Your GP will usually be able to diagnose atopic eczema by assessing your or your child's skin and asking some questions about the condition, such as:
- whether the rash is itchy
- when the symptoms first began
- whether you have flare-ups of severe symptoms and periods when your symptoms are less severe
- whether there is a history of atopic eczema in your family
- whether you have any other conditions that may be related to your eczema, such as allergies or asthma
- whether it has affected the typical areas, such as skin creases, in the past
Your GP will also assess the severity of your eczema, such as how much the itching is bothering you and how widespread the areas of dry skin are. Tell your GP if your condition is affecting your quality of life, for example if you have difficulty sleeping or if it is limiting your daily activities.
Checklist for diagnosing atopic eczema
To confirm a diagnosis of atopic eczema, your GP may assess the appearance of your skin against a checklist of symptoms.
Typically, to be diagnosed with atopic eczema, you must have had an itchy skin condition in the last 12 months, as well as three or more of the following signs and symptoms:
- You have itchiness and irritation in the creases of your skin, such as the front of your elbows, behind your knees, the front of your ankles, around your neck or around your eyes.
- You currently have asthma or hay fever, or you have had them in the past. For children who are less than four years old, they must have an immediate relative, such as a parent, brother or sister, who has asthma or hay fever.
- Your skin has been generally dry in the last 12 months.
- Your condition started when you were two years of age or younger (this does not apply if your child is less than four years of age).
- There is eczema on the skin in your joints, such as your elbow, knees and wrists, or on the forehead, cheeks or outer surface of the arms or legs in children under four years of age.
If your symptoms do not meet these criteria, you may still have atopic eczema, although other types of skin problems may be more likely.
Establishing triggers
Your GP will work with you to establish what triggers make your eczema worse (see Atopic eczema - causes). They may ask you about your diet and lifestyle to see if any obvious factors may be contributing to your symptoms. For example, you may have noticed that some soaps or shampoos make the eczema worse.
Your GP may use other methods to try to determine what is triggering your eczema. For example, they may ask you to keep a food diary for four to six weeks to find out whether a specific food makes your symptoms worse.
A food diary involves writing down everything you eat and making a record of any eczema flare-ups that you have. Your GP can see if there are any patterns between your symptoms and what you eat.
Diagnosing a food allergy
Some types of food can make your eczema symptoms worse within 24-48 hours, and you may be allergic to some types of food. A food allergy can cause:
- vomiting
- diarrhoea
- an itchy red rash, like nettle rash
- worsening of eczema symptoms
These symptoms usually develop within a few minutes to an hour after exposure to the food. See the Health A-Z topic about Food allergy - symptoms for more information.
If you or your child develop these symptoms immediately after coming into contact with a particular food, you may have a food allergy.
