How Eczema Is Treated

Daily moisturizing and topical drugs remain central to treatment

There is no cure for atopic dermatitis (eczema), but there are treatments that can help manage this common inflammatory skin condition. Regardless of the stage of the disease, self-care is important to relieve current symptoms and prevent future episodes and skin infections.

This article discusses the different types of treatment for eczema. This includes over-the-counter therapies, prescriptions, specialist-driven procedures, and complementary medicine.

Verywell / Michela Buttignol

Home Remedies and Lifestyle

Eczema can be triggered or worsened by things you are sensitive to. This could include pollen, certain foods, or a change in weather. Cold weather is often a trigger.

It could also include things you do, like scratching or getting stressed. Lifestyle and personal care choices play a central role in preventing or managing acute episodes of eczema, which are called flares.

The following home remedies that may offer some relief.

Avoidance of Triggers

There are a wide variety of triggers that can cause an eczema flare. These can vary from one person to the next and may include:

  • Stress
  • Very dry skin
  • Soaps and household cleaners
  • Fragrances
  • Food allergens
  • Metals, especially nickel
  • Cigarette smoke
  • Cold, dry weather
  • Hot, humid weather
  • Colds and flu
  • Abrasive fabrics, especially wool and polyester
  • Antibacterial ointments like neomycin and bacitracin

Unfortunately, it is often difficult to know which triggers are causing your flares. You may want to keep a diary to record exposures to suspected triggers, especially when eczema starts to flare.

Avoiding triggers is often easier said than done. It involves buy-in from your family and a clear set of rules to avoid accidental exposures. This may include reading ingredient labels if you have sensitivities, dressing appropriately for the weather, and using stress-management techniques.

Skin Cleansers and Body Washes

If you have eczema, one of the worst things you can do is wash with traditional bar soaps. They are not only harsh but can strip away many of the skin's natural oils. These oils are known as a natural moisturizing factor, or NMF, which are meant to protect the skin.

Choose an eczema-friendly soap or cleanser designed specifically for dry, sensitive skin. An ever-expanding range is available on store shelves. The best of them carry the seal of acceptance from the National Eczema Association.

For infants, toddlers, and young children, you can choose to avoid cleansing products and opt for plain water baths only. Older children, teens, and adults may also benefit from soaping the hands, armpits, and groin rather than the entire body.

Antibacterial gels are ideal for cleaning hands, since their alcohol base does not reduce NMF.

"Soak-and-Seal" Baths

Water constantly evaporates from the deeper layers of the skin, an effect known as transepidermal water loss (TEWL). When you oversaturate the skin, this effect increases, drawing out even more water and leaving it tight and dry.

For people with eczema, these concerns are more than cosmetic. Bathing helps loosen skin scales and reduce itch, but it needs to be done safely with the "soak-and-seal" technique. To do this:

  • Draw a lukewarm (not hot) bath, soaking for no more than 10 minutes.
  • Use a mild cleanser rather than harsh soap.
  • Avoid scrubbing.
  • Towel off gently by blotting (not rubbing) the skin.
  • Apply any topical medications you may be using.
  • While the skin is still damp and porous, apply moisturizer.
  • Allow the moisturizer to absorb for several minutes before dressing.

If you are experiencing a severe flare, you may want to avoid cleansers altogether and just use water.

Bleach Baths

If your eczema is severe, a twice-weekly dilute bleach bath may help control symptoms, particularly if you have recurrent skin infections. Research remains split on how well it works. However, done correctly, a bleach bath is generally considered safe and may help neutralize bacteria and other infectious agents on the skin.

A bleach bath can be made with 1/4-cup to 1/2-cup of 5% household bleach to 40 gallons of lukewarm water. You should soak for no longer than 10 minutes and moisturize immediately after rinsing and toweling off. Never submerge your head in a bleach bath, and rinse your eyes immediately if you get water in them.

A bleach bath should never be used for children without your pediatrician's approval. People with severe cracking may want to avoid bleach baths since they can be painful if the skin is broken.

Sun Exposure

Many people with eczema claim that sunlight helps improve mild to moderate symptoms of the disease. It is believed that sun exposure increases the production of vitamin D in the skin. This releases anti-inflammatory compounds (called cathelicidins) that reduce local redness and swelling.

Natural sunlight is generally considered safe if limited to no more than 10 to 30 minutes of exposure several times per week. When first starting out, five minutes may be enough to see how well you tolerate sunlight. If there is no redness, tingling, or pain, you can gradually increase your time in the sun over the course of days and weeks.

