Understanding Eczema: Triggers, Treatment & How to Reclaim Calm Skin

Eczema affects over 230 million people globally — yet it is still one of the most misunderstood skin conditions. Whether you're navigating a recent diagnosis, managing flares for your child, or simply trying to understand what your skin is telling you, this guide is your starting point.

What Is Eczema?

Eczema is clinically known as atopic dermatitis. It is a chronic inflammatory skin condition characterised by dry, itchy, and inflamed skin.

It is not contagious, and it is not caused by poor hygiene. Rather, it is a complex interplay of genetics, immune dysfunction, and environmental factors that compromise the skin's natural barrier.

The skin barrier in people with eczema is structurally different: it loses moisture more rapidly and is more permeable to irritants and allergens. This is why consistent, targeted skincare is not a luxury for eczema-prone skin, it is a clinical necessity.

 

"Eczema is fundamentally a barrier disease. When we treat the barrier consistently, and correctly, we dramatically reduce the frequency and severity of flares."
— Dr. Ayasha Naidoo, Consultant Dermatologist

 

Types of Eczema

Not all eczema presents the same way. Understanding your type is the first step toward effective management:

• Atopic Dermatitis — The most common form, often beginning in childhood and linked to asthma and hay fever.
• Contact Dermatitis — Triggered by direct contact with an irritant or allergen (e.g. fragrances, metals, cleaning agents).
• Dyshidrotic Eczema — Presents as small, intensely itchy blisters on the hands and feet.
• Nummular Eczema — Coin-shaped patches of irritated skin, often triggered by dry weather or insect bites.
• Seborrhoeic Dermatitis — Affects oily areas like the scalp, face, and chest; often confused with dandruff.

How Is Eczema Diagnosed?

There is no single definitive test for eczema. Diagnosis is primarily clinical; meaning a dermatologist or GP will assess your skin's appearance, your personal and family medical history, and the pattern of your symptoms.

Key diagnostic criteria include:

• Persistent or recurring itchy skin (pruritus)
• Characteristic distribution — inner elbows, behind knees, neck, wrists, and ankles in adults; face and scalp in infants
• Personal or family history of atopic conditions (asthma, allergic rhinitis)
• Onset before age 2 (in most cases)

Your dermatologist may also recommend patch testing to identify specific contact allergens, or a skin prick test if food or environmental allergies are suspected as triggers.

 

"Many patients come to me having self-diagnosed with eczema when they actually have psoriasis, rosacea, or a fungal infection. A proper diagnosis changes everything, including the treatment plan."
— Dr. Lerato Dlamini, Specialist Dermatologist, Johannesburg

 

Common Triggers to Know

Eczema is not random. Flares are almost always triggered by identifiable factors. Learning yours is one of the most empowering things you can do for your skin.

Environmental Triggers

• Dry, cold air or sudden temperature changes
• High humidity and sweating
• Dust mites, pet dander, pollen, and mould
• Cigarette smoke

Skincare & Product Triggers

• Fragrances and synthetic perfumes
• Alcohol-based toners and astringents
• Harsh sulphate cleansers (SLS/SLES)
• Preservatives such as parabens and formaldehyde-releasing agents
• Rough textures and synthetic fabrics

Lifestyle & Internal Triggers

• Stress — one of the most significant and underestimated triggers
• Poor sleep quality
• Dietary factors (in some individuals): dairy, gluten, eggs, soy, and tree nuts
• Hormonal fluctuations (menstrual cycle, pregnancy, menopause)
• Certain medications, including aspirin and some antibiotics

 

"Stress doesn't just affect your mood; it directly elevates cortisol, which disrupts the skin barrier and amplifies the inflammatory response. Managing stress is as important as managing your skincare routine."
— Dr. Sipho Khumalo, Integrative Dermatologist

 

Lifestyle Choices That Make a Difference

Eczema management is a whole-body practice. The following lifestyle adjustments have strong clinical and anecdotal support:

1. Moisturise Immediately After Bathing

Apply a rich, fragrance-free emollient within 3 minutes of stepping out of the shower — while skin is still slightly damp. This locks in moisture before transepidermal water loss occurs.

