Eczema — particularly atopic dermatitis — follows a predictable seasonal pattern for most sufferers. The skin that was manageable through summer starts to break down in October, and by December it can feel completely out of control. If you have been relying on the same moisturiser and mild steroid cream for years, winter may be the time that reveals they are no longer enough.
At Lambert Medical Practice in Surbiton, Dr Nancy Abdelrahman sees a significant increase in dermatology appointments in November and December — predominantly from people whose eczema has become unmanageable with over-the-counter treatments. This guide explains why winter triggers flares, what more effective treatments are available, and when it makes sense to seek specialist review.
Why Does Eczema Get Worse in Winter?
Several factors converge between October and February to disrupt the skin barrier in people with atopic eczema:
Cold, dry outdoor air
Low ambient humidity strips moisture from already-compromised skin. Even a 20-minute walk can trigger significant transepidermal water loss in atopic skin.
Central heating
Indoor heating further reduces humidity. Office and home environments can drop below 30% relative humidity in winter — well below the 45–60% optimal for eczema-prone skin.
Reduced UV light
Natural UV has mild immunosuppressive effects on inflamed skin. The near-absence of UV light in December removes this benefit.
Indoor allergen exposure
More time indoors means greater exposure to house dust mites, mould, and pet dander — all common eczema triggers.
The Ladder of Eczema Treatment
Effective eczema management follows a stepwise approach. If the rung you are currently on is not controlling your symptoms, it may simply be time to step up:
| Step | Treatment | Notes |
|---|
| 1 | Emollients (moisturisers) | Applied liberally, at least twice daily. The foundation of all eczema management. |
| 2 | Mild topical corticosteroids | Hydrocortisone 1% (OTC). Appropriate for mild, intermittent flares. |
| 3 | Moderate/potent topical corticosteroids | Prescription only (e.g. betamethasone, mometasone). For moderate-to-severe flares on trunk and limbs. |
| 4 | Topical calcineurin inhibitors (TCIs) | Tacrolimus or pimecrolimus. Prescription. Steroid-sparing, suitable for face and sensitive areas. |
| 5 | Topical JAK inhibitors | Ruxolitinib cream. Newer option with good evidence for moderate eczema. |
| 6 | Systemic treatment | Oral immunosuppressants or dupilumab (biologic). For severe, refractory eczema. |
Winter Skincare for Eczema: Practical Steps
- Increase emollient frequency: Apply immediately after bathing while skin is still slightly damp. Use a thick, fragrance-free cream or ointment rather than a lotion in winter.
- Avoid hot showers: Hot water strips the skin barrier. Lukewarm and brief (under 10 minutes) is better.
- Use a humidifier indoors: Target 45–55% relative humidity, particularly in the bedroom.
- Wear cotton layers next to skin: Wool and synthetic fibres are common mechanical irritants.
- Treat flares early: Applying a topical corticosteroid at the first sign of a flare prevents it escalating. Do not wait until the skin is weeping or infected.
- Watch for infection: Eczema skin is vulnerable to Staphylococcus aureus colonisation. Yellow crusting, weeping, or rapidly worsening patches need antibiotic treatment (topical or systemic) in addition to anti-inflammatory treatment.
When to See a Dermatologist
Seek a specialist review if any of the following apply:
- Your eczema is affecting your sleep most nights
- Standard topical steroids are no longer bringing it under control
- You are having frequent secondary infections
- Large body surface areas are affected
- You have not had a full skin assessment in the past year
- You are concerned about the amount of topical steroid you are applying (steroid phobia is common — but overuse and underuse both cause problems)
At Lambert Medical Practice, Dr Nancy Abdelrahman — a GP with a specialist interest in dermatology — provides a comprehensive eczema review including trigger identification, assessment of secondary infection, review of your current treatment ladder, and prescription of appropriate stronger treatments if indicated.
Book a Private Eczema Assessment in Surbiton
Dr Nancy Abdelrahman · Lambert Medical · Same-week appointments available · No referral needed
Frequently Asked Questions
Cold dry air, central heating, reduced UV, and more time indoors with allergens like dust mites all compound to compromise the skin barrier and trigger inflammation.
Prescription-strength topical steroids, calcineurin inhibitors (tacrolimus, pimecrolimus), topical JAK inhibitors, and in severe cases systemic immunosuppressants or dupilumab.
If eczema disrupts your sleep, OTC treatments have stopped working, you have frequent infections, or large areas are affected — a specialist review is warranted.
Usually within a few days. Book online at lambertmedicalpractice.co.uk or WhatsApp 07882 677844. No referral needed.
Yes — Lambert Medical Practice sees both children and adults for eczema assessment and management.