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Finding the right topical treatment for your eczema can feel overwhelming. There are many treatment options, and they vary in type, effectiveness, and side effects. The best option for your skin will depend on your symptoms, your age, and the size and location of your affected areas.
Your dermatology provider can help you figure out which topical medication for eczema will best suit your needs. If a treatment isn’t working or causes side effects, let your dermatologist know. Staying consistent with your treatment plan and daily skin care routine is also important to evaluate how well a medication is working.
Read on to learn some important topics to discuss with your healthcare provider when deciding on the right treatment plan for your eczema.
When choosing a topical therapy for eczema, it’s important to take into account how severe your symptoms are. The U.S. Food and Drug Administration (FDA) has approved prescription treatments for mild, moderate, and severe cases of eczema. Since 2021, many new nonsteroidal topical options have been approved, giving people more choices than ever before.
Topical steroids, also called topical corticosteroids, are the oldest and most commonly prescribed topical treatments for atopic dermatitis (the most common type of eczema). Examples of topical steroids include betamethasone, hydrocortisone, and triamcinolone.
The potency (strength) of each topical steroid depends on the type of medication and how concentrated it is. Your healthcare provider will choose the right strength based on how severe your symptoms are, where the eczema appears on the skin, the size of those areas, and other factors. Follow your healthcare provider’s instructions carefully to prevent side effects.
Topical calcineurin inhibitors are medications that calm the immune system. This helps relieve inflammation, itchy skin, dryness, and changes in skin color. Like topical steroids, topical calcineurin inhibitors reduce skin inflammation. However, they don’t cause the same side effects as topical steroids, such as skin thinning.
Topical calcineurin inhibitors are usually second-line treatments for mild, moderate, or severe cases of atopic dermatitis. A doctor may prescribe them if topical steroids are not effective. They may also recommend them as maintenance medication, to help keep symptoms under control.
There are two topical calcineurin inhibitors currently available by prescription: pimecrolimus cream (Elidel) and tacrolimus ointment (Protopic). Elidel is approved by the FDA to treat mild to moderate atopic dermatitis. Protopic is approved for moderate to severe atopic dermatitis.
Topical PDE4 inhibitors are a newer type of topical medication for mild to moderate atopic dermatitis. There are currently two available.
Crisaborole (Eucrisa) was the first FDA-approved PDE4 inhibitor available by prescription. It’s a steroid-free medication approved for mild to moderate atopic dermatitis. Crisaborole can be used on more sensitive skin.
In 2024, the FDA approved roflumilast cream (Zoryve) to treat mild to moderate atopic dermatitis in adults and children. Like Eucrisa, it’s steroid-free.
Topical JAK inhibitors are designed to help mild to moderate eczema. They’re a newer option for people who haven’t seen results with other therapies or aren’t able to use them. There are currently two topical JAK inhibitors available by prescription.
Ruxolitinib (Opzelura) was the first topical JAK inhibitor approved for atopic dermatitis by the FDA.
Delgocitinib (Anzupgo) cream was FDA-approved in 2025 for treating moderate-to-severe chronic hand eczema in adults.
In December 2024, the FDA approved tapinarof cream 1 percent (Vtama), an aryl hydrocarbon receptor (AHR) agonist, to treat eczema. This medication is part of a newer group of nonsteroidal, targeted topical therapies that help relieve eczema symptoms with fewer long-term side effects.
Topical treatments can cause side effects, which vary depending on medication. If you experience side effects that are uncomfortable or disruptive, contact your healthcare provider. They may suggest ways to deal with the side effects or recommend a different treatment option.
The side effects of topical steroids depend on the medication’s strength, where it’s applied, and how long it’s used.
Common side effects include:
You can help prevent these side effects by closely following your healthcare provider’s directions and using the medication as prescribed.
The most common side effects of topical calcineurin inhibitors are itching and burning. These symptoms usually go away on their own after a few days of treatment.
The most common side effect of the topical PDE4 inhibitor crisaborole is pain, burning, or stinging where it’s applied. Dermatologists recommend applying crisaborole right after bathing. After applying crisaborole, wait 15 minutes before applying your moisturizer.
Some of the most common side effects of topical JAK inhibitors include:
Some common side effects of tapinarof cream for atopic dermatitis include upper and lower respiratory tract infections (such as colds or coughs), raised bumps around pores (folliculitis), vomiting, asthma, and headache.
Age is an important factor when choosing topical treatments for atopic dermatitis. Not all treatments are safe for babies and young children. Age approvals may vary by country, so always follow your dermatologist’s advice and your local health regulations.
Babies and young children absorb topical steroids more easily, which increases the risk of side effects. For this reason, doctors usually recommend lower-strength topical steroids for pediatric use (in babies and young children), especially when treating large areas of skin.
Tacrolimus and pimecrolimus should not be used in children under 2 years old. Tacrolimus comes in two strengths: 0.03 percent and 0.1 percent. Only the lower-strength formulation of tacrolimus, 0.03 percent, is approved for adults and children ages 2 to 15.
Crisaborole is approved for adults and children as young as 3 months. Roflumilast cream 0.15 percent is approved for ages 6 and older, while the 0.05 percent version can be used in children age 2 to 5.
Ruxolitinib cream has been approved by the FDA for use in adults and children 2 years and older. Delgocitinib is approved for adults only.
Tapinarof cream is approved for adults and children 2 years and older.
The location and size of the affected area also help determine the best topical treatment for atopic dermatitis. For example, if you have a flare-up on a delicate area, such as your face, your healthcare provider will likely recommend a gentler option. If large areas of your skin are affected, you’ll need to apply more medication, which can increase the risk of side effects.
Topical steroids come in many forms, including ointments, creams, lotions, and gels, and each has its pros and cons. Ointments are great for locking in moisture, while lotions are easier to apply to areas with hair.
Lower-strength steroids are recommended for large areas, sensitive regions like the face, or places where skin rubs together. Higher-strength steroids may be used on thicker skin, such as the hands or feet.
Topical calcineurin inhibitors are especially useful for sensitive areas like the face because they reduce inflammation without causing thinning of the skin — a common side effect of topical steroids.
These newer treatments generally have few restrictions on where they can be applied — though they should not be applied to the eyes, mouth, or genitals.
JAK inhibitors are also relatively new and have few restrictions on where they can be applied. Ruxolitinib cream should only be applied twice daily to a maximum of 20 percent of the body surface area. If a large body area is affected, your doctor may recommend another treatment.
Tapinarof cream can be used on most areas of the body, including sensitive areas like the face. It should not be used on the vagina, eyes, or mouth.
Finding the right prescription treatment option for eczema can take time, but it’s worth it for your comfort and quality of life.
Daily moisturizing is one of the most effective ways to control your eczema. It’s proven that regularly applying a good moisturizer can significantly soothe your skin, reduce flare-ups, and lessen your need for prescription creams.
Talk to your doctor about your options and lean on them for guidance to create a treatment plan that works for you.
On MyEczemaTeam, people share their experiences with eczema, get advice, and find support from others who understand.
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