When it comes to sun exposure, more is not always better. Too much sun can actually trigger an eczema flare while increasing the risk of sun damage and skin cancer.

When outdoors, always wear sunscreen with an SPF rating of 15 or higher. This allows enough ultraviolet (UV) radiation to penetrate the skin to have a therapeutic effect, but not enough to cause burning.

There is some evidence that the zinc oxide used in some mineral sunscreens may be beneficial for eczema. If your skin condition is severe, use sunscreen intended for sensitive skin or babies.

Over-the-Counter (OTC) Therapies

The most important over-the-counter (OTC) therapy for eczema is moisturizer. Daily moisturizing is essential to eczema treatment, regardless of the severity of your case.

The addition of a medication may be recommended if moisturizing alone doesn't improve your skin. Mild to moderate eczema can often be managed with OTC medications.


Itching and dry skin (xerosis) characterize eczema at every stage of the disease. At the same time, dry skin can trigger a flare if left untreated.

Not only is dry skin itchier, but it compromises the barrier function of the skin. This allows bacteria, fungi, and viruses easy access to vulnerable tissues. Even if these microbes do not establish an active infection, they can incite the inflammation needed to trigger a flare.

Routinely moisturizing with the right ointment, cream, or lotion can help rehydrate the skin and restore its barrier function:

  • Ointments tend to be the best choice for all, and especially severe, cases of eczema. This is because they are "greasier" and provide a longer-lasting moisture barrier. Many contain ingredients like petrolatum or mineral oil.
  • Creams are good for people with mild to moderate eczema and are preferred by many because they absorb better than ointments.
  • Lotions (composed primarily of water) may be sufficient for those with mild eczema.

Among the broad categories of skin moisturizers you can select from:

  • Moisturizers for scaly eczema are a good choice if you have flaking but no breaks or cracks in the skin. They can cause stinging if the skin is broken.
  • Emollient moisturizers are ideal if you are in the middle of an acute flare. They are non-irritating and form a water-tight seal on the outermost layer of skin cells.
  • Ceramide moisturizers tend to be more costly but are excellent options because they smooth skin and promote healing.

Studies have also shown that moisturizers with ceramides and urea may be beneficial to people with eczema because they appear to enhance hydration and the healing of an active eczema rash.

Whatever option you use, avoid moisturizers with fragrances and dyes, which can be irritating. In addition, while healing, avoid cosmetics or choose products that are fragrance-free and hypoallergenic. Moisturize before applying makeup and reapply moisturizer when needed.

Moisturize at least three times daily, applying the product in a thick layer and rubbing in a downward motion. Avoid rubbing in circles or up-and-down because this can generate heat and irritate inflamed skin.

Hydrocortisone Cream

If your eczema isn't improving with moisturizing creams, a low-potency OTC hydrocortisone cream can help treat rashes and reduce skin inflammation. Hydrocortisone is a type of topical steroid that helps reduce itching and swelling by suppressing inflammatory chemicals produced by the immune system.

OTC hydrocortisone is sold at drugstores in strengths of 0.5% and 1%. After cleansing, a thin layer is applied to the affected skin and gently rubbed in. A moisturizer can then be applied to lock in moisture.

In the United States, topical steroids are classified by potency levels from 1 (highest) to 7 (lowest). Both 0.5% and 1% hydrocortisone belong to Class 7, the lowest strength.

Common side effects include stinging, burning, redness, and dryness. Acne, folliculitis ("hair bumps"), stretch marks, discoloration, and skin atrophy (thinning) may also occur, especially when hydrocortisone is overused.

While technically safe to use on the face, OTC hydrocortisone cream is only intended for occasional, short-term use. It should be used with extreme caution around the eyes. Most people won't experience any side effects if a low-potency hydrocortisone cream is used for less than four weeks.


Despite what some might tell you, antihistamines do not inherently relieve itching in people with eczema.

Antihistamines work by blocking a chemical known as histamine that the immune system produces when confronted with an allergen (like pollen or pet dander). Since histamine is not a major player in an eczema itch, the benefits of antihistamines can vary from one person to the next.

If eczema is triggered by an allergy, an antihistamine may avert a flare or reduce its severity. On the other hand, if an allergy is not involved, an antihistamine may have no effect.

Antihistamines are most often recommended if itching is keeping you up at night. Older-generation antihistamines like Benadryl (diphenhydramine) have a sedating effect that can help you rest and may temper systemic inflammation.

If an antihistamine is needed during the day, a non-drowsy formulation should be used, such as:

Topical antihistamines should be avoided, since they can irritate the skin and provoke an eczema flare.


