Eczema
Specialist assessment and treatment for children and adults with eczema
At Midland Skin we assess and treat eczema in children and adults from Birmingham, Solihull, Coventry, Wolverhampton, Worcester and across the Midlands. Treatment ranges from skincare advice and prescription creams, biologic medicines and newer targeted treatments.
Quick Facts about eczema
Best for
Eczema or suspected eczema
Appointment
Initial dermatology assessment
Treatment
Creams, tablets or injections
Symptoms
Scaly, itchy or sore skin
Provider
Consultant dermatologist
Price
See below
What is eczema?
Eczema is a group of conditions that cause inflammation of the skin. It is also called dermatitis, both words mean the same thing.
The skin may become itchy, dry, inflamed, scaly, cracked, blistered or weepy. Eczema may affect a small area or be more widespread, and its appearance can differ between skin tones.
There are several types, including atopic eczema, irritant or allergic contact dermatitis, hand eczema, discoid eczema and seborrhoeic dermatitis. More than one type or contributing factor may be present at the same time.
Eczema is not contagious. Some forms are short-lived, but others follow a longer course with periods of improvement and recurrence.
When should I see a dermatologist for eczema?
Whether eczema affects you or your child, a dermatology assessment can be worthwhile when symptoms are persistent, keep returning or are becoming difficult to manage.
Establishing the type of eczema, and whether something else may be causing the rash, helps determine what treatment is appropriate. Specialist assessment can be particularly useful when:
- you are uncertain whether the rash is eczema or which type of eczema it is
- the rash is persistent, recurrent, spreading or changing
- over-the-counter products or treatment from your GP have not provided adequate control
- itching, soreness or skin cracking is affecting sleep, school, work or everyday activities
- the skin is repeatedly weeping, crusting or becoming infected
- you would like to discuss narrowband UVB, oral medication or injection treatments
The Consultant Dermatologist accepting responsibility for your care assesses the condition and recommends treatment only where it is considered appropriate.
George Dunstan
Why getting the diagnosis right matters
Eczema is not a single diagnosis. Atopic eczema, irritant contact dermatitis, allergic contact dermatitis, discoid eczema and seborrhoeic dermatitis can require different approaches to treatment and prevention.
Other conditions—including psoriasis, fungal infection, scabies, rosacea and other inflammatory rashes—can sometimes resemble eczema. For example, round patches of discoid eczema may be mistaken for a fungal infection, while eczema affecting the hands or face may have an irritant, allergic or atopic cause.
The history and appearance of the skin are often sufficient to establish the most likely diagnosis. Tests are not routinely required for every patient.
Where clinically appropriate, investigations may include a skin scraping, swab, biopsy or targeted allergy blood test. If allergic contact dermatitis is suspected, referral for specialist patch testing may be recommended.
Treatment pathway
Initial dermatology assessment
The Consultant Dermatologist examines the rash and reviews the symptoms, pattern of flares, previous treatments, skincare, relevant exposures and medical history.
Care plan
An individual plan is discussed. This may include skincare changes, prescription treatment, referral for narrowband UVB or systemic treatment, with investigations or specialist allergy referral where appropriate.
Review consultation
A review consultation is required to assess the response and decide whether treatment should be continued, changed or stopped. The dermatologist will also discuss flare prevention and ongoing management where appropriate.
What causes eczema and what can make it worse?
The factors involved depend on the type of eczema.
Atopic eczema involves the skin barrier and immune system and often runs in families alongside asthma or hay fever. Dryness, soaps, detergents, heat, sweating, illness, infection and stress may aggravate symptoms, although a flare does not always have an identifiable trigger.
Irritant contact dermatitis results from direct damage to the skin. Repeated exposure to water, soaps, detergents, cleaning products or workplace chemicals is a common cause, particularly on the hands.
Allergic contact dermatitis develops when the immune system reacts to a substance touching the skin. Possible allergens include fragrances, preservatives, hair dyes, metals and ingredients in skincare or cosmetic products.
Seborrhoeic dermatitis is associated with the skin’s response to the normally harmless yeast Malassezia and tends to affect the scalp, face, ears, chest or skin folds.
