While there is no cure for eczema, fortunately, there are treatments depending on the severity, including over-the-counter products, prescription topical creams, and oral and injectable medications.
This article takes a look at the best clinical and over-the-counter treatments for people with eczema. We’ve obtained input from top experts on this subject, who discuss clinical remedies that can be obtained with a prescription, as well as over-the-counter products that received the Seal of Acceptance from the National Eczema Association.
It’s important to keep in mind that symptoms from eczema can be different for each individual. Not all people with eczema will respond to treatments in similar ways, so you should educate yourself about all options available – and talk to your doctor or Board Certified Dermatologist, first.
Eczema is the skin disease component of Atopic Dermatitis, which is a chronic, itchy, inflammatory disease of unknown etiology, said Dr. Matthew J. Elias, a Board Certified Dermatologist at Elias Dermatology.
Eczema or dry, itchy skin is usually the first sign in the constellation of Atopic Dermatitis, and can include food allergies, asthma and allergic rhinitis – typically known as the atopic march, which is the progression of allergic disease at other sites whose barrier is similar to the skin, like the GI tract, lungs, and nasal passageways which are all epithelial surfaces.
“Eczema can affect any age group though it is typically most commonly diagnosed in childhood,” Dr. Elias said. “The biggest myth with eczema is that it only affects the skin when the current working theory is that it can affect any skin barrier as above.”
Eczema can affect all age ranges, but most patients who will get eczema (90%) have it by their 5th birthday, said Dr. Jeremy Green, Board Certified Dermatologist at Skin Associates of South Florida.
The most common complaints among those who have eczema include itchy, dry, painful and unsightly skin, and many patients with eczema “are ashamed as people think something is wrong with them or they’re contagious,” Dr. Green said.
Eczema is not contagious, said Paul Yamauchi, PhD, a dermatologist in private practice at the Dermatology Institute and Skin Care Center in Santa Monica, California.
“Eczema is not just a cosmetic skin condition but a systemic condition,” explained Dr. Yamauchi, who also directs the Clinical Science Institute, which offers cutting-edge technology in the research and treatment of various skin diseases including psoriasis, acne, rosacea, eczema, skin cancer, and other medical skin conditions.
“There are several other conditions associated with eczema including asthma, hay fever, food allergies, lack of sleep, attention deficit disorder, hives, bacterial and viral infections, anxiety, depression,” Dr. Yamauchi noted. “The truth is people suffering from eczema have a reduced quality of life, which will affect their performance at school and work.”
Dr. Green agreed that eczema can really affect a person’s self-esteem.
“Sufferers may dress to cover up their skin and shy away from wearing bathing suits or clothes that show skin,” Dr. Green said. “In extremely severe cases of eczema, patients can even require hospitalization for IV antibiotics and anti-inflammatory medications.”
The benefits of clinical remedies are they have been investigated rigorously in clinical trials, according to Dr. Yamauchi.
That’s because when clinical trials are performed, the number one priority required by the FDA is patient safety; and the data is carefully analyzed for statistical significance and all adverse events are reported.
“The clinician can review the clinical efficacy and the safety of the medication and make the decision whether to prescribe that medication or not,” Dr. Yamauchi explained.
“Natural remedies, in general, do not undergo rigorous testing, and often times full disclosure of safety or efficacy is not reported,” Dr. Yamauchi said. “Just because the remedy is natural does not mean it is safer. Unfortunately, there are many false claims and untruthful advertising behind natural remedies.”
Dr. Elias agreed that clinical remedies have the benefit of clinical studies showing their safety and efficacy, and that “by undergoing rigorous review, you are assured with clinical remedies what to expect treatment wise.”
Any patient would benefit from clinical remedies, Dr. Yamauchi said, and the type of medication prescribed would depend on the severity of eczema and the symptoms, such as itching.
“For milder cases of eczema, a topical prescription cream is usually prescribed,” Dr. Yamauchi said. “For more severe eczema that is disrupting the patient’s quality of life, a systemic agent is prescribed such as a pill or an injection.”
According to Dr. Elias, eczema that is not responding to over-the-counter treatments would be ideal for clinical remedies, such as prescription strength topical steroids, emollients, and even immunosuppressant medications that are topical, oral or even injectable, like biologics.
If a person has an allergy or hypersensitivity reaction to a medication, then it must be avoided, Dr. Yamauchi advised.
“In addition, if there is a contraindication to a medication such as a preexisting condition that conflicts with the medication, then that medication must be avoided,” Dr. Yamauchi said.
Dr. Elias noted that patients that are allergic to topical steroids or certain classes of steroids, or other prescription strength products that are completely controlled with over-the-counter moisturizers, are likely able to avoid clinical remedies.
For milder cases of eczema, a steroid or non-steroid cream is recommended, Dr. Yamauchi said, and for more severe cases, systemic medications are recommended as a shot or a pill.
“Cortisone pills and shots provide fast relief for a flare-up but should not be administered too often because of potential adverse events,” advised Dr. Yamauchi, noting that currently many drugs are being investigated to treat eczema, which is safer to use long-term.
