Dry, red, itchy patches that keep coming back are one of the most common reasons people visit a skin doctor. In Pakistan we often call all of it khaarish or ek ki bimari, but eczema (atopic dermatitis) is a specific long-term skin condition with its own treatment plan. It is not contagious, it is not caused by dirty blood, and it cannot be cured by a single cream, but it can be controlled very well once you understand how the medicines work.
Eczema is a condition where the skin barrier is weak. The skin loses moisture easily and reacts strongly to triggers, which leads to dryness, itching and inflammation. It often starts in childhood, with patches on the cheeks, behind the knees and inside the elbows, but adults can develop it too. It frequently runs in families that also have asthma, hay fever or allergies.
The main sign is intense itching, often worse at night. The skin may look red, rough, scaly or thickened from scratching. In babies you may see weepy patches on the face. During a flare, small blisters can appear and then crust over. If the skin turns yellow, oozes pus or becomes very painful, it may be infected and needs a doctor right away.
Triggers differ from person to person, but a few come up again and again. Harsh soaps and strong detergents, very hot showers, dry winter air, dust and dust mites, sweat in summer, woollen clothes, fragranced products and stress are all common. Food allergy plays a role in some small children, but cutting out foods without a doctor’s advice can cause nutrition problems. If dust is a big trigger for your family, our guide on dust allergy and allergic rhinitis has useful tips.
Step one: moisturise, moisturise, moisturise. Emollients are the base of every eczema plan. Apply a thick, fragrance free moisturiser at least twice a day and straight after a bath while the skin is still slightly damp. Creams and ointments hold moisture better than thin lotions. Browse the moisturizers and creams and dry skin sections for options, and read our winter dry skin care tips for daily routines.
Step two: anti-inflammatory creams. During flares, doctors prescribe a topical steroid of the right strength for the body area. Mild ones are used on the face and folds, stronger ones on thick skin like palms and soles. The key is correct use: a thin layer on the affected patch only, for the time your doctor sets. Used properly, they are safe and effective. Used carelessly or bought as a beauty cream, they can thin the skin. Ask your pharmacist to explain the risks of steroid creams before you start.
Step three: non-steroid options. Calcineurin inhibitor creams such as tacrolimus are used for sensitive areas or for long-term control, again on a doctor’s prescription.
Step four: itch and infection control. Sedating antihistamines at night may help sleep in some people, though they do not treat the rash itself. If the skin is infected, a doctor may add an antibiotic cream or tablet. Severe eczema may need light therapy or newer medicines under a specialist.
Prescription creams and tablets are available on request. You can upload your prescription and we will confirm what we have in stock. For general skin concerns, see the skin conditions category.
Keep baths short and lukewarm, and use a gentle, soap free cleanser. Pat the skin dry, never rub. Cut nails short to limit scratch damage, and let cotton clothes touch the skin. Wash new clothes before wearing them and rinse laundry well. In winter, use a humidifier or keep a bowl of water in the room if the air is very dry. For children, our baby skin care in winter guide covers bathing and moisturising.
Ask which steroid strength you are getting and for how many days. Ask how much cream to use, and whether you should keep moisturising after the rash clears. Ask what a flare plan looks like, meaning what to do the moment the itch starts, and which signs mean you should come back quickly.
Is eczema contagious? No. You cannot catch it from touching, sharing towels or sitting near someone.
Will my child outgrow it? Many children improve with age, but some keep a tendency to dry, sensitive skin, so a good moisturising habit stays useful.
Can I use a steroid cream every day? Only as your doctor directs. Short, correct courses are safe, and long unsupervised use is the problem.
Does eczema look like fungal infection? Sometimes. A ring-shaped scaly patch may be fungal, and treating it with a steroid can make it worse. Get a diagnosis first.
Is a herbal cream a safe alternative? Some products contain hidden steroids. Always check the ingredients or ask your pharmacist.
Disclaimer: This article is for general awareness and does not replace professional medical advice. Please consult a doctor or pharmacist before using any cream or medicine, especially for children, pregnant women and the elderly.
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