2. Bathe in Lukewarm Water

Hot water strips the skin's natural lipid barrier. Keep showers short (under 10 minutes) and use lukewarm water only.

3. Wear Natural Fibres

Opt for 100% cotton, bamboo, or silk against the skin. Avoid synthetic blends that cause friction and heat.

4. Manage Stress Actively

Incorporate mindfulness, breathwork, yoga, or therapy into your routine. The gut-skin-brain axis is real, and stress management is a frontline eczema intervention.

5. Audit Your Diet

While food triggers are highly individual, an anti-inflammatory diet rich in omega-3 fatty acids (oily fish, flaxseed), antioxidants (berries, leafy greens), and probiotics (fermented foods) supports skin health from within.

6. Optimise Your Sleep Environment

Use hypoallergenic bedding, wash linen weekly in hot water, and keep your bedroom cool and well-ventilated. Nighttime scratching is a major driver of skin damage and infection.

7. Avoid Known Irritants

Switch to fragrance-free laundry detergents, avoid fabric softeners, and use gentle, pH-balanced cleansers throughout your home and personal care routine.

Childhood Eczema: A Guide for Parents

Eczema is the most common chronic skin condition in children, affecting approximately 1 in 5 children in South Africa. It typically appears in the first 6 months of life and, while many children outgrow it, others carry it into adulthood. 

Recognising Eczema in Babies & Children

• Infants (0–2 years): Red, weeping patches on the cheeks, scalp, and outer limbs
• Toddlers & children (2–12 years): Dry, thickened skin in the creases of elbows, knees, wrists, and ankles
• Teenagers: Often localised to the hands, face, and neck; may worsen with hormonal changes

How Parents Can Manage Childhood Eczema

• Establish a twice-daily moisturising routine — morning and night, using a gentle, paediatric-appropriate emollient. Consistency is more important than the product itself.
• Use soap-free, fragrance-free cleansers for bath time. Avoid bubble baths entirely.
• Keep nails short to minimise skin damage from scratching. Consider cotton mittens for infants at night.
• Dress children in loose, breathable cotton and avoid overheating — heat is a major trigger in children.
• Identify and eliminate food triggers in consultation with a paediatric allergist. Do not eliminate food groups without professional guidance.
• Create a low-allergen home environment: vacuum regularly, use dust mite-proof mattress covers, and keep pets out of the child's bedroom.
• Communicate with teachers and caregivers so they understand the condition and can prevent exposure to known triggers at school.

 

"Parents often feel helpless watching their child scratch. The most important thing I tell them is: moisturise, moisturise, moisturise. A well-hydrated barrier is your child's best defence against a flare."
— Dr. Nomsa Vilakazi, Paediatric Dermatologist

 

When to See a Doctor

Seek medical attention if your child's eczema is:

• Weeping, crusting, or showing signs of infection (yellow/green discharge, increased warmth)
• Severely disrupting sleep
• Not responding to over-the-counter emollients after 2–3 weeks
• Covering large areas of the body

Treatment Options: What to Expect

Eczema treatment is tiered — starting with the gentlest interventions and escalating based on severity.

Step 1: Emollient Therapy (First Line)

Daily, liberal application of a rich moisturiser is the cornerstone of all eczema management. This alone can prevent the majority of mild-to-moderate flares.

Step 2: Topical Corticosteroids

Prescribed for active flares, these reduce inflammation rapidly. They should be used as directed typically for short courses, to avoid side effects such as skin thinning.

Step 3: Topical Calcineurin Inhibitors (TCIs)

Non-steroidal anti-inflammatory creams (e.g. tacrolimus, pimecrolimus) are particularly useful for sensitive areas like the face and eyelids.

Step 4: Systemic Treatments

For moderate-to-severe eczema unresponsive to topical treatments, dermatologists may prescribe oral immunosuppressants or newer biologic therapies such as dupilumab, which targets the specific immune pathways driving atopic dermatitis.

Step 5: Phototherapy

Narrowband UVB light therapy can be highly effective for widespread eczema and is administered in a clinical setting.

How Soon Should You Feel Better?

This is one of the most common questions, and the honest answer is: it depends on the treatment and the severity of your flare.

Important: Eczema is a chronic condition. Even when your skin clears, maintenance therapy, particularly consistent moisturising is essential to prevent relapse.

