KISS: Practical Tips for Managing Eczema for Patients and Families

CKS Jan 2018  Primary Care Dermatology Society October 2019

How much emollient should I use?

• As much as you can! Ideally, an emollient should be applied 3-4 times per day (minimum twice daily) and for those with extensive eczema you should get through about 500g every week
• Emollients are the mainstay of eczema treatment and using plenty of emollient reduces the need for steroid creams

How and where do I apply emollient?

• Emollient should be applied to the whole body (not just affected areas)
• Gently rub the emollient into the skin until no longer visible; Apply downward in the direction of the hairs to reduce the risk of folliculitis (inflammation of the hair follicles) 
• The emollient may sting initially when you use it but this improves in a couple of days
• The Primary Care Dermatology Society has a link for good video clips of how to apply emollient properly - look under step 3 using this link - click here

How do I use steroid cream/ointment and how much should I use?

• Apply steroid cream or ointment only to affected areas of skin
• One Finger Tip Unit (FTU) is the amount of cream squeezed from a standard tube along an adult’s fingertip from the very end of the finger to the first crease. One FTU is enough to treat an area of skin twice the size of the flat of an adult’s hand with the fingers together (see video link below for further explanation)
• Apply emollients first and allow to dry into the skin for 20 minutes before applying the steroid
• Click here for a good video clip of how to apply steroid creams and ointments

What about bathing and showering?

• Do not use soaps or shower gels as these dry your skin out - use your emollient as a soap substitute (ointment emollients dissolved in hot water work well)
• For children be aware they can get slippery when you use emollients in the bath or shower! 
• You may have used (or been prescribed) specific bath or shower emollients in the past, but your doctor may stop prescribing these now as there is no good evidence these help with eczema for most people - using your usual emollient in the bath/shower is just as effective 
• Pat dry after bath/shower then put plenty of emollient on

How do I prevent my skin from becoming infected?

• Ideally, use pump dispensers for emollients
• If you have thicker emollients (e.g. ointments) these may come in tubs - don’t put fingers or hands into the tub but use a clean spatula or spoon to scoop out the ointment