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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. An eczema flare is assessed from clear photos plus video, with emollients and the right potency of steroid cream prescribed per body site; eczema herpeticum, widespread weeping infection or fever need in-person care.
- What it is: a long-term inflammatory skin condition driven by a leaky skin barrier and an over-reactive immune response, affecting about 1 in 5 children and 1 in 10 adults; most children improve by their teens, and it is not contagious.
- Emollients first: the base of every eczema plan is emollient applied generously at least twice a day, several hundred grams a week for widespread eczema, and continued when the skin looks clear; emollient-soaked clothing and bedding catch fire easily, so keep away from flames.
- Steroid creams: used correctly, a short course of the right potency for the body site, usually once daily for 1 to 2 weeks and then stopped, is safe; the harm comes from potent steroids used continuously on thin skin, and from undertreating out of fear.
- Infection signs: weeping, honey-coloured crusts, spreading redness, pain or a flare that stops responding mean infected eczema; clusters of small punched-out blisters spreading fast with fever can be eczema herpeticum, an emergency.
- Emergency: call 112 if you become drowsy or confused, are breathing very fast, or have cold blotchy skin alongside fever during an eczema flare.
Book same-day in-person care rather than an online appointment if a flare is suddenly much worse and painful with fever or widespread weeping and crusting, or if clusters of small, painful, punched-out blisters are spreading fast. That pattern can be eczema herpeticum, a herpes-virus infection of eczema, and it needs urgent hospital assessment, particularly in babies and children.[3]
Can an online doctor treat eczema?
Often, yes. Clear photographs and a video consultation can often provide enough information to assess an eczema flare, confirm the diagnosis and prescribe treatment, usually emollients plus a short course of topical steroid matched to each body site. Severe, infected or blistering eczema needs in-person care.
Eczema suits online care because control is a routine, not a single prescription: the right moisturiser, the right steroid strength for the right place, and a clear plan for when a flare starts. On Mobi Doctor, a licensed doctor can set that plan up, adjust it when your skin changes, and refer you on when topical treatment is no longer enough.
Listen: Eczema Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with eczema
- Flare assessment from photos: extent, redness, scratch damage and any signs of infection all show on good photographs, which is exactly the detail the doctor needs to judge severity and choose treatment.
- A steroid plan, not just a tube: you get the potency matched to each body site, a clear number of days to treat, and what to step down to. Those details are what make topical steroids work safely.
- An emollient routine with honest quantities: most people use a fraction of what actually helps. The doctor recommends realistic amounts and textures you will keep using.
- Escalation when creams are not enough: frequent or severe flares justify maintenance dosing or a dermatology referral for light therapy and newer systemic treatments, and the doctor tells you when you have reached that point.
📷 Photograph your worst areas in daylight (elbow and knee creases, hands, neck, eyelids) plus one wider shot showing how much of your body is involved. If anything weeps, crusts or blisters, add a close-up: that single detail can change the prescription from a steroid cream to infection treatment.
What the doctor checks in an online eczema consultation
The assessment is structured, not a glance at a photo. In an eczema consultation, the doctor will typically assess:
- Extent and severity: how red, thickened and scratch-damaged the skin is, and roughly what proportion of the body is involved, judged from a wider shot plus close-ups.
- Pattern and sites: elbow and knee creases, hands, eyelids and face each tolerate different steroid strengths, so the doctor maps exactly where the eczema sits.
- Signs of infection: weeping, golden crusting, rapidly worsening pain or fever shift the plan from a steroid cream to infection treatment.[2]
- Itch and sleep: how much scratching and night waking the flare causes, which measures severity beyond what photographs show.
- Triggers and history: soaps, detergents, wool, heat, stress, dust mites and pets, plus any personal or family history of asthma and hay fever.
- What you have already used: which emollients and steroid creams, in what amounts and for how long, because a half-used course is the most common reason a flare drags on.
- Photo quality: daylight pictures of clean, cream-free skin, close-ups of the worst patches and one wider shot; on the video call the doctor can watch you move an affected joint crease and check delicate sites such as the eyelids.
