Eczema & Dermatitis
Calm · Repair · Protect
Medical Understanding — Lasting Relief — Excellence on Harley Street
Eczema is not simply dry or sensitive skin. It is a chronic inflammatory condition driven by a compromised skin barrier and an overactive immune response — and managing it well requires more than moisturiser and mild steroid cream.
Atopic eczema affects around one in five children and one in twelve adults in the UK, yet many patients spend years cycling through over-the-counter products and short-term prescriptions without ever addressing the underlying mechanisms that sustain the condition. The itch–scratch cycle, repeated flares, and disrupted sleep take a significant toll on quality of life that tends to be underestimated in routine clinical settings.
At PHP Aesthetic-Wellness, Dr Philippe Hamida-Pisal and Dr Jihyun Byun approach eczema as the complex, multifactorial condition it is. Assessment covers the type and distribution of eczema, the state of the skin barrier, trigger profile, previous treatment history, and any co-existing conditions such as asthma, allergic rhinitis, or food sensitivities. From this, we design a management programme that works in the long term — not simply during the current flare.
Types of Eczema & Dermatitis
Several distinct forms of eczema exist, each with different triggers, distributions, and management priorities. Identifying the correct type is the essential first step.
“Eczema is a condition that demands patience from the clinician as much as from the patient. The goal is not to suppress the current flare and move on — it is to understand why the skin keeps breaking down, and to change that.” PHP Aesthetic-Wellness, 22 Harley Street
Our Approach to Eczema Management
Effective eczema management is built on three principles: restoring the skin barrier, controlling inflammation, and identifying and reducing exposure to triggers. Every treatment we use is selected with these priorities in mind, in the sequence the skin can safely receive them.
Prescription Topicals
The foundation of eczema management. Prescription-grade emollients restore lipid content to a depleted barrier and reduce transepidermal water loss. Topical corticosteroids — selected by potency and body site — control acute inflammation without the risks associated with prolonged unsupervised use. Topical calcineurin inhibitors (tacrolimus, pimecrolimus) offer a steroid-sparing option for sensitive sites including the face and eyelids.
The correct emollient, the correct steroid potency, and a clear application protocol are prescribed at consultation and reviewed as the skin responds.
LED Therapy
Red and near-infrared LED wavelengths reduce inflammatory cytokine activity, calm the immune response in the skin, and support barrier repair without any heat, discomfort, or risk of triggering a flare. LED therapy is one of the safest adjunctive treatments available for eczema — it can be used on actively inflamed skin and across all skin types.
Particularly beneficial for patients with chronic, low-grade inflammation between flares, and for those seeking to reduce their dependence on topical corticosteroids over time.
Polynucleotides
Injected into the dermis, polynucleotides stimulate fibroblast activity and rebuild the extracellular matrix — restoring the structural components of a barrier compromised by chronic eczema. By improving dermal hydration, elasticity, and scaffold integrity, they reduce the skin’s vulnerability to irritants and allergens and create a more resilient foundation less susceptible to recurrent breakdown.
Used during remission periods to strengthen the skin between flares and support a sustained reduction in flare frequency over time.
Exosomes
Exosomes modulate the immune signalling that drives eczema at the cellular level — dampening the Th2-dominant inflammatory response, supporting keratinocyte repair, and promoting barrier restoration. Applied topically following a gentle procedure, they accelerate recovery and help to normalise the skin’s inflammatory threshold over a course of treatment.
An important adjunct for patients whose eczema involves significant barrier breakdown and immune dysregulation, where biological recalibration is as important as topical management.
Trigger Identification & Allergy Review
For contact dermatitis and adult-onset eczema in particular, identifying the specific irritant or allergen responsible is as therapeutically important as any prescription. We conduct a thorough review of occupational exposures, skincare ingredients, dietary factors, and environmental triggers as part of the initial assessment.
Where patch testing or specialist allergy investigation is indicated, we coordinate referral to appropriate colleagues and incorporate the findings into your management plan.
Skin Booster
Hyaluronic acid-based skin boosters delivered via microinjection provide deep, sustained hydration to a dermis chronically depleted by eczema and repeated inflammatory cycles. By restoring moisture levels from within, they complement topical emollient therapy and improve the skin’s overall resilience and texture between flares.
Used during stable remission periods as a hydration and quality-of-skin intervention, particularly for patients with persistent dryness, rough texture, and lichenification following chronic eczema.
Understanding Your Triggers
Identifying and reducing exposure to personal triggers is one of the most effective long-term interventions for eczema. Triggers vary significantly between individuals and are always explored as part of the initial consultation.
Skincare & Products
Fragrances, preservatives, sodium lauryl sulphate, and certain emulsifiers are among the most frequent contact triggers. A full product review is part of every eczema consultation.
Environment
House dust mites, pet dander, mould, and seasonal pollen are common environmental triggers, particularly for atopic eczema. Cold, dry air and central heating significantly worsen barrier function in winter.
Stress & Sleep
Psychological stress is a well-established eczema trigger, mediated through the skin–brain axis. Sleep disruption caused by itch in turn worsens stress — breaking this cycle is a key part of long-term management.
Your Eczema Journey
Eczema management is a long-term commitment, not a single course of treatment. We support patients through every phase — from acute flares to sustained remission — with a plan that evolves as their skin does.
Full Eczema Assessment
A thorough evaluation of your eczema type, severity, trigger profile, treatment history, and any co-existing conditions — the foundation of everything that follows.
Flare Management Plan
A clear prescription protocol for managing acute flares: the right emollient, the right topical treatment at the right potency, with a step-down plan as the skin responds.
Remission & Repair
During stable periods, in-clinic treatments — LED therapy, polynucleotides, exosomes, and skin booster — strengthen the barrier and reduce the frequency and severity of future flares.
Long-Term Maintenance
Regular reviews adapt the management plan as your skin, lifestyle, and seasons change. The goal is a sustained reduction in flare frequency and a skin that is progressively more resilient.
Related Skin Concerns
Eczema frequently co-exists with or gives rise to other skin concerns that benefit from attention alongside the primary condition:
Post-Inflammatory Marks
Repeated eczema flares leave post-inflammatory hyperpigmentation, particularly in medium-to-deep skin tones. Addressed once the eczema is well controlled and the barrier is stable.
Skin Sensitivity
Chronic eczema sensitises the skin to a wide range of products and environmental factors. Barrier repair and a carefully edited skincare routine reduce reactivity significantly over time.
Redness & Rosacea
Eczema and rosacea can co-exist and share certain management principles — particularly around barrier repair and the avoidance of common irritant triggers.
Book an Eczema Consultation
PHP Aesthetic-Wellness
22 Harley Street, Suite 8, London W1G 9PL
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