The causative factors are often difficult to establish, although atopy may play a considerable role. In many instances a good history with appropriately directed patch testing may elucidate the cause. Good skin hygiene is essential for the control of eczemas.
Daily showers using bland non- detergent cleansing agents are the backbone of therapy.
Every attempt should be made to remove scabs, crusts and slough by soaking and gentle compression. Soothing emollient preparations may, especially in the elderly, be all that are required, allaying irritation and assisting healing and recovery of barrier function. Limit use of soap and detergents to a minimum substituting with bland cleansers. Preparations containing potentially sensitising constituents, such as perfumes and preservatives, should be avoided. Infected eczemas respond to topical dressings with antiseptics such as povidone-iodine or clioquinol.