You leave with a written flare plan: which cream, where, for how many days, and what to do the day the next flare starts.
Why does eczema flare?
Eczema flares because the skin's outer barrier is weak: it loses water quickly and lets irritants and allergens in, so the immune system reacts with inflammation and itch. Scratching damages the barrier further and drives more itch. Common triggers include soaps, heat, stress, dust mites and dry winter air, and the tendency often runs in families.[3]
A leaky barrier and the itch-scratch cycle
Eczema-prone skin holds moisture poorly and reacts easily, which is why daily emollients matter between flares, not just during them: they patch the barrier and reduce how often flares happen. The itch-scratch cycle is the engine of a bad flare. Scratching feels irresistible but inflames and thickens the skin, so breaking the cycle, with treatment and by keeping nails short, is central to getting control.
Triggers worth reviewing
Common culprits are soaps, detergents and fragranced products; wool or scratchy synthetics; heat, sweating and dry winter air; stress and short sleep; and house-dust mites, pollens or pet dander. In young children food allergy is occasionally involved; in adults it rarely drives eczema, so exclusion diets are not worth starting without medical advice. A short symptom diary alongside your photos often exposes the pattern, and once you know a trigger you can plan around it.
Is it eczema, psoriasis or ringworm?
Itchy, scaly patches are not always eczema. Eczema is poorly defined, very itchy and often weeps; psoriasis forms thick, sharply edged plaques with silvery scale and is less itchy; ringworm makes a single expanding ring with a scaly edge and a clearer centre. The distinction changes the treatment: a steroid cream helps eczema but can make ringworm worse.
Swipe sideways to compare →
| Feature | Eczema | Psoriasis | Ringworm |
|---|---|---|---|
| Edge | Poorly defined, blurred into normal skin | Sharply defined, thick plaque | Ring-shaped with an active scaly edge |
| Itch | Intense | Variable, often mild | Mild to moderate |
| Usual sites | Elbow and knee creases, hands, face | Outer elbows and knees, scalp, lower back | Anywhere, often one or a few patches |
| Clue | Dry, weeping, personal or family atopy | Silvery scale, symmetrical, nail changes | Expands outward, centre clears |
If your patch does not fit eczema (especially a spreading ring, or a scaly plaque that barely itches), say so, because the photo assessment is exactly how the doctor tells these apart.
Infected eczema and eczema herpeticum
Bacterial infection
Broken, scratched skin is an easy target for bacteria. Suspect infection when a patch weeps, forms golden crusts, becomes hotter and more painful, spreads quickly or stops responding to your usual treatment, especially with fever. Antibiotics are only prescribed when there are genuine signs of bacterial infection like these; they add nothing to an ordinary flare, and unnecessary courses fuel antibiotic resistance.[2]
Eczema herpeticum: rare and urgent
When the cold-sore virus infects eczema, it can spread alarmingly fast: clusters of small, uniform, painful blisters or punched-out sores appearing over hours to days, often with fever and feeling unwell. This is a medical emergency needing same-day in-person care and antiviral treatment.[3] Do not wait for an online appointment, and do not put steroid cream on it.
Eczema in children, pregnancy and while travelling
Eczema is very common in children, and the principles are the same: generous emollients, mild steroids for the face and stronger ones where the skin is tougher, and prompt attention to infection. Eczema herpeticum is more dangerous in babies and young children, so fast-spreading painful blisters in a child always warrant same-day in-person care rather than an online appointment.[5]
In pregnancy, emollients remain the foundation and mild to moderate topical steroids are generally considered suitable for short courses;[1] tell the doctor if you are pregnant or breastfeeding so the plan is tailored, as some systemic eczema medicines are not used at that time. For travellers and expats, changes in climate, hard water, hotel soaps, air conditioning and swimming-pool chlorine are classic flare triggers. Carrying enough of your usual emollient and a short steroid course, and being able to review your skin online from abroad, keeps a holiday flare from taking over the trip.
How can I reduce eczema flares?
