Eczema care that calms the itch and repairs the barrier a barrier-first approach
Eczema is a group of chronic, itchy inflammatory conditions in which a weakened skin barrier and an over-reactive immune response leave the skin dry, red and easily irritated.
Eczema, also called dermatitis, is a chronic, non-contagious inflammatory skin condition marked by intense itch, dryness and red, inflamed patches. It arises when a weakened skin barrier lets moisture escape and irritants in, while the immune system over-reacts. It cannot be cured outright, but with barrier repair, trigger control and cortisone-sparing treatment it can be well controlled.
Eczema, or dermatitis, is not a single disease but a family of chronic inflammatory conditions that share one central feature: an impaired skin barrier. When the barrier is weak, water escapes and irritants, allergens and microbes get in more easily, which drives dryness, redness and the relentless itch that defines eczema. The most common form is atopic dermatitis, but contact, seborrhoeic, hand-and-foot and several other patterns each behave differently in cause, site and treatment.
Eczema typically runs a relapsing course, settling and flaring in response to triggers rather than following a straight line. It often starts in infancy or childhood and may ease with age, though it can begin or return in adulthood, particularly on the hands. It is strongly linked with a personal or family history of asthma and hay fever, and it is not contagious and cannot be caught from another person.
At Clinovia our approach follows Inside Out Medicine: we repair and protect the barrier, calm the immune over-reaction and track down the triggers that keep the skin inflamed. A dermatologist confirms the type of eczema, scores it with EASI and DLQI, and uses allergy patch testing where contact allergy is suspected. Treatment favours cortisone-sparing topical care, with phototherapy or biologic options reserved for more severe disease, and every decision follows examination.
Eczema & Dermatitis — Subtypes
Atopic DermatitisAtopic dermatitis is a chronic form of eczema in which a weakened skin barrier drives itch and redness; it runs in flares and remissions and often settles in the body's flexures.
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Contact EczemaContact eczema is inflammation triggered when a substance touching the skin acts as an allergen or irritant; it appears as sharply bordered redness and itch at the site of contact.
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Seborrheic DermatitisSeborrhoeic dermatitis is a chronic reaction to Malassezia yeast in oil-rich areas, causing flaking and redness across the scalp, brows and the folds of the face.
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Hand & Foot EczemaHand and foot eczema brings dryness, itch and cracking to the palms, fingers and soles; it recurs and worsens with wet work and damp, sweaty footwear.
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Nummular EczemaNummular eczema presents as coin-shaped, sharply bordered and itchy round plaques on the skin, arising on a background of marked dryness and a damaged barrier.
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Stasis DermatitisStasis dermatitis is chronic skin inflammation around the ankle caused by pooled blood from leg vein insufficiency, with swelling, itch, discolouration and, in time, ulcers.
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Infant EczemaInfant eczema is atopic eczema that starts in babyhood with dryness and itch on the cheeks, scalp and body folds; it is readily managed with the right bathing and moisturising routine.
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Symptoms
- Intense, often relentless itching that tends to worsen at night
- Dry, rough or scaly skin that feels tight and irritable
- Red or inflamed patches, often in the elbow and knee creases
- Oozing, crusting or weeping when patches are scratched open
- Thickened, leathery skin from long-standing rubbing and scratching
- Cracked, sore skin on the hands, fingers or feet
Triggers
- Soaps, detergents and frequent hand washing
- Dry air, heat, sweating and sudden temperature change
- House-dust mites, pollen and pet dander
- Wool, synthetic fabrics and rough clothing
- Psychological stress and periods of disrupted sleep
- Certain foods in some children with atopic eczema
Diagnosis
Clinical examination
A dermatologist examines the pattern and sites of the rash, the skin creases in atopic eczema or the hands in occupational eczema, and reviews your personal and family history of asthma, hay fever and allergy.
Allergy patch testing
Where contact allergy is suspected, a panel of more than forty allergens is applied to the back and read over several days, turning likely triggers into a clear, personalised avoidance list.
Severity and impact scoring
We record severity with the EASI score and the effect on sleep, work and mood with the DLQI, giving an objective baseline against which the response to treatment can be measured over time.
Ruling out mimics
Because psoriasis, fungal infection and scabies can resemble eczema, dermoscopy and, when needed, simple tests are used to confirm the diagnosis before a long-term treatment plan is agreed.
Treatment
We avoid cortisone as a first step to reduce the skin-thinning and rebound risk associated with long-term topical steroid use.
Barrier repair and moisturising
The foundation of every plan is generous, regular use of ceramide-based moisturisers to rebuild the skin barrier. Applied to damp skin as part of a daily routine, this alone reduces dryness, itch and how often active treatment is needed.
