Eczema: A Pharmacist’s Guide to Skincare and Managing Flare-Ups

I have been a pharmacist for over 12 years, and managing eczema, recognising aggravating skin factors and repairing the skin barrier are some of the most common skincare concerns I deal with in community pharmacy. 

Understanding what can trigger or aggravate eczema, how to manage a flare-up and how to support the skin barrier can make a significant difference to the overall health of eczema-prone skin.

What is eczema? 

According to the Eczema Association Australia, eczema is a broad term used to describe a group of conditions that can cause the skin to become red, dry, itchy and scaly. In severe cases, the skin may weep, bleed and develop crusting, resulting in significant discomfort for the affected individual.

Atopic dermatitis (AD) is the most common form of eczema and develops through a complex interaction between genetic and environmental factors. Although eczema and atopic dermatitis are technically not synonymous, the terms are often used interchangeably in both clinical and general contexts.

Eczema most commonly develops during the first year of life; however, it can also develop for the first time during adulthood. It is a chronic skin condition that cannot currently be cured; however, its symptoms can be effectively managed with appropriate treatment and ongoing skin care. 

What does eczema look like?

Eczema typically presents as dry, red and inflamed patches of skin. It commonly affects the face, the creases behind the elbows and knees, and the wrists and ankles. The defining symptom of atopic dermatitis is itch (pruritus), which can be severe and debilitating. Symptoms may become particularly troublesome overnight, potentially resulting in disturbed sleep and reduced quality of life. 

Skincare ingredients that may aggravate eczema

As a pharmacist, I frequently speak with people who experience eczema and provide counselling on appropriate skin care measures to help manage their symptoms and prevent flare-ups. Certain ingredients found in skincare products can irritate sensitive or eczema-prone skin, potentially worsening an existing flare-up or triggering a new one. 

Ingredients and skincare products that may aggravate eczema include soaps, fragrances, essential oils, urea, retinoids and drying alcohols. Urea has different effects depending on its concentration. At lower concentrations it acts as a humectant, locking in moisture and improving hydration of the skin. However, at higher concentrations, it has a keratolytic action that helps soften and break down hard, thickened and scaly skin. When high concentration urea products are applied to an impaired skin barrier, such as skin affected by eczema, higher-concentration urea products may cause irritation, stinging or discomfort.

Over-exfoliation, with chemical or physical exfoliants, can also worsen eczema by causing further irritation and contributing to disruption of the skin barrier. 

For people with eczema-prone or sensitive skin, avoiding potential irritants and maintaining the integrity of the skin barrier are integral components of their skin care routine.

Managing an eczema flare-up

Topical corticosteroids are the first-line treatment option for managing eczema across all age groups according to the Therapeutic Guidelines. The potency selected depends on several factors, including the location and severity of the flare-up, as well as the patient’s age and individual circumstances.

Pharmacists play an important role in counselling patients on the appropriate use of topical corticosteroids, including how much to apply, where to apply it and for how long. Appropriate treatment is important to ensure that the inflammation is adequately controlled and the skin is given the opportunity to fully heal. Undertreatment is a common reason for treatment failure in eczema management and may contribute to persistent or recurrent inflammation.

Repairing and maintaining a healthy skin barrier

Avoiding known triggers is an important part of managing eczema and reducing the risk of flare-ups. Dry skin can also aggravate eczema and contribute to the development of a flare-up. Regular moisturising helps to reduce water loss, relieve dryness and itch, support the skin barrier, and improve overall skin condition.

Moisturisers containing ceramides may be particularly beneficial for conditions such as eczema, which are associated with impaired skin-barrier function. Regular, daily use can help maintain skin hydration and support the skin barrier.

Short, warm (rather than hot) baths or showers are also recommended for people with eczema. A gentle, non-soap-based cleanser or oil can be used to cleanse the skin while minimising potential irritation and dryness.

Managing eczema is about more than treating a flare-up. From my experience in community pharmacy, supporting the skin barrier, avoiding aggravating factors and using treatments appropriately can all help keep eczema under control and maintain healthier skin.

Recommended Skincare for Eczema

Based in community pharmacy experience, a simple, gentle skincare routine can help support eczema-prone skin. I have selected the following products to help cleanse, hydrate, moisturise and support the skin barrier:

References:

1. Understanding Eczema. [Internet] Eczema Association Australasia. [cited September 2026].
   Available from https://www.eczema.org.au/understanding-eczema/.

2. Dermatitis/Eczema: The Australasian College of Dermatologists [Internet] [cited September 2026]
   Available from https://www.dermcoll.edu.au/atoz/dermatitis-eczema/

3. 8 skincare ingredients to avoid if you have eczema, according to dermatologists [Internet] National Eczema Association [cited September 2026]
   Available from https://nationaleczema.org/

4. Therapeutic Guidelines. Atopic dermatitis [cited September 2026] Therapeutic Guidelines Limited