Food allergy can coexist with atopic eczema, particularly in some children, but it is not the usual explanation for eczema. Allergy investigations should be selected according to the history rather than using broad screening panels or starting restrictive diets without clinical guidance.
How is eczema treated at Midland Skin?
Treatment depends on the type of eczema, the areas affected, its severity, what has already been tried and any relevant health considerations.
Midland Skin offers treatment for both children and adults, from management of localised eczema to specialist treatment for more extensive or difficult-to-control disease. Attending an assessment does not guarantee that a particular medication or treatment will be recommended.
Skincare and aggravating factors
The dermatologist may recommend changes to washing, moisturising and the products used on the skin. Emollients and soap substitutes can help support the skin barrier, while reducing exposure to relevant irritants or allergens may be particularly important in contact or hand eczema.
Advice is individualised. Long lists of possible triggers are rarely helpful when there is no evidence that they are relevant to the individual patient.
Prescription topical treatment
Prescription treatment may include a topical corticosteroid selected for the body area, severity and type of eczema.
The dermatologist will explain how much to apply, where to use it, how long to use it and whether it should subsequently be reduced or used intermittently. Both undertreatment and unsupervised overuse can cause difficulties.
Steroid-sparing treatments such as tacrolimus or pimecrolimus may be considered where appropriate. Antifungal treatment may form part of the plan for seborrhoeic dermatitis, while treatment for infection is recommended only when infection is suspected.
Dressings or wet-wrap treatment may also be recommended for selected patients to support topical treatment and reduce scratching.
Allergy blood tests and specialist allergy assessment
Midland Skin can offer targeted allergy blood tests where the symptoms and clinical history suggest that these may be useful. Allergy test results must be interpreted alongside the history because a positive result does not necessarily mean that the allergen is causing the eczema.
Where a child requires more extensive allergy investigation or assessment, Midland Skin has referral partners who provide specialist children’s allergy services.
Suspected allergic contact dermatitis requires patch testing rather than an allergy blood test. Referral to a specialist patch-testing service may therefore be recommended.
Narrowband UVB phototherapy
Midland Skin does not offer narrowband UVB phototherapy on site but, following review, your Dermatologist can arrange referral for selected patients with more extensive or difficult-to-control eczema.
Treatment uses a carefully controlled wavelength of ultraviolet light to reduce inflammation and itching. It is delivered as a planned course requiring regular treatment appointments.
Suitability depends on the type and extent of eczema, age, skin type, medical history and previous treatment. Narrowband UVB is not necessary or appropriate for every patient.
Systemic medicines, biologics and newer treatments
For selected patients with moderate-to-severe atopic eczema, Midland Skin can offer systemic treatment when topical treatment or narrowband UVB has not provided adequate control or is not appropriate.
Options that may be considered include:
- Conventional systemic medicines, such as ciclosporin or methotrexate
- Biologic medicines, such as dupilumab, tralokinumab or lebrikizumab
- Newer targeted oral treatments, including the JAK inhibitors upadacitinib, abrocitinib and baricitinib
The choice depends on the patient’s age, eczema severity, previous treatment, medical history and the balance of potential benefits and risks. Not every treatment is suitable or licensed for every age group.
These medicines require specialist assessment, preliminary investigations and ongoing monitoring. A particular treatment cannot be promised before this assessment has taken place.
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Control, recurrence and long-term management
Many forms of eczema can be controlled but are not permanently cured. Atopic, discoid and seborrhoeic dermatitis may improve and then flare again.
Contact dermatitis may improve substantially when the relevant irritant or allergen is identified and avoided, although the skin can take time to recover.
Recurrence does not necessarily mean that treatment has failed. Some patients require regular skin-barrier care, early treatment of flares or intermittent maintenance treatment. Patients receiving narrowband UVB, biologic medicines or other systemic treatment require an appropriate monitoring and review plan.
Darkening or lightening of the skin may remain after the inflammation has settled, particularly in more deeply pigmented skin. These changes often improve gradually but can last longer than the active eczema.
