Skin Condition · Kensington, London

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Eczema and Dry Skin: A Barrier Problem, Not Just Dryness

Name: Faciem Dermatology & Medical Clinic
Price range: $$$

Eczema is a long-term inflammatory skin condition in which a weakened barrier loses water easily and the immune system overreacts to things that would not normally provoke it. The result is dry, itchy, red or darkened skin that flares and settles. Dry skin alone is a symptom; eczema is the underlying condition.

This page reflects how eczema and dry skin are assessed and managed at Faciem, and is reviewed for clinical accuracy.
Last reviewed: 12 September 2026.
Patient information only. Eczema has several distinct types that respond differently, and any treatment plan follows a face-to-face consultation with Dr Prasad.

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TL;DR

Eczema is a chronic inflammatory condition combining a leaky skin barrier with an overactive immune response, producing dry, intensely itchy skin that flares and settles. Atopic eczema is the most common form and often runs alongside asthma and hay fever. In deeper skin tones it frequently leaves lasting dark marks, so early control matters more. Eczema is managed, not cured, and assessment at Faciem is by Dr Prasad, a GMC-registered doctor.

About the Condition

What Is Eczema & Dry Skin?

Eczema, also called dermatitis, is inflammation of the skin arising from a defective barrier and an overactive immune response. The barrier loses water and admits irritants and allergens; the immune system responds with inflammation. This produces dryness, intense itch, redness in fair skin, and grey, purple or darker discolouration in deeper skin tones.

What eczema looks and feels like

Itch is the defining feature, and it usually precedes anything visible. Skin is dry, rough and may crack, weep or crust during a flare. In fair skin the affected areas look pink or red; in Black, South Asian and other deeper skin tones inflammation reads as grey, purple, or simply darker than the surrounding skin, which is one reason eczema is under-recognised in those groups. Distribution varies with age: infants tend to be affected on the face and outer limbs, while older children and adults develop it in the skin creases — inner elbows, behind the knees, wrists, ankles and neck. Long-standing eczema becomes lichenified, meaning thickened and leathery with exaggerated skin lines from repeated scratching.

Who tends to get eczema

Atopic eczema usually begins in early childhood, often before the first birthday, and many children improve considerably by adolescence. A substantial number continue into adult life, and some develop eczema for the first time as adults. It clusters in families alongside asthma and hay fever, the group of conditions described as atopic, and is associated with variations in the gene for filaggrin, a protein essential to barrier function. Eczema affects every skin tone but is more prevalent and often more severe in Black and South Asian populations, and the risk of lasting pigment change after a flare is considerably higher in those groups. Skin tone is recorded on the Fitzpatrick scale at assessment, and it changes what is looked for rather than what is prescribed: in Fitzpatrick IV to VI skin, inflammation reads as violet, grey or simply darker instead of red, so severity is easy to underestimate and treatment is easy to pitch too low, and the post-inflammatory pigmentation left behind can take months to fade once the eczema itself has settled.

The different types, and what resembles eczema

Eczema is an umbrella term covering several distinct types. Atopic eczema is the immune-driven form described above. Contact dermatitis follows exposure to an irritant such as detergent, or an allergen such as nickel or fragrance, and appears where the contact occurred. Discoid eczema forms coin-shaped patches, often on the limbs. Seborrhoeic dermatitis affects the greasy areas — scalp, brows, sides of the nose — is linked to a yeast, and is a common cause of the flaking and itching covered under scalp and hair problems. Several conditions mimic eczema: psoriasis produces better-defined plaques with thicker scale, fungal infection spreads with a raised advancing edge, and scabies causes intense itch that is typically worse at night and affects other household members.

Causes & Contributing Factors

What Causes Eczema & Dry Skin?

Eczema is caused by a combination of an impaired skin barrier and an overactive immune response, both largely determined by genetics. Triggers do not cause eczema; they provoke flares in skin already predisposed to it. Identifying your own triggers matters more than following a general list.

Barrier dysfunction

Skin affected by eczema loses water more readily and admits irritants and allergens more easily. Variations in the filaggrin gene, which affect a protein essential to barrier structure, are strongly associated with atopic eczema.

Immune overactivity

The immune system in eczema responds disproportionately to substances that would not normally provoke inflammation. This is why treatment targets the immune response as well as repairing the surface.

Irritants and allergens

Soaps, detergents, fragrance, wool and frequent hand washing commonly provoke flares. Contact allergy to nickel, preservatives or fragrance may drive eczema that appears in a specific distribution or fails to settle.