In some cases, prescription medications may be appropriate as the first treatment you try. In others, they are considered only if eczema symptoms worsen or fail to respond to conservative treatment.

These drugs are sometimes used on their own or in combination with other treatments.

Topical Steroids

Topical steroids are intended for the short-term treatment of acute eczema symptoms. They are not used to prevent flares or as a substitute for a moisturizer.

These drugs are available as ointments, lotions, and creams, as well as specialized solutions for the scalp and beard areas.

The choice of a topical steroid is directed by the location of eczema, the age of the user, and the severity of the rash. Lower-potency steroids are typically used where the skin is thinnest (like the face and back of the hands). A high-potency steroid may be needed for thick skin (such as the feet).

The following are examples of commonly used topical steroids (class 6 is the weakest, and class 1 the strongest):

  • Potency Class 6: Desonex gel (0.05% desonide)
  • Potency Class 5: Dermatop cream (0.1% prednicarbate)
  • Potency Class 4: Synalar (0.025% fluocinolone acetonide)
  • Potency Class 3: Lidex-E cream (0.05% fluocinonide)
  • Potency Class 2: Elocon ointment (0.05% halobetasol propionate)
  • Potency Class 1: Vanos cream (0.1% fluocinonide)

These drugs should always be used in the lowest effective potency for the shortest amount of time to avoid side effects. If used inappropriately, you may be at a higher risk for side effects, including skin atrophy, easy bruising, stretch marks, and spider veins (telangiectasia).

As such, stronger topical steroids are typically only prescribed in the first-line treatment of moderate to severe eczema.

The overuse or prolonged use of topical steroids can have potentially serious consequences. This includes irreversible skin atrophy, pustular psoriasis, and corticosteroid withdrawal.

Topical Calcineurin Inhibitors

If topical steroids fail to provide relief, a class of drugs called topical calcineurin inhibitors (TCIs) may be prescribed. TCIs work by blocking a protein called calcineurin. This protein stimulates the production of inflammatory cytokines, which signal the body's immune responses.

Elidel (pimecrolimus) and Protopic (tacrolimus) are the two TCIs currently approved for use in the treatment of eczema. They are used as second-line therapy for moderate to severe eczema in adults or children 2 years of age and older.

Unlike topical steroids, Elidel and Protopic are not absorbed into deeper tissues and do not cause skin thinning or discoloration. As such, they can be used safely on the face and other delicate skin. Common side effects include skin redness, headache, acne, nausea, folliculitis, and flu-like symptoms.

In 2006, the FDA issued a black box warning advising health professionals and consumers that Elidel and Protopic may increase the risk of skin cancer and lymphoma. However, this warning is somewhat controversial, because the majority of recent large-scale studies do not provide evidence to support the relationship.

Oral Steroids

On rare occasions, a short course of oral steroids may be prescribed to control a severe eczema flare. These are generally only recommended if eczema symptoms are resistant to other therapies or when other treatment options are limited.

Few healthcare providers will ever consider using an oral steroid in children with eczema, no matter how severe.

Extreme caution should be exercised in all cases of oral steroid use. The prolonged use of steroids (30 days or more) can increase the risk of sepsis, thromboembolism, and bone fracture. It can also cause a "rebound effect" in which symptoms will re-emerge violently once the treatment is stopped.

To avoid this, the steroid dose would be gradually tapered down over the course of weeks or months.

Prednisone, hydrocortisone, and Celestone (betamethasone) are among the oral steroids healthcare providers may consider. They work by suppressing the immune system as a whole and are only intended for short-term use.

Stronger oral immunosuppressants like cyclosporine, methotrexate, and Imuran (azathioprine) have also been tried. However, there is little solid evidence to support their use for this purpose.


In some cases, eczema can compromise the skin and allow bacteria to establish an infection. Secondary bacterial skin infections are common among people with eczema (most especially Staphylococcus aureus infections). They can be treated with topical or oral antibiotics.

Topical antibiotics are usually enough to treat minor local infections. Oral antibiotics may be needed for infections involving larger areas of the skin. Cephalosporins, nafcillin, and vancomycin are among the antibiotics most commonly used.

The duration of therapy can vary depending on the severity of symptoms. It generally does not exceed 14 days due to the risk of antibiotic resistance.

Antibiotics can only treat bacterial infections. Fungal infections like ringworm can be treated with antifungal drugs (like miconazole cream). Viral infections like herpes simplex can be treated with antivirals (like acyclovir).

The risk of secondary skin infections can be greatly reduced by washing your hands thoroughly before applying topical treatments or moisturizers to the skin.