You reduce eczema flares by protecting the skin barrier and avoiding your triggers: moisturise every day even when the skin is clear, swap soaps and shower gels for a soap substitute, wear cotton rather than wool, keep the bedroom cool, and manage stress and dust-mite exposure. Consistent daily emollient use is the single most effective step.[1]
Identifying personal triggers is worth the effort. A short diary noting flares against weather, products, foods, stress and sleep often reveals a pattern you can then plan around. Practical measures help too: using a non-biological detergent with an extra rinse cycle, wearing gloves for wet or dirty work, patting rather than rubbing the skin dry, and applying emollient within minutes of washing while the skin is still slightly damp so it locks moisture in.
Hand eczema deserves a special mention because it is so often driven by work: frequent hand-washing, gloves, detergents and food handling all strip the barrier. Protecting the hands (lukewarm water, thorough drying, emollient after every wash, and task gloves over a cotton liner) is central. Eyelid eczema, another common site, usually needs only a mild steroid, because the skin there is thin and reacts to potent ones.
Which eczema treatment might the doctor recommend?
Treatment follows the flare: emollients every day as the base, a topical steroid matched in strength to the body site for a defined number of days, infection treatment only when there are genuine signs of it, and referral when good topical treatment is not holding. This is the framework the doctors use, aligned with the cited guidance:[1]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Dry, itchy patches in typical creases (mild flare) | Daily emollients plus a short course of mild topical steroid such as hydrocortisone | Usually yes | Uncertain diagnosis, or no response after 1–2 weeks of correct use |
| Widespread or thickened patches (moderate flare) | Moderate-potency steroid for trunk and limbs, milder options for face and folds, generous emollients | Usually yes | Flares returning as soon as treatment stops, or eczema dominating sleep and daily life |
| Weeping, golden-crusted or rapidly worsening patches | Assessment for infected eczema; antibiotics only with clear signs of bacterial infection[2] | Often, case-dependent | Fever, feeling unwell or widespread infected skin: same-day in-person care |
| Clusters of painful, punched-out blisters spreading fast | Urgent same-day hospital assessment for suspected eczema herpeticum | No | Always, particularly in babies and children |
| Severe eczema despite good topical treatment | Dermatology referral for light therapy or systemic treatment | Assessment and referral, not ongoing management | Specialist initiation and monitoring are needed |
Not sure which row is your flare? A doctor can tell you in one consultation.
See available times →Treatment options for eczema
What you can do yourself
Emollients are the foundation: applied generously at least twice daily and after washing, they repair the barrier and reduce how often you flare.[4] Use a soap substitute rather than foaming shower gels, keep showers short and lukewarm, pat dry, and moisturise within minutes. Choose cotton over wool next to the skin, keep nails short, keep the bedroom cool, and press or cool itchy skin instead of scratching where you can.
Prescription treatment
A prescription is never issued without a consultation. After the assessment, the doctor prescribes what fits your skin. Topical corticosteroids remain the fastest way to end a flare, and safety lies in the details: a mild steroid such as hydrocortisone for the face, eyelids and skin folds; a moderate or potent one such as clobetasone, mometasone or betamethasone for the trunk and limbs; once-daily application until the skin is smooth, then two or three days more, typically one to two weeks in total.[1] For people who flare repeatedly in the same places, twice-weekly maintenance dosing can prevent relapses. Steroid-sparing calcineurin-inhibitor creams (tacrolimus, pimecrolimus) suit delicate sites such as the face. A sedating antihistamine occasionally helps sleep during a bad flare, though it does not treat the eczema itself. Infected eczema may need antibiotic treatment after that assessment.[2] And when eczema stays severe or uncontrolled despite good topical treatment, the doctor refers you to dermatology, where light therapy and modern systemic medicines, including biologic injections and JAK-inhibitor tablets, have changed what severe eczema means.
When eczema is treated online, and when you need in-person care
Treated online: typical flares of previously diagnosed eczema; first assessments of dry, itchy, crease-pattern rashes in adults; emollient and steroid plans, including step-downs and twice-weekly maintenance; hand and eyelid eczema needing site-specific advice; and reviews when a flare is not settling as expected.
