The Eczema Sufferer’s Handbook

How to spot your triggers, calm the itch, and give your skin space to recover.

A practical guide for anyone dealing with eczema, psoriasis, dermatitis or sensitive skin flare-ups. Not a medical diagnosis. Not a cure. Just honest, useful advice from experience and reputable sources.

If your skin is weeping, crusting, hot, infected-looking or rapidly spreading, see a GP or pharmacist. This guide is for day-to-day management, not emergencies.

What causes flare-ups?

Most flare-ups are not random. They happen when your skin barrier is weakened, your immune system is under pressure, or your body reacts to a personal trigger – environmental, dietary, hormonal, emotional, seasonal, or a mixture of all of them at once.

The frustrating part is that a flare can appear hours or days after the thing that caused it, which makes it hard to connect cause and effect. That is why tracking helps.

Common triggers

Environmental and household: laundry detergent and fabric conditioner, scented soaps and shower gels, SLS in shampoos and cleansers, hot showers, chlorinated pools, cold weather, central heating, dust mites, pet dander, pollen, cleaning sprays, hand sanitiser, wool and rough fabrics, tight waistbands and collars.

Dietary and lifestyle: alcohol, high sugar intake, ultra-processed foods and refined carbohydrates can worsen inflammation for some people. Some notice patterns with dairy, gluten, eggs, tomatoes, citrus or certain additives – but this is very individual, so avoid cutting out whole food groups without a clear pattern or professional advice. Poor sleep, stress, dehydration and illness all lower resilience.

Hormonal and internal: menstrual cycle changes, pregnancy, perimenopause, menopause and thyroid shifts can all affect skin behaviour. For psoriasis, infections, smoking, alcohol, skin injuries and some medicines can be relevant triggers.

The 14-day skin diary

For two weeks, track your skin like a detective, not a critic. You are looking for patterns, not perfection.

Each day, note:

Where is the flare? Face, hands, elbows, eyelids, scalp, legs, skin folds?
How does it feel? Itchy, burning, tight, cracked, weeping, scaly, hot?
What touched your skin? Laundry products, soap, skincare, perfume, clothing, jewellery, bedding, workplace chemicals?
What happened in the last 24-72 hours? Stress, poor sleep, alcohol, new food, exercise, weather change, hormonal changes?
What helped? Cold compress, balm, prescribed cream, oatmeal bath, antihistamine, loose clothing, avoiding heat?
Itch score 0-10, morning and evening. This reveals improvement before the skin looks better.

If the same product, fabric, food or stress pattern appears before several flares, test a careful avoidance period.

What to do when a flare-up starts

Step 1 – Cool the itch quickly. Use a cool compress for 5-10 minutes (not ice directly on skin). Take a short lukewarm shower, not a hot bath. Pat dry – do not rub – then moisturise while the skin is still slightly damp. Keep nails short. At night, cotton gloves or soft sleeves reduce scratching damage. Try pressing, tapping or gently pinching near the itchy area instead of scratching through the skin.

Step 2 – Rebuild the barrier. Dry, cracked skin loses moisture and lets irritants in. A balm or ointment softens the skin and creates a protective layer so it has space to calm down. Apply a thin layer, warm it between your fingertips first, and use little and often – especially after washing. If your skin is broken or highly reactive, always patch-test on a small area first and wait 24 hours. Stop using anything that stings badly, burns or makes the flare worse.

Step 3 – Use the right treatment for the right problem.

Emollients and balms: helpful for dryness, tightness, barrier support and reducing the urge to scratch.
Topical corticosteroids: often prescribed for eczema flares to reduce inflammation. Use the strength and duration your GP or dermatologist recommends.
Psoriasis treatments: may include vitamin D creams, coal tar, scalp treatments, light therapy or systemic treatments depending on severity.
Antihistamines: may help some people sleep if itching disrupts rest, but they do not treat the underlying skin inflammation.

Seek medical advice if skin is weeping, hot, painful, rapidly spreading, infected-looking or not improving.

Oatmeal baths

Colloidal oatmeal (finely ground oats) disperses in water and can leave a soothing film on the skin. Many people find it helpful during itchy, dry flare-ups.

Bath method: Blend plain, unflavoured oats into a very fine powder. Add about one cup to a lukewarm bath and stir until the water looks milky. Soak for 10-15 minutes, pat dry gently, then apply a balm or emollient straight away.

Shower pouch: Put finely ground oats into a clean muslin cloth or cotton sock. Run lukewarm water through it and squeeze the milky liquid over itchy areas. Do not scrub. Rinse lightly if needed, pat dry, moisturise immediately.

Avoid hot water, fragranced bath products and rough towel-drying. These can restart the itch-scratch cycle.

Reduce triggers at home

Laundry: Switch to a fragrance-free, non-biological detergent. Skip fabric conditioner, fragrance beads and dryer sheets. Use an extra rinse cycle for bedding, towels, underwear and anything worn next to irritated skin.

Washing and skincare: Use soap-free, fragrance-free cleansers where possible. Avoid strong scrubs, exfoliating acids, retinoids and essential oils directly on active flares. Moisturise after every wash, especially hands, face, elbows and anywhere that cracks or flakes.

Clothing and bedding: Choose soft cotton, bamboo, silk or smooth breathable fabrics. Avoid scratchy wool or rough synthetics during flares. Keep bedrooms cool and consider a humidifier if central heating dries the air.

UV therapy and newer treatments

Phototherapy uses controlled ultraviolet light under medical supervision. It is not the same as using sunbeds. UVB phototherapy may be offered for more widespread eczema or psoriasis that has not responded well to topical treatment alone.

For moderate to severe eczema or psoriasis, dermatologists may also consider stronger topical treatments, calcineurin inhibitors, systemic medicines, injections or biologic treatments. These are decisions to make with a clinician, especially if the condition is affecting your sleep, confidence or daily life.

The honest truth

A balm, oatmeal bath, cold compress or prescribed cream can calm a flare and give your skin space to heal. That matters. Relief is not a small thing when your skin is driving you mad.

But long-term improvement usually comes from identifying your personal triggers and reducing them. That might mean changing laundry products, avoiding hot showers, managing stress, simplifying skincare, treating infection, improving sleep or getting medical support for persistent inflammation.

The goal is straightforward: calm the flare, protect the barrier, stop the scratching, then use your diary to stop the next one from being inevitable.

Quick flare-up checklist

Cool the itch: cold compress or lukewarm rinse.
Do not scratch: press, tap, cover or protect the area.
Moisturise fast: apply balm or emollient while skin is still slightly damp.
Remove likely irritants: fragrance, detergent residue, wool, heat, sweat, harsh soap.
Record the flare: location, severity, possible triggers, what helped.
Seek help if infected, painful, spreading or not improving.

Sources: This guide draws on general patient guidance from the NHS, NICE, the National Eczema Association, the National Eczema Society and Allergy UK.

Rescue Balm by Essence of Nature is a 100% natural, steroid-free balm made for exactly this kind of skin – dry, irritated and reactive. It is one option among the emollients and balms mentioned above. You can read more about it here or try it in the shop.