JAK Inhibitors

In September 2021, the FDA approved Opzelura (ruxolitinib) for the treatment of mild to moderate atopic dermatitis. It is recommended for those whose symptoms do not properly respond to topical prescription therapies. Opzelura was the first JAK inhibitor approved for atopic dermatitis treatment in the United States, making it the first treatment of its kind.

The FDA has since approved Cibinqo (abrocitinib) and Rinvoq (upadacitinib) for the treatment of refractory, moderate-to-severe atopic dermatitis in those whose disease is not well controlled with other systemic medications, including biologics. Rinvoq is approved for those ages 12 and over, whereas Cibinqo is only approved for use in adults.

JAK inhibitors interfere with an enzyme that usually promotes inflammation. The drugs work by selectively blocking pathways that cause many of the symptoms of atopic dermatitis, including inflammation and itching.

Off-Label Medications

Leukotriene inhibitors, such as Singulair (montelukast) or Accolate (zafirlukast), may be used off-label for the treatment of eczema. However, the benefits of such use have yet to be established.

They might be used to treat eczema when symptoms are severe and resistant to any other form of therapy.

As suggested by their name, leukotriene inhibitors work by blocking an inflammatory compound known as leukotriene, which causes the redness and swelling characteristic of dermatitis. They are more commonly used to treat asthma and severe seasonal or year-round allergies.

Taken once daily by mouth, leukotriene inhibitors may cause fever, headache, sore throat, nausea, stomach pain, diarrhea, and upper respiratory infection.

Specialist-Driven Procedures

There are a handful of procedures that may benefit people with severe, recurrent, or treatment-resistant eczema symptoms. These are not used on their own but are typically combined with other therapies.


Phototherapy, also known as light therapy, functions similarly to sun exposure. It involves controlled bursts of UVA or UVB radiation delivered either in a dermatologist's office or specialized clinic.

Phototherapy is typically added to the treatment plan when topical therapies prove less than effective.

Phototherapy can reduce itch and inflammation associated with eczema and usually requires multiple treatments. Common side effects include skin dryness, redness, and mild sunburn. In rare cases, phototherapy can cause skin eruptions, liver spots (lentigines), and the reactivation of a herpes infection.

Phototherapy can be extremely effective in some people, but its use is often limited by cost, availability, and convenience. Coal tar or light-sensitizing drugs like psoralen are sometimes used to enhance the effects of phototherapy.

Wet Wrap Therapy

Wet wrap therapy is sometimes recommended for people with severe, difficult-to-treat eczema. The aim of wet wrap therapy is to help rehydrate the skin while enhancing the absorption of topical drugs. A bottom wet layer provides steady hydration, while a top dry layer helps lock in moisture.

Wet wrap therapy is individualized but typically involves the following steps:

  1. The skin is soaked in warm water for 15 to 20 minutes and patted dry.
  2. Topical medications are applied.
  3. The skin is wrapped with a layer of wet gauze and covered with an elastic bandage or other dry fabric.
  4. The wrap is left in place for two to six hours.

While wet wrap therapy can be performed at home, it should always be used as directed by a healthcare provider or dermatologist. It is not appropriate for everyone, particularly those with broken skin, in whom the risk of bacterial infection is high.


Immunotherapy is meant to minimize the effects of allergy. Most types of eczema are not allergies, but symptoms can flare when you're around allergens that can trigger an allergic reaction.

Immunotherapy works by desensitizing you to allergens that trigger attacks. By exposing you to incrementally increasing doses, your immune system "learns" not to react excessively. After allergy symptoms are controlled, ongoing treatments may be needed to maintain control.

There are two types of immunotherapy:

  • Allergy shots have been shown to be a modestly effective add-on approach and may help reduce the frequency or severity of eczema flares. The procedure typically requires once or twice weekly shots for several months, followed by maintenance shots every two to four weeks.
  • Allergy drops, also known as sublingual immunotherapy, are generally less effective than shots but may be suitable for people who are scared of needles. The procedure to administer them is more or less the same as allergy shots, but this form is mostly used off-label since it is not formally approved by the FDA.

To determine what shots or drops you need, an allergist will conduct a skin prick test to identify your specific allergens. Allergy shots cannot treat food allergies.

Immunotherapy is sometimes used in the treatment of eczema. However, a 2016 review of studies in the Cochrane Database of Systematic Reviews found no convincing evidence that allergy shots or drops were effective in reducing symptoms for children or adults.