“Because eczema is due to a hyperactive immune system that causes inflammation in the skin, these targeted therapies normalize the immune the system to a better balance,” Dr. Yamauchi explained.
According to the National Eczema Association, cortisone pills or shots are sometimes used but they are not safe for long-term use. The association also states that cortisone (steroid) creams applied directly to the affected area are “helpful and a mainstay of therapy.”
Clinical remedies work much quicker and provide faster relief than natural remedies and have undergone rigorous clinical trials, Dr. Yamauchi added.
“Natural remedies are not as predictable but nonetheless can be beneficial if they are safe,” Dr. Yamauchi said.
At Dr. Elias’ practice, “we recommend prescriptions based upon the patient’s disease state, including time of disease, severity, locations affected, and comorbidities like itching.”
Because each individual’s experience with eczema is different, the best clinical remedies are wide and varied, he said.
For instance, “classically topical steroids of all strengths are the first line treatment for eczema,” Dr. Elias said. “Combining these prescriptions with barrier repair products and emollients typically provides relief for many patients.”
In other cases, “some patients may need more aggressive treatments, like injectable biologics such as Dupixent, which some long-term eczema sufferers consider a miracle due to its amazing ability to clear the most difficult cases of eczema and relief horrible symptoms like severe itching,” Dr. Elais said.
Dupixent is the first biologic medication approved by the U.S. Food and Drug Administration for adults with moderate to severe atopic dermatitis for whom topical treatments have not worked or are not advised, according to the National Eczema Association.
In clinical trials, more than half of patients using Dupixent for 16 weeks reported their symptoms of atopic dermatitis were reduced by 75 percent. Dupixent is taken by way of injection every other week after an initial loading dose and is available by prescription only.
As far as potential side effects are concerned, the most commonly reported, according to the National Eczema Association, include pink eye, injection site reactions, or cold sores on the mouth or lips.
The National Eczema Association further advises to consult with your doctor to weigh the benefits versus the risks to determine if a biologic like Dupixent is the right treatment, especially if you’re trying to conceive, nursing or pregnant.
Topicals for Eczema
Topical treatments for eczema are medications that are applied to the skin to manage symptoms and reduce inflammation, according to the National Eczema Association. There are a few different types of topicals for eczema, and the most common include prescription steroids in varying strengths, calcineurin inhibitors, and PDE4 inhibitors.
Prescription Steroids can ease redness and reduce inflammation and itching so your skin can begin to heal. According to the National Eczema Association, Corticosteroids have been used for more than 50 years in topical medications to treat many kinds of inflammatory skin conditions including eczema.
Calcineurin inhibitors like Protopic and Elidel “can be put to great use and can make a difference,” Dr. Peter Lio, a practicing dermatologist in Chicago, stated in a presentation at the National Eczema Association annual patient conference.
Dr. Lio stated that they’re “actually fairly crummy” for an acute ﬂare-up; and that he thinks it’s best to best to get ﬂare-ups under control with a cortisone, using it for just a few days at best, or for a week or two if the ﬂare-up is really bad. “Get things looking good, then use a topical calcineurin inhibitor to help maintain that,” he said.
PDE4 Inhibitors: Eucrisa, which is FDA approved, is a topical treatment for children and adults with mild to moderate atopic dermatitis.
When applied to the skin, Eucrisa works on an enzyme called phosphodiesterase 4, or PDE4, which is produced by cells in our immune system and helps the body function in part by controlling cytokines, which are bits of protein also produced by our cells that contribute to inflammation.
When cytokines are mistakenly triggered in the body, the resulting inflammation can contribute to the development of certain diseases, including atopic dermatitis, according to the National Eczema Association.
In clinical trials, Eucrisa reduced symptoms of atopic dermatitis such as itching, redness, thickened skin, weepy rash, and raw, scratched lesions. Overall, participants achieved clear or almost clear skin after 28 days of use.
An immunosuppressant is a type of medication prescribed by a doctor that helps control or suppress the immune system to slow down the symptoms of severe eczema, according to the National Eczema Association.
Typically prescribed for moderate to severe conditions in children and adults, immunosuppressants can help stop the itch and scratch cycle, enable the skin to heal, and diminish the risk of skin infection.
According to the National Eczema Association, the most commonly used are Azathioprine, Cyclosporine, Methotrexate, and Mycophenolate. Keep in mind that these medications are considered off-label – in other words, they’re not approved by the Food and Drug Administration to specifically treat atopic dermatitis and other forms of eczema.
The National Eczema Association noted the following details about each medication:
- Azathioprine is an oral medication first used in transplant patients to prevent the body from rejecting a transplanted organ.
- Cyclosporine is an oral or injectable medication first used to prevent the body from rejecting a transplanted organ.
- Methotrexate is an oral or injectable medication used frequently in psoriasis and different types of arthritis. It is a chemotherapy agent, first used on cancer patients.
- Mycophenolate mofetil is used in transplant patients and for other diseases of the immune system.