In-person care: suspected eczema herpeticum, always and urgently, the same day; widespread infected eczema with fever or feeling very unwell; rashes in the first weeks of life; severe or uncontrolled eczema that justifies dermatology assessment for light therapy or systemic treatment, which specialists initiate and monitor; and any rash where the diagnosis stays uncertain after photo and video review. The same photo-and-video assessment the doctors use for acne applies here: it can often provide enough information, and when it cannot, the doctor says so and points you to the right care.
When to get in-person care
Go for same-day in-person care if you suspect eczema herpeticum (fast-spreading clusters of painful small blisters or punched-out sores, especially with fever) or if widespread infected eczema comes with fever, shivering or feeling very unwell. If you become drowsy or confused, are breathing very fast, or have cold blotchy skin alongside fever, call 112 immediately.
Treating eczema at home: what helps and what does not
Generous, frequent emollients are the real foundation of eczema care, and they are home care: applied more often than feels necessary, alongside short lukewarm showers, fragrance-free products and avoiding known triggers. For mild eczema, done properly, this is often enough.
What home care cannot do: it cannot calm a genuine flare that needs prescription-strength steroid or non-steroid creams, and it cannot treat infected eczema, which looks weepy, crusted or suddenly worse and needs a doctor. If itch is breaking your sleep, or you are flaring within days of finishing every course of shop-bought hydrocortisone, the routine is not the problem: the treatment strength is.
The strongest at-home treatment is still a doctor. A video consultation brings one to your sofa: an honest assessment, and a prescription to a local pharmacy when treatment is right. You can see a doctor over video, usually within 15 minutes. Book a video consultation: the exact price is shown before you pay.
Is eczema contagious?
No. Eczema is not contagious at all: it is a skin-barrier and immune condition, and no amount of contact, shared towels or swimming pools passes it to anyone else. Children with eczema need no separation from anyone.
The one nuance: eczema that becomes infected, weeping, crusted or suddenly worse, can carry bacteria or the cold-sore virus on the skin, and that infection can spread. Infected eczema needs a doctor, both for the person who has it and for close contacts.
Often confused: psoriasis carries the same myth, and the same answer: psoriasis is not contagious either.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Upload your skin photos, then speak to a licensed doctor: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with your plan: everything agreed before you hang up: your plan, and a prescription to use at a pharmacy near you where medication is clinically right for you. If your doctor decides you need to be seen in person, you get a full refund.
No sign-up needed
Not sure it’s eczema? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Dry Skin can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about eczema
What is eczema?
Eczema, or atopic dermatitis, is a long-term inflammatory skin condition in which the skin barrier leaks water and lets irritants and allergens in, and the immune system over-reacts to them, producing dry, intensely itchy, red, cracked and sometimes weeping patches. It typically starts in childhood, runs in families alongside asthma and hay fever, and flares and settles in episodes rather than staying constant.
What causes eczema, and why does it flare?
Eczema is caused by a combination of genes that weaken the skin barrier, often a change in the filaggrin gene, and an immune system that over-reacts; it is not caused by poor hygiene or diet. Flares are set off by dry skin, soap and detergents, wool, sweat and heat, house-dust mite, pet dander, stress, infections, hormonal changes and, in a minority, specific food allergens.
What are the symptoms of eczema?
Eczema causes dry, itchy, red or darker-than-usual patches that may crack, weep, crust or thicken with scratching, most often in the elbow creases, behind the knees, on the hands, wrists, neck, eyelids and face; babies get it on the cheeks and outer limbs. The itch is often worst at night and disturbs sleep, and the skin between flares stays dry and easily irritated.
Can an online doctor prescribe steroid cream for eczema in Europe?
Yes, after a consultation. A prescription is never issued without one: the doctor assesses your eczema from photos and history by video first, then prescribes the potency that fits the body sites affected and the severity of the flare, alongside a named emollient. Any prescription can be used at a pharmacy near you, and infected or very widespread eczema is directed to in-person care.
