Costs associated with eczema can include:
- Prescription medicines (under NHS England: free for those under 16 years old, free for those age 16-18 in full-time education, free for those with a HC1 exemption certificate) – including emollients, bath oils, soap substitutes, steroid creams and antihistamines
- Shop-bought products, such as tubigrips and ‘eczema-friendly’ cosmetic/bathing items (e.g. moisturisers, shower gels, shampoos, deodorants, sunscreen, hair removal products, make-up)
- Private healthcare (such as paying to see a dermatologist privately rather than on the NHS)
- Alternative and complementary therapies, such as homeopathy and acupuncture
- Household products, such as laundry detergent
- Costs of food (e.g. avoiding triggers and having a ‘healthy’ diet)
- Expenses for getting to medical appointments, e.g. travel costs and time off work
Many of these costs were seen as ‘just part of having eczema’. Some people said being able to afford things to help with their eczema was a top priority. Aman justified spending money on his skin with an ‘economist’ approach of valuing health over immediate cost. Eczema-related expenses were a big concern though for those with low and unstable incomes, such as students/recent graduates and people early on in their careers. Some young people were aware of inequalities meaning that those with less money often don’t have as many options for medical help/treatments or for avoiding triggers. A few people felt it was unfair that other long-term health conditions qualify for free prescriptions.
Paying for eczema treatments (prescription and shop-bought)
Prescription medicines were the main financial cost of eczema talked about by young people. Some received their prescription medicines for free, others had to pay. Often parents had been in charge of sorting prescriptions and it could come as a shock to young people to learn that they could have to pay for their eczema treatments in the future.
Many people used a mixture of prescribed treatments and shop-bought products. The costs of these were sometimes compared. Alice thought prescription medicines are a ‘rip off’ whereas Naomi and Aman think they’re reasonable for the quantity/quality. Some people put off seeing a doctor because of the prescription costs and tried shop-bought things instead. Some emollients are cheaper on prescription than bought from a shop, while others are the opposite.
Some people were exempt from paying prescriptions (for example, if they were under age 16 or up to age 18 in full time education). Others had Prescription Pre-payment Certificates (PPC) where they had paid fixed instalments for either 1 month, 3 months or 12 months of prescription costs. Georgia said her PPC is ‘handy at the moment’ because she’s going through emollients quickly. Those with low incomes and without savings, such as some university students and others with part-time jobs, had applied to the NHS Low Income Scheme (via HC1 forms). Hazel had one of these whilst at university and stocked up on prescription products – she’s since been using these medicines (within their expiry dates).
Some had seen dermatologists privately, often paid for by a parent. Molly had seen a private dermatologist who she found helpful because they had talked in detail about eczema. Aadam’s parents had medical insurance which covered him seeing a specialist doctor. Some people had also paid to see alternative therapy practitioners, such as Gary who went for homeopathy treatment.
Trying lots of different eczema treatments
A key thing about eczema treatments for many is ‘trial-and-error’. Lots of people had an array of products they had used for a while and then had to stop. Ele used bath oils for a while before it irritated her skin. The costs add up and could put people off trying new things or buying them again. Aman found a prescribed soap substitute worked well for his skin but he hasn’t got it on prescription again as he doesn’t want it to be a regular expense. Hazel says her last round of prescriptions was ‘a really big chance to take’ – there were many things she was trying for the first time and the prescription charges added up.
Getting a big quantity of prescribed treatment such as emollients in one prescription could save money and avoid repeat trips to the doctor, but smaller sized bottles/tubes are useful too. Evie likes having small bottles of emollient as they’re easier to carry but she says it’s not worth getting just one for the prescription charge.
Lots of people thought ‘natural’ products and a healthy diet were good for the skin but usually more expensive. Ele tried a cheap shop-bought moisturisers but it was perfumed and sat on her skin instead of absorbing. Not everyone agreed that expensive products were better though. Gary had tried lots of different shop-bought moisturisers, varying in price, and had found a cheap one to be the best. Hazel and Georgia prefer bath/beauty products that are ‘cruelty free’ and not tested on animals.
Some made their own home remedies to save money. However, they found ingredients like Manuka honey are expensive. Ele worried that if the honey made her eczema worse, she would be ‘literally washing [money] down the sink’.
Extra costs of having eczema
Shams said there’s an ‘uncalculated’ costs of eczema. He gave the example of doing laundry: emollients get on his clothes, meaning he has to wash them more often and use extra detergent to remove the marks. Others buy particular kinds of washing-up liquid (which don’t trigger their eczema as much) and rubber gloves. Aisha and Ele have to throw away razors after shaving with them just once. Some people talked about there being an extra cost of some foods when avoiding triggers, such as buying alternative products like goats milk instead of cow’s milk. ‘Healthy’ diets were sometimes seen as more expensive too. Traveling to medical appointments can mean taking time off work and the cost of transport. Cat sometimes got taxis to phototherapy sessions.
Some people talked about things they saved money on because of eczema. Cat doesn’t buy perfume because it triggers her eczema and has cut down drinking alcohol since starting on immunosuppressants.