The following over-the-counter creams for eczema received the National Eczema Association Seal of Acceptance™. This criteria includes a list of ingredients that should be avoided because they contain known irritants. Depending on the product, the review panel considers testing data on sensitivity as well as the ingredients and formulation data.
It’s important to note that acceptance of a specific product does not represent an endorsement of that product by the National Eczema Association. Also, keep in mind that some of these products might contain ingredients that some people are allergic to, so before you try any of these products, talk to a Board Certified Dermatologist or your primary doctor, first.
Best Eczema Creams for Kids
For children with eczema, several products received the Seal of Acceptance by the National Eczema Association, which noted the following details of each:
CeraVe® Baby Moisturizing Lotion: This patented formula contains vitamins and 3 essential ceramides that help protect and maintain a baby’s delicate skin barrier. This can be purchased at Bed Bath & Beyond for $8.99 and at Walgreens for $9.99.
CeraVe® Baby Moisturizing Cream: This cream can help protect and maintain a baby’s skin with ceramides 1, 3 and 6-11. This product costs $8.99 at Bed Bath & Beyond and costs $9.42 on Amazon.
CeraVe® Baby Healing Ointment: This product can moisturize, protect, and maintain a baby's skin with essential ceramides and vitamins, and a diaper rash protectant. This ointment costs $5.50 on eBay, comparatively, it’s also sold on Amazon for $9.99.
AVEENO® Eczema Therapy Soothing Bath Treatment: This product, which contains colloidal oatmeal, can relieve dry, itchy, irritated skin. This product costs $4.75 at Rite Aid and $4.99 at Target.
Best Eczema Creams for Adults
Cetaphil® PRO Gentle Body Wash: This product is formulated to soothe dry, sensitive skin. It contains shea butter and sunflower seed oil, which are considered rare allergens, and may be of concern relating to food allergies. This wash costs $22.95 on Amazon or $20.49 at CVS Pharmacy.
Cetaphil® PRO Gentle Moisturizer: This product can potentially calm, sooth, restore and moisturize to help alleviate the dryness and itching associated with eczema. It contains shea butter and sunflower seed oil, which are considered rare allergens, and may be of concern relating to food allergies. This moisturizer costs $24.98 on Amazon, comparatively, it can also be purchased at Walmart for $15.64.
Best Eczema Creams for Sensitive Skin
Vaniply™ Ointment: This product forms a protective film on the skin to help retain its natural moisture. Designed for sensitive skin, it’s free of dyes, fragrance, masking fragrance, lanolin, parabens, and formaldehyde. It’s considered beneficial in skin problems including topical dermatitis, chafing, & drying effects of weather. This ointment costs $9.02 at Walmart, comparatively, it can also be purchased on Amazon for $7.36.
Neutrogena® Sensitive Skin Sunscreen Lotion SPF 60+: This product provides “superior” broad-spectrum UVA/UVB protection, and is considered ultralight. It contains a blend of unique blend of naturally-sourced physical sunscreens (titanium dioxide and zinc oxide) to provide protection that’s hypoallergenic. This sunscreen costs $9.97 at Walmart, it can also be purchased for $8.99 at Amazon.
The following eczema products, which don’t need a prescription from a doctor, also received the National Eczema Association Seal of Acceptance:
Exederm® Flare Control Cream: This product, which contains 1% hydrocortisone, has been formulated to avoid harsh chemicals and unnecessary additives that may irritate and cause a rash on sensitive skin or trigger an eczema flare-up. This cream costs $9.99 at Bed Bath & Beyond, it can also be purchased at Rite Aid for $7.69.
TriCalm® Hydrogel: This is a steroid-free itch relief gel that’s clinically proven five times more effective than hydrocortisone 1% at reducing itch. It is dermatologist recommended for relief of itching, burning and stinging from common skin irritations such as dry skin, poison ivy/oak/sumac, insect bites, athlete’s foot and rashes caused by soaps, detergents, cosmetics or jewelry. This product costs $7.45 on Amazon and $.8.49 at Walgreens.
Cortizone 10® Intensive Healing Eczema Lotion: This product, which contains seven intensive moisturizers to soothe and help heal eczema-affected skin, is formulated to stop the itch associated with eczema while the moisturizing formula helps heal skin. It’s considered the strongest itch medicine you can buy without a prescription. This lotion can be purchased at Walmart for $7.88, it can also be bought at Rite Aid for around $7.
When it comes to selecting clinical and over-the-counter remedies for people with eczema, it’s important to be properly evaluated and managed by a Board Certified Dermatologist as there are many amazing new treatments out there for long-time suffering patients of eczema, Dr. Elias said.
“A patient should always talk to their Board Certified Dermatologist prior to starting any regiment for their skin, as some components of products may actually exacerbate their eczema so it is always best to discuss with the expert Dermatologist,” Dr. Elias advised.
If you are feeling hopeless or helpless, Dr. Green recommends contacting your closest medical school’s department of dermatology, because “chances are they will have either a pediatric dermatologist or a medical dermatologist skilled in the treatment of the most difficult eczema cases.”
» For Further Reading: Expert Guide: Top Natural Remedies for People with Eczema