Complementary and Alternative Medicine

Although there's not a lot of scientific evidence to support the use of complementary and alternative therapies for eczema, there are a few that have shown promise.

Coconut Oil

Coconut oil is sometimes used as a natural moisturizer for eczema and appears to have an occlusive effect. This means it seals off water molecules so they are retained in the skin.

It is also gentle on the skin and has anti-inflammatory and antimicrobial properties that may be useful in treating the disease.

A 2014 study found that children with eczema experienced improved skin hydration and fewer symptoms after applying coconut oil to the skin for eight weeks.

A number of other plant oils, such as sunflower oil and shea butter, also have moisturizing qualities. Olive oil, on the other hand, may dry the skin and further diminish its barrier function.

Vitamin D

Vitamin D plays a central role in the effects of sun exposure on eczema. It makes sense, then, that vitamin D supplements taken orally may also help relieve eczema symptoms.

A 2016 review of studies published in the journal Nutrients supported this hypothesis. It demonstrated that vitamin D deficiency was more common in people with eczema. Supplementation in those with a deficiency resulted in a roughly 40% improvement in symptoms.

Other studies have shown little benefit to supplementation. However, with high rates of vitamin D deficiency in the United States, it may be beneficial even if it doesn't directly improve eczema.


Probiotics are live bacteria sold in supplement form. They're found naturally in fermented foods like yogurt, miso, and kefir. They help support healthy gut flora and aid with digestion.

According to a review of studies published in JAMA Pediatrics, the use of probiotic supplements for at least eight weeks improved eczema in children 1 year of age and older. Supplements containing mixed bacterial strains proved more effective than those with a single strain.

While other studies have shown little or no effect, the use of probiotics does not appear to cause any harm. It may even help improve milk allergy symptoms (a common eczema trigger) in some children.

Speak with your healthcare provider before trying any complementary therapy. They can help ensure that it's safe and doesn't interfere with your treatment or any of your medications.


Eczema doesn't have a cure, but there are treatments that can help you relieve symptoms and prevent flares. You can help manage eczema at home by avoiding triggers like stress and certain foods. Wash with eczema-friendly soaps, and try taking diluted bleach baths.

Over-the-counter moisturizing creams are important for rehydrating the skin. Hydrocortisone creams can also help heal skin inflammation. Prescription medicines and procedures may be recommended for moderate-to-severe cases.

A Word From Verywell

Although eczema cannot be cured, it can be successfully controlled with the right combination of treatments. Proper skin care with a consistent moisturizing routine is a big part of the treatment plan.

Many patients find the need to try different treatment options or even change their treatment regimen over time. Your healthcare provider can help guide you and will likely use a step-wise approach, seeing if some options work before trying others that may have more risks.

In some cases, other specialists⁠—such as a dermatologist, allergist, or nutritionist⁠—may be needed to unlock the right combination of individualized treatments. Persistence and patience are key to finding the regimen that works best for you.

Frequently Asked Questions

  • What causes eczema?

    Eczema is likely caused by a combination of factors. These may include allergens, genetics, environmental irritants, and stress.

  • How do you treat your baby's eczema?

    To help reduce your baby's symptoms, the American Academy of Dermatology Association recommends the following tips:

    • For baths, use lukewarm water and a mild, fragrance-free cleanser.
    • Use a fragrance-free moisturizer twice a day.
    • Note any triggers that make eczema worse, such as sweat, laundry detergent, or baby wipes.
    • Check with your pediatrician or dermatologist to see if medication is needed.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  8. Food and Drug Administration. Rinvoq (upadacitinib) extended-release tablets.

  9. Food and Drug Administration. Cibinqo (abrocitinib) tablets.

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  11. National Eczema Association. Prescription phototherapy.

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  14. Evangelista MT, Abad-Casintahan F, Lopez-Villafuerte L. The effect of topical virgin coconut oil on SCORAD index, transepidermal water loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: A randomized, double-blind, clinical trial. International Journal of Dermatology. 2013;53(1):100-108. doi:10.1111/ijd.12339

  15. Kim M, Kim S-N, Lee Y, Choe Y, Ahn K. Vitamin D status and efficacy of vitamin D supplementation in atopic dermatitis: A systematic review and meta-analysis. Nutrients. 2016;8(12):789. doi:10.3390/nu8120789

  16. Chang Y-S, Trivedi MK, Jha A, Lin Y-F, Dimaano L, García-Romero MT. Synbiotics for prevention and treatment of atopic dermatitis. JAMA Pediatrics. 2016;170(3):236. doi:10.1001/jamapediatrics.2015.3943

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By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.