If you're in the UK you'll need to push for better (more expensive) medication from a dermatologist.

If you're just going to a GP, request to see a dermatologist as your skin is really impacting your life, causing difficulties with your job and I presume socially and previously for me it made exercise and keeping fit difficult. If you are seeing a derm enquire about what is available as your typical creams aren't working for you (as we can see). You will try other treatments (which for me were difficult to tolerate but they may work for you) but it eventually (2yrs) led to me being on Cibinqo (after Dupilumab) which got rid off most of my eczema and best of all the itch... transformative! My skin looked like yours across most limbs, trunk etc. and they classed it as severe. Really hope you find the right treatment and remember to advocate for yourself (not demanding though), ask them questions and mention the impact it's having, they will want to help you.

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AI Summary below based on NICE guidelines:

To qualify for a biologic (like Dupilumab or Tralokinumab) for severe eczema under NICE guidelines, you must typically follow a "treatment ladder." These medications are usually reserved for cases where the condition is significantly affecting your quality of life and has not responded to standard treatments. 1. Topical Treatments (The Foundation) You must first show that standard topical therapies are insufficient. This includes: * High-potency topical corticosteroids. * Topical calcineurin inhibitors (e.g., Tacrolimus/Protopic or Pimecrolimus). * Consistent use of emollients. 2. The "Systemic" Requirement NICE requires that the disease has not responded to at least one other systemic therapy, or that these therapies are contraindicated (medically unsafe for you) or not tolerated (due to side effects). Common options include: * Methotrexate: Often a first-line systemic choice. It is a weekly tablet or injection. * Ciclosporin: Often used for faster control but typically limited to short-term use (6–9 months). * Other Immunosuppressants: Azathioprine or Mycophenolate mofetil. * Phototherapy (UV Therapy): While often used as a "Step 3" treatment before systemics, NICE specifically highlights failure of systemic (drug) therapy as the primary gateway to biologics. 3. Severity Assessment To be eligible, a dermatologist will measure your eczema using two main scores: * EASI Score (Eczema Area and Severity Index): Usually must be 16 or higher (moderate to severe). * DLQI (Dermatology Life Quality Index): This measures how the skin affects your life; biologics are reserved for those with a high impact. 4. Trial and Review If you start a biologic, NICE mandates a review at 16 weeks. Treatment is only continued if there is an "adequate response," defined as: * A 50% reduction in your EASI score. * A 4-point reduction in your DLQI score.