Eczema assessment and treatment: FAQs
Who will assess me or my child?
Children and adults are assessed by a Consultant Dermatologist. The dermatologist reviews the appearance and distribution of the rash, the symptoms, previous treatment and factors that may be contributing to the condition.
Will a prescription be provided at the first appointment?
A prescription may be provided when the diagnosis and appropriate treatment plan are sufficiently clear. A particular medication cannot be guaranteed before assessment. Occasionally, further information, an investigation or referral may be needed before treatment can be finalised.
Do creams need to be stopped before the appointment?
Prescribed treatment does not usually need to be stopped before the appointment and should not be stopped unless a healthcare professional advises this. If the rash changes or temporarily clears with treatment, bring photographs showing how it looked during a flare. If practical, avoid applying a thick layer of cream immediately before the examination.
What should I bring to the initial assessment?
Bring details or photographs of prescription treatments, over-the-counter products and skincare that have been used, including how long they were used and what happened. Previous dermatology letters, allergy or patch-testing results and photographs of earlier flares may also be helpful. If hand or contact dermatitis is suspected, information about relevant work, hobbies and products may be important.
Will allergy tests or other investigations be needed?
Most eczema is diagnosed from the history and examination and does not require routine testing. A skin scraping, swab or occasionally a biopsy may be considered when another diagnosis or infection needs to be excluded. Targeted allergy blood tests can be offered where clinically appropriate. Children requiring more extensive allergy assessment can be referred to one of Midland Skin’s specialist referral partners. Suspected allergic contact dermatitis may require referral for patch testing.
Why is a review consultation required?
A review consultation is required to assess the response to treatment and decide whether treatment should be continued, changed or stopped. It also allows the diagnosis to be reconsidered if the response is not as expected and provides an opportunity to agree ongoing management and monitoring.
Why choose Midland Skin for eczema treatment?
Midland Skin provides Consultant Dermatologist assessment and treatment for both children and adults, from persistent localised eczema to more extensive or difficult-to-control atopic eczema.
Depending on the assessment, the pathway can include prescription topical treatment, targeted allergy blood tests, narrowband UVB phototherapy, biologic medicines and newer targeted treatments. Structured review allows the dermatologist to assess whether treatment is working, reconsider the diagnosis when necessary and decide how treatment should be adjusted or monitored.
Specialist referral partners are also available when a child requires a more extensive allergy assessment.
Fees
Eczema Show pricing
Book ConsultationInitial extended dermatology assessment
For eczema, psoriasis, complex or long-standing problems & second opinions. Up to 35 minutes
Children's initial dermatology assessment (0-11y)
Up to 35 minutes
Review consultation
Standard, up to 20 minutes
Clinical sources used for this article
This page has been medically reviewed by a Consultant Dermatologist. Last reviewed: September 2026.
British Association of Dermatologists patient information leaflets consulted:
- Atopic eczema
- Contact dermatitis
- Hand dermatitis
- Discoid eczema
- Seborrhoeic dermatitis
- Food allergy and eczema in children and young people
Accessed September 2026.
About the Author
This page has been written and/or medically reviewed by Dr Sajjad Rajpar, Consultant Dermatologist and Medical Director of Midland Skin, Birmingham.
Dr Rajpar is on the GMC Specialist Register in Dermatology and has over 20 years’ experience in clinical dermatology. He provides clinical oversight to ensure the information on this page is accurate, balanced and consistent with current dermatology practice.
Dr Sajjad Rajpar
Date last updated: 28th Sep 2026
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The content on this website is provided for general information only. It is not, and must not be treated as, medical advice, a diagnosis, or a recommendation for any particular treatment. We make reasonable efforts to keep information accurate and up to date, but medicine and technology change, and content may not reflect the most current evidence, guidance, product information, or individual practice. You should not rely on this website to make decisions about your health or treatment. Always seek personalised advice from an appropriately qualified healthcare professional. Any examples, images, testimonials, and outcome descriptions are illustrative only. Results vary between individuals and no outcome can be guaranteed.