Environment and weather

Cold dry air, central heating, humidity, sweat and hard water all affect how eczema behaves, and many people find flares follow a seasonal pattern — a detail that helps when planning treatment.

Stress, illness and the itch-scratch cycle

Stress and infection can precipitate flares, and scratching damages the barrier further, driving more inflammation and more itch. Breaking that cycle is often the most useful thing treatment achieves.

Treatments We Offer

How Eczema & Dry Skin Is Treated at Faciem

Eczema is treated on two fronts: repairing and protecting the barrier daily, and calming the immune response during flares. Emollients do the first; prescription creams — topical anti-inflammatories and immunomodulators — do the second, and most mild to moderate eczema is controlled this way. Neither works well alone, and the right combination depends on the type of eczema, its severity, and where on the body it is.

Dermatology Consultation

Eczema is a medical diagnosis and prescription treatment is usually part of the plan. A consultation takes a detailed history of your skin and past treatments, examines it, and records clinical photographs — establishing the type, identifying triggers, and ruling out the conditions that resemble eczema.

Best for: diagnosis and prescription treatment

Read about Dermatology Consultation

Medical-Grade Skincare

Barrier repair is the foundation of eczema management and is what reduces how often flares occur. A regime is chosen to support the barrier without the fragrances and detergents that commonly provoke it.

Best for: daily barrier support between flares

Read about Medical-Grade Skincare

Hydrafacial

Where facial skin is dry and dull but not actively inflamed, gentle hydration and infusion can improve comfort and texture. It is not a treatment for an active flare.

Best for: dry, dull facial skin between flares

Read about Hydrafacial

Where topical treatment does not achieve control, light treatment or oral medicines may be appropriate and would be arranged by onward referral. Suitability is decided at a face-to-face consultation with Dr Prasad, and results vary between individuals.

When to Seek Medical Advice

When Should You See a Doctor About Eczema?

See a doctor about eczema if it is disturbing sleep, not settling with over-the-counter emollients, spreading, or showing signs of infection. Early treatment matters particularly in deeper skin tones, where inflammation is more likely to leave lasting marks once the flare has resolved.

Worth getting checked

Conditions that can look similar

Self-Care & Prevention

Managing Eczema Between Flares

Daily emollient use is the single most effective home measure in eczema, and it works by preventing flares rather than treating them. Applying it consistently when the skin looks fine is what reduces how often it does not.

Do

Avoid

This is general guidance and does not replace individual assessment. What suits your skin depends on the type and severity of your eczema and where on the body it affects you.

Why Patients Choose Faciem

Eczema Treated as a Medical Condition

Eczema is frequently managed as a moisturising problem when it is an immune one. Emollients are essential, but they do not treat inflammation, and undertreated inflammation is what leaves marks and thickened skin behind.

Experience & Expertise

Why Eczema Should Be Assessed by a Doctor

Eczema is under-treated more often than it is over-treated, usually because of anxiety about topical steroids that leaves inflammation running for months. Persistent inflammation is what thickens skin and, in deeper skin tones, what leaves the lasting dark or pale marks patients often find more troubling than the eczema itself. There is also the diagnostic question: psoriasis, fungal infection and scabies all resemble eczema, and a steroid applied to a fungal infection makes it spread. Dr Prasad establishes which type of eczema is present, rules out what mimics it, and sets treatment at a level that actually controls the inflammation rather than suppressing it briefly.

Dr Anamica Prasad — MBChB (1999), Dip Dermatology (2001), MRCGP, DFFP, DRCOG · a GMC-registered doctor
Member of the Joint Council for Cosmetic Practitioners (JCCP), British Medical Laser Association (BMLA), Royal Society of Medicine and the Aesthetic Complications Group
Clinic operated by Derma Medical UK Ltd, registered with the Care Quality Commission for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury · CQC Location ID 1-25573003746
Face-to-face medical consultation and examination before any treatment is prescribed
20 years’ experience in dermatology, treating inflammatory skin disease across every skin tone

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Eczema & Dry Skin FAQs

Your Questions, Answered

Direct answers on causes, steroid creams, psoriasis confusion, and the everyday questions about makeup, exercise and swimming. If your question is more specific to your own skin, bring it to your consultation.

What causes eczema?

Eczema is caused by a combination of an impaired skin barrier, which loses water and admits irritants, and an overactive immune response to substances that would not normally provoke inflammation. Both are largely genetic. Triggers such as soaps, detergents, weather, stress and infection provoke flares but do not cause the condition.

Does eczema go away on its own?

