Why does eczema appear in later life?

Eczema is often thought of as a childhood condition, but that’s not accurate. It usually appears for
the first time in childhood, but eczema can affect people at any age. Around half of people with eczema lack a protein called filaggrin, which is strongly linked to the development of atopic eczema, meaning they have a faulty skin barrier. So even though eczema may improve after childhood, it can return at any stage of life.

Eczema can also suddenly appear for the first time in later life, for reasons that can be difficult to
determine. Skin tends to become drier as we get older, which can lead to roughness, scaling and
itchiness. This can mean the skin is more prone to eczema. Sometimes the emergence of eczema in later life can be attributed to a particularly stressful event or period such as following a bereavement.

There are certain types of eczema that are more common in later life: varicose (gravitational/venous) eczema and asteatotic eczema (eczema craquelé).

How is eczema in later life treated?

Emollients are the main first-line treatment for eczema and are necessary to keep your skin moisturised. Emollients can be bought over the counter in pharmacies and some supermarkets or supplied on prescription.

There is a wide range of emollients, which vary in their levels of greasiness. The drier the skin, the greasier an emollient is needed. Ointments are the greasiest type of emollient. If you find that a particular emollient doesn’t suit your skin, try a different one. Different emollients tend to suit different people.

If you have trouble applying emollient to areas of the body that are difficult to reach, such as the back, try an applicator, such as those available at BackBliss (www.backbliss.com).

Take care when trying new moisturising creams. Apply a small amount to a small area of skin and re-apply to this area for three consecutive days, as it can take up to three days for a delayed allergic reaction to occur. Products containing perfume or lanolin are best avoided, as people with eczema are more likely to experience adverse reactions to them.

Soaps, shower gels and bubble baths can dry out the skin. It’s best to use an emollient soap substitute or a cream-based leave-on emollient as a soap substitute.

Bath emollients make the shower tray and bath more slippery. Use non-slip bath mats to help reduce the risk of slipping. Support bars fixed to the wall in the shower or by the bath will provide extra safety when showering/bathing. Pour bath emollient into the bath after you get in rather than before. As an extra precaution it’s a good idea to empty out bath water before getting out of the bath.

Topical steroids are the most common treatment for inflammation in eczema. They should be used according to the instructions of your GP. If you experience no improvement after having used topical steroids for the length of time stipulated by your GP, go back to your GP for further advice. You may need a stronger topical steroid or to be assessed for infection.

For more information on eczema in later life, please see our Eczema in later life factsheet