 

"Patients often stop their emollient routine the moment their skin looks clear. That's exactly when you need to maintain it. Eczema management is a marathon, not a sprint."
— Dr. Ayasha Naidoo, Consultant Dermatologist

 

Sative's Recommended Products for Eczema-Prone Skin

At Sative, every formulation is built around one principle: skin that is nourished, protected, and respected. Our products are free from harsh sulphates, synthetic fragrances, and known irritants, making them well-suited for sensitive and eczema-prone skin.

We recommend consulting with your dermatologist before introducing new products during an active flare. The following are best used as part of a daily maintenance routine. 

🧴 For Gentle Cleansing

Cleansing is where most eczema-prone skin goes wrong. Harsh soaps and sulphate-heavy washes strip the skin's acid mantle and accelerate moisture loss. 

These two Sative formulations cleanse without compromise:

Soothe + Hydrate Face Cleanser
A soap-free, pH-balanced facial cleanser designed for reactive and sensitive skin.

It removes impurities without disrupting the skin barrier — ideal for eczema-prone faces that need cleansing without stripping. → Add to Cart

Goat Milk + Turmeric with Kaolin Clay Soap
Goat milk is naturally rich in lactic acid and skin-identical fatty acids that support barrier function.

Turmeric brings anti-inflammatory properties, while kaolin clay gently draws out impurities without over-drying. A gentler alternative to conventional soap for eczema-prone skin. → Add to Cart

💧 For Daily Barrier Support & Deep Moisturising

The single most important step in any eczema routine is consistent, generous moisturising.

Apply immediately after bathing while skin is still slightly damp to seal in hydration.

Brightening Body Butter
A rich, occlusive body butter that delivers deep nourishment to dry, compromised skin. The dense emollient texture creates a protective layer over the skin barrier — exactly what eczema-prone skin needs between flares. Apply liberally to affected areas morning and night. → Add to Cart

Youthful Glow Moisturising Cream
A lightweight yet deeply hydrating cream that absorbs quickly without leaving a heavy residue. Suitable for daily use, and gentle enough for older children and teenagers managing eczema. → Add to Cart

Brightening Daily Moisturiser Cream
Formulated for daily use, this moisturiser supports an even skin tone while delivering consistent hydration — ideal for post-flare skin that needs both repair and maintenance. → Add to Cart

🌿 For Soothing & Skin Recovery

During and after a flare, the skin needs actives that calm inflammation, support cell renewal, and restore radiance without aggravating sensitivity.

Rejuvenating Rose Bomb Facial Oil
Rosehip oil is one of the most clinically studied oils for skin barrier repair. Rich in essential fatty acids (linoleic acid) that are often deficient in eczema-prone skin.

This facial oil helps restore lipid balance, reduce redness, and support skin recovery post-flare. Best used as the final step in your evening routine. → Add to Cart

Pigmentation Correcting Body Oil
Post-inflammatory hyperpigmentation (PIH)  (the dark marks left behind after an eczema flare) is a common concern, particularly on darker skin tones.

This body oil targets discolouration while nourishing the skin barrier. → Add to Cart

🧼 For Body Cleansing (Active Flare Caution)

If you're managing body eczema and need a wash that won't aggravate inflammation, avoid acid-based washes during active flares.

The following are better suited to maintenance phases:

Radiance Boost Body Wash with Glycolic Acid
Note: Contains glycolic acid — a chemical exfoliant. Use only during remission phases on non-affected areas. Avoid on broken or actively inflamed skin.

Helps prevent the build-up of dead skin cells that can trap heat and worsen eczema over time. → Add to Cart

Build Your Eczema Routine with Sative

A simple, consistent routine is more effective than a complex one. Here's how to layer Sative products for eczema management:

Key Takeaways

Eczema is not a life sentence, it is a manageable condition. With the right diagnosis, a consistent skincare routine, informed lifestyle choices, and appropriate medical support, most people with eczema can achieve long periods of clear, comfortable skin.

The key is consistency, patience, and working with your skin rather than against it.

If you suspect you or your child has eczema, always seek a formal diagnosis from a qualified dermatologist or GP before beginning any treatment protocol.

Disclaimer: This article is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.