Eczema

What usually happens

Moisturiser is the treatment, not the afterthought. Used generously and often — including on the days the skin looks fine — it is what keeps flares apart. Most people use a fraction of what would actually help.

Steroid creams are usually under-used, not over-used. Fear of them is common and it leads to dabbing on too little for too few days, which never settles the flare and so seems to confirm that they do not work. Used properly, for a defined stretch, they are how a flare is brought under control.

Scratching is part of the disease, not a lack of willpower. Breaking the itch-scratch cycle is a treatment goal in itself, which is why night-time itch is worth mentioning.

Food is rarely the cause in adults. It matters more in young children, and even then testing without a clear story tends to mislead more than it helps.

At your appointment

We will look at where it is, how it behaves, and what you have already tried — including how much and for how long, because that is usually where the answer is.

We will go through what to use where: the face and the body are not the same, and strength is matched to the site.

We will talk about triggers worth avoiding and the many that are not worth chasing.

If it keeps returning despite proper treatment, that is the point at which we look further rather than repeating the same plan.

Worth asking

• —How much cream should I actually be using, and how often?
• —How many days should I use the stronger cream before stopping?
• —What should I use on my face compared with elsewhere?
• —What would tell you this needs a different approach?