Many children improve considerably by adolescence, though the underlying tendency often persists and skin may remain dry and sensitive. Adult eczema is less likely to resolve spontaneously. Because it flares and settles, eczema is managed continuously over time instead of being treated once and forgotten.

Can I wear makeup if I have eczema on my face?

Makeup can be worn over facial eczema once the skin is intact rather than cracked or weeping. Apply your emollient first and allow 15 to 20 minutes for it to absorb, so foundation is not sitting on wet cream. Fragrance-free mineral formulas are the safest starting point, and anything new is worth patch testing behind the ear for 48 hours. Remove it with a soap substitute rather than a foaming cleanser, and leave the area bare during an active flare or while a prescribed cream is on the skin.

Is it eczema or psoriasis?

Psoriasis forms better-defined plaques with thicker scale, while atopic eczema favours the skin creases and is dominated by itch. Fungal infection spreads outward with a raised advancing edge, and scabies causes itch that worsens at night and affects other household members. The distinction matters because a steroid applied to a fungal infection makes it spread, so a rash that is not clearly eczema should be diagnosed before it is treated.

Can I exercise or swim with eczema?

Exercise and swimming both suit eczema with a little preparation. Sweat and chlorine are irritants rather than causes, so apply emollient around 30 minutes before you train or swim, rinse in lukewarm water within 10 minutes of finishing, and reapply emollient while the skin is still damp. Cotton or smooth technical fabrics are kinder than wool in kit that rubs. If a particular pool leaves your skin irritable for a day or two afterwards, note it as a trigger and bring that to your consultation.

Are steroid creams for eczema harmful?

Fear of topical steroids is one of the main reasons eczema stays under-treated, with inflammation left running for months. Topical anti-inflammatories and immunomodulators are a standard part of medical eczema care: Dr Prasad prescribes at a level that controls the inflammation, then reviews it so treatment is stepped down as advised once the skin settles — not stopped the moment it looks clear. Untreated inflammation carries its own cost: it thickens skin and, in deeper skin tones, leaves lasting dark or pale marks.

How much does eczema treatment cost?

Eczema care at Faciem is priced as a private dermatology consultation plus any prescriptions and review appointments, because what treatment is needed depends on the type and severity found at examination — there is no set package. Consultation options are set out on our private doctor appointments page, and fees are confirmed before anything goes ahead.

Sources & Further Reading

Atopic eczema — symptoms, causes and treatment — NHS
Atopic eczema patient information leaflet — British Association of Dermatologists
Atopic dermatitis — DermNet NZ

These are general sources of patient information and do not replace individual medical assessment. Your own diagnosis and treatment plan come from a face-to-face consultation.

Eczema & Dry Skin in Kensington, London

A Doctor-Led Clinic in the Heart of Kensington

Doctor-led eczema diagnosis and treatment is available at Faciem Dermatology & Medical Clinic on Kensington Church St, London, led by Dr Prasad — a few minutes’ walk from High Street Kensington station and around ten from Notting Hill Gate. Because eczema is reviewed and adjusted over time, access matters: the clinic is open Monday to Saturday, 10am to 7pm, closed Sunday, with Kensington council underground parking nearby. Many of the patients we see for eczema come from Chelsea, Holland Park, Notting Hill and across West London.

Plan Your Visit

Faciem Dermatology & Medical Clinic
Phone: +44 20 7131 3539
7 Kensington Church St, London W8 4LF, United Kingdom
Tube: High Street Kensington (few minutes’ walk) · Notting Hill Gate (~10 minutes)
Parking: Kensington council underground car park nearby
Open Monday–Saturday, 10am–7pm · Sunday closed
Eczema consultations bookable online; treatment planned after diagnosis
Consultation-first — no treatment without medical assessment
Serving Kensington, Chelsea, Notting Hill & Central London

Continue Exploring

Related Conditions & Treatments

Loss of Pigment in Skin

The pale patches inflammation can leave once a flare settles — and why calming the eczema comes before treating the mark.

Rough & Bobbly Skin

Keratosis pilaris, which frequently accompanies eczema and is often mistaken for it.

Rosacea

Another inflammatory condition affecting a sensitive barrier, with quite different treatment.

Faciem Dermatology & Medical Clinic · Kensington

Control the Flares, Not Just the Dryness

Book a consultation with Dr Prasad to establish which type of eczema you have, what triggers it, and the treatment plan that keeps inflammation controlled between flares.

Prefer to talk? +44 20 7131 3539

Monday – Saturday	10am – 7pm
Sunday	Closed