Are steroid creams safe for eczema?
Used correctly, yes: the right potency for the body site, usually once daily for up to two weeks on a flare, then stopped while the emollient continues. Mild steroids suit the face and skin folds; stronger ones are kept for thick skin on the hands and limbs. Problems come mainly from potent steroids used continuously on thin skin; undertreating eczema out of fear prolongs the itch and the damage.
How much emollient should I use for eczema?
Far more than most people use. An adult with widespread eczema needs several hundred grams of emollient a week, applied generously at least twice a day and after every wash, in the direction of hair growth, and continued every day when the skin looks clear. Steroid cream goes on the inflamed patches first, with emollient around and over it at least half an hour later.
How do I know if my eczema is infected?
Infected eczema shows weeping, golden or honey-coloured crusts, spreading redness, warmth, pain, or a flare that suddenly stops responding to the usual creams, sometimes with fever. Clusters of small, painful, punched-out blisters spreading fast are different and more urgent: they can be eczema herpeticum, a herpes infection of eczema that needs in-person hospital assessment without delay.
Is it eczema, psoriasis or ringworm?
Eczema is intensely itchy, poorly defined, sits in the elbow and knee creases and on the hands and face, and has a long history of dry skin. Psoriasis forms thick, well-defined plaques with silvery scale on elbows, knees, scalp and lower back and itches less. Ringworm makes one or a few ring-shaped scaly patches with a clearer centre that spread outward, and it gets worse with steroid cream.
Can eczema be cured, and how long does a flare last?
Eczema cannot be cured, but it can be controlled: most children improve by their teens and most adults reach long calm stretches with short, promptly treated flares. A typical eczema flare settles within one to two weeks of a correct steroid course plus generous emollient; one that is not improving after two weeks, or keeps returning as soon as treatment stops, needs a review of the plan and the triggers.
Is eczema contagious?
No. Eczema is an inflammatory condition of the skin barrier and the immune system, not an infection, so it cannot be passed on by touch, sharing towels or swimming. What can spread is an infection on top of eczema: impetigo-like bacterial crusting, or the herpes virus that causes eczema herpeticum, which is why anyone with a cold sore should avoid touching eczema-affected skin.
What can I do at home to calm an eczema flare?
Calm an eczema flare at home by applying emollient thickly several times a day, using the prescribed steroid cream once daily on the inflamed patches, washing with a soap substitute in lukewarm water, keeping the bedroom cool, wearing loose cotton, cutting nails short, using a cold compress for the worst itch, and taking a non-drowsy antihistamine only for hay fever symptoms alongside it. Wet wraps help thick, stubborn patches.
How can I reduce eczema flares?
Reduce eczema flares by moisturising every day even when clear, replacing soap and shower gel with emollient, avoiding wool and overheating, rinsing after swimming, washing clothes in non-biological detergent without fabric conditioner, managing dust mite with covers and hot washes, treating hay fever and stress, and starting the steroid cream at the first sign of a flare rather than waiting. Twice-weekly steroid on known trouble spots prevents relapses in frequent flarers.
Is eczema treated differently in pregnancy or in older people?
In pregnancy, eczema often worsens; emollients are unrestricted and mild to moderate steroid creams are used in short courses, which the doctor agrees with you rather than leaving the eczema untreated. In older people, eczema is often a new, dry, cracked eczema of the shins that needs ointment-based emollients and a check of medicines. Children are seen in person: Mobi Doctor sees adults aged 18 and over only.
- Eczema (atopic): Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2024.
- Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing (NG190), NICE, National Institute for Health and Care Excellence, 2021.
- Atopic dermatitis, DermNet New Zealand Trust, reviewed 2024.
- Eczema: symptoms and diagnosis, HSE, Health Service Executive (Ireland), accessed August 2026.
- Eczema herpeticum, DermNet, DermNet New Zealand Trust, accessed August 2026.
- Atopic eczema, NHS, National Health Service (UK), accessed October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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