Cortisone-sparing topical care
To calm inflammation we favour calcineurin inhibitors and PDE-4 inhibitors rather than relying on steroids. Topical corticosteroids are not the first step and long-term dependence is avoided, with any steroid use kept short and targeted.
Phototherapy
For widespread or stubborn eczema, narrowband UVB at 311 nm can reduce inflammation and itch without cortisone. Sessions run two to three times a week in our cabin, with the course reviewed against the EASI score.
Systemic and biologic therapy
When eczema is severe and resistant, conventional systemics or biologic agents targeting IL-4 and IL-13 may be considered after screening. Response is measured with EASI and DLQI, and safety is monitored throughout treatment.
Related treatments
NB-UVB PhototherapyNarrowband UVB at 311 nm calms inflammation in psoriasis and eczema without cortisone. Sessions run two to three times a week, with a typical course of 20–30 and PASI/EASI tracking.
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Biologic TreatmentsBiologic drugs selectively block targets such as IL-17 and IL-23 in psoriasis and IL-4/13 in eczema. They are considered in moderate-to-severe, resistant disease after screening.
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Cortisone-Free Topical PlanA cortisone-free topical plan combines calcineurin inhibitors, PDE-4 inhibitors and ceramide barrier repair to control inflammation without steroid side effects.
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Allergy & Patch TestingPatch testing identifies the allergens driving contact eczema. A panel of 40-plus allergens is applied to the back, read over several days, and turned into an avoidance list.
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Living with it
A daily routine
Short, lukewarm showers, a gentle cleanser and moisturiser applied within minutes of washing keep the barrier intact. A consistent routine matters more than any single product and is the strongest defence against flares.
Reducing triggers
Once your triggers are known, whether soaps, fabrics, dust mites or stress, small and practical changes reduce how often the skin flares. We tailor advice to your life rather than impose a long list of restrictions.
The gut-skin axis
The relationship between diet, the gut and eczema is still being researched. We may assess it alongside proven dermatological treatment, but we do not present it as a cure or a reason to delay effective care.
Sleep and the itch cycle
Night-time itching disrupts sleep and scratching worsens the rash, feeding a vicious cycle. Controlling inflammation, protecting the barrier and managing the itch directly all help restore sleep and break that loop.
Treatment in İstanbul
At Clinovia in Eyüpsultan, İstanbul, eczema is assessed and treated by a dermatologist, from barrier repair and cortisone-sparing topical plans to allergy patch testing and NB-UVB phototherapy. Consultation is available in Turkish, English, Georgian, Azerbaijani and Russian, and a same-day callback is offered for new enquiries. Patients travelling from Georgia, Azerbaijan or Russia are helped to plan treatment around the length of their stay.
- Defterdar, Fethi Çelebi Cd. No:15, Eyüpsultan/İstanbul
- +90 212 267 52 10
- Mon–Sat: 09:00 – 19:00 · Sunday: closed
Frequently asked questions
Eczema cannot be permanently cured, because it is a chronic condition rooted in barrier and immune function. It can, however, be controlled very effectively: with consistent barrier repair, trigger avoidance and cortisone-sparing treatment, most people reach long periods with little or no visible rash. Many children also see their eczema improve markedly as they grow.
No. Eczema is not contagious and cannot be passed to another person through touch, sharing items or close contact. It results from a weakened skin barrier and an over-reactive immune system, not an infection. Broken skin can occasionally become infected with bacteria, and that infection is treated separately when it occurs.
Both are chronic inflammatory conditions, but they differ. Eczema is intensely itchy with dry, ill-defined patches, often in the skin creases, and is driven by a weak barrier. Psoriasis shows well-defined plaques with thick silvery scale on the elbows, knees and scalp. A dermatologist distinguishes them on examination and dermoscopy.
No. At Clinovia topical corticosteroids are not the first step, and we build cortisone-sparing plans around barrier repair, calcineurin inhibitors and PDE-4 inhibitors. Steroids may still have a short, targeted role in a flare, but long-term dependence is avoided, and phototherapy or biologics are used for more severe disease.
Yes. Recurrent hand eczema is common, especially with wet work or frequent washing, and it responds to a structured plan. Patch testing can uncover a contact allergy driving it, while barrier repair, cortisone-sparing topicals and practical changes to hand care reduce relapses. Targeted phototherapy helps stubborn cases.
Yes. International patients are assessed and treated at Clinovia during a visit to İstanbul, with consultation available in five languages. A dermatologist plans what can be started during your stay, since barrier repair and any phototherapy continue over time, and can arrange follow-up after you return home. A same-day callback is offered for new enquiries.
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