Eczema looks different for every person, and so does the care that helps. Atopic dermatitis (AD), the most common form of eczema, is a chronic condition. Many people manage it well with a steady routine and the right treatment plan. For others, symptoms keep getting in the way even when they are doing everything they have been told to do.
If that sounds familiar, you are not doing anything wrong, and you are not alone. Research suggests that more than half of adults with moderate to severe atopic dermatitis report inadequate disease control.¹⁻³ Recognizing when your eczema may need additional support is a practical step, and it starts with knowing what to look for.
Signs your eczema may need more support
Eczema is more than what shows on the skin. It can affect sleep, mood, work, school and relationships. These patterns may be worth raising with a healthcare provider:
- Symptoms that do not settle. Itch, dryness or inflammation that continues for weeks, or flares that return soon after a treatment is stopped.
- Disrupted sleep and daily life. Itch that wakes you at night, makes it hard to focus, or keeps you from things you want to do.
- A routine that is hard to sustain. Your current treatments no longer seem to work as they once did, or managing your skin takes more time and effort than you can keep up.
- Effects beyond the skin. Ongoing stress, low mood, social withdrawal or financial strain connected to your eczema.
- Signs of infection. Oozing, crusting, increasing pain or fever need prompt attention from a healthcare provider.
Any one of these can be reason enough to ask whether your care plan still fits your needs.
Understanding the gap between your goals and your care
Treatment goals are personal. For one person, a good outcome means sleeping through the night. For another, it means wearing the clothes they like, finishing a workday without constant itch or joining friends at an event without planning around a flare.
A treatment-goal gap exists when your day-to-day life does not match what you hoped your care would allow. Naming that gap gives you something specific to bring to your next visit. Try writing down your top three goals, such as less itch, better sleep or fewer flares, and note how close you feel you are to each one. NEA’s guide to preparing for your eczema appointment can help you organize these thoughts.
How specialist care may help
A dermatologist or other healthcare provider experienced in AD can review your full history, not just your current flare. Depending on your situation, that visit may include:
- Reviewing what you have tried before, what helped and what did not
- Confirming your diagnosis, since other skin conditions can look like eczema
- Looking at your triggers, your skin care routine and how consistently you are able to follow your plan
- Discussing the full range of treatment options, from moisturizers and topical medications to light therapy and prescription medicines taken by mouth or by injection, and whether any of them make sense for you
Eczema has no cure, and no single approach works for everyone. The aim of specialist care is to build a plan around your symptoms and your goals, then adjust it as your needs change. Decisions about treatment are best made with your healthcare provider.
Making the conversation count
A little preparation can help you get more from your visit. Consider bringing:
- A short history of your eczema and how it has changed over the past six to 12 months
- A list of current and past treatments, including what helped and any side effects
- Recent photos of your skin, especially if it looks different on the day of your visit
- Your top three goals and any questions you want answered
Care also works best as a two-way conversation. In a recent NEA Article, two NEA Ambassadors who co-authored a paper in the Journal of the American Academy of Dermatology described wanting visits that begin with how they are doing as a person and that explain the reasons behind treatment decisions. It is reasonable to ask your healthcare provider to talk through the “why” behind any plan.
Where to find support
- Eczema Provider Finder: search for healthcare providers with eczema experience near you.
- How to Prepare for Your Eczema Appointment: a seven-step guide with printable discussion tools.
- Eczema Awareness Month webinar: Is It Eczema? (Oct. 22).
- State of AD Indicator Report: NEA’s national and state-by-state look at atopic dermatitis in the U.S.
Asking for more support does not mean you have failed at managing your eczema. It means your needs may have changed, and your care can change with them.
This article is for informational purposes only and is not a substitute for medical advice. Talk with your healthcare provider about your care.
This article was funded in part by Sanofi and Regeneron.
Sources
- McCleary KK. More Than Skin Deep “Voice of the Patient” Report. 2020.
- Simpson EL, Guttman-Yassky E, Margolis DJ, et al. Association of inadequately controlled disease and disease severity with patient-reported disease burden in adults with atopic dermatitis. JAMA Dermatol. 2018;154(8):903-912.
- Wei W, Anderson P, Gadkari A, et al. Extent and consequences of inadequate disease control among adults with a history of moderate to severe atopic dermatitis. J Dermatol. 2018;45(2):150-157.
Statistic as presented on NEA’s Eczema Facts page.
