a skin specialist or their own GP. We strongly advise that if your eczema is getting  worse or you have any new symptoms that you did not have before, that you contact your GP in the first instance. If you would like to speak to a GP through our service, please book a video consultation. 

Who Is This Service For?

This service is suitable for you only if:

• You have been diagnosed with eczema in the past by a doctor. 
• You are able to upload recent photos of your eczema
• You are not looking for Protopic/Tacrolimus cream
• You are not pregnant, trying to become pregnant or are breastfeeding
• You are not taking any immunosuppressive medication such as methotrexate or etanercept
• You are not looking for products containing tretinoin in any strength or dosage. 
• You are not looking for medication intended to be used for another adult or a child. 
• You have never had a serious complication of eczema at any time in the past. A serious complication of eczema includes: 
  • Bacterial infection of eczema that meant you had to be admitted to hospital for antibiotics
  • Infection of eczema with a virus such as herpes that meant you had to take anti-viral medication
  • Being admitted to hospital because of complications of your eczema

This service is not suitable for you if:

• You have never been diagnosed with eczema in the past by a doctor
• You are not able to upload recent photos of your eczema
• You are looking for a prescription for Protopic/Tacrolimus cream
• You are pregnant or are breastfeeding
• You are taking immunosuppressive medication such as methotrexate or etanercept
• You are looking for products containing (tretinoin) in any strength or dosage. 
• You are looking for medication to be used for another adult or a child. 
• You feel your eczema has some infection present currently. 
• You have had a serious complication of eczema at any time in the past. A serious complication of eczema includes: 
  • Bacterial infection of eczema that meant you had to be admitted to hospital for antibiotics
  • Infection of eczema with a virus such as herpes that meant you had to take anti-viral medication
  • Being admitted to hospital because of complications of your eczema

How the service works

• Online consultations with Irish based doctors
• Our doctors issue a prescription if medically safe and suitable
• Valid in any Irish pharmacy to buy your medication
• Prescription sent to your chosen pharmacy via secure email (Healthmail) within minutes of approval

The accuracy of the information you provide is very important for the safe prescribing of the most suitable type of medication. 

The information that you provide is treated with the same patient-doctor confidentiality as in a normal face-to-face consultation.