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Getting the Best Results With Topical Eczema Treatments

Posted on November 08, 2021
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Joan Grossman

  • Many types of topical treatments can improve eczema symptoms.
  • Basic skin care practices and healthy lifestyle changes can contribute to better well-being and reduced eczema flares.
  • Sticking to your topical treatment plan is crucial to receiving the benefits of the medicine.
  • If you are having problems with your treatment plan, always talk to your doctor before making any adjustments.

For the best results with topical eczema treatments, you must adhere to your treatment regimen, be patient with results, and be sure that you are using treatments as directed. Prescription topical treatments are a mainstay for reducing eczema symptoms. They may be used with other treatment options, like ultraviolet phototherapy or systemic drugs taken orally or by injection.

Eczema is a chronic inflammatory skin condition caused by disorders in the immune system and a weakened skin barrier. The most common type of eczema is atopic dermatitis (AD), which is sometimes called atopic eczema. AD is characterized by dry, itchy, and scaly skin that may become infected during flare-ups.

MyEczemaTeam members frequently express their frustration with topical treatments and the effort required to keep up with skin care. “I spend my entire day putting cream on (when work allows), and still the dermatologist has the audacity to say my most hated phrase, ‘Your skin’s very dry,’ 😭😭😭'' a member wrote.

Topical treatments for eczema include topical steroids such as hydrocortisone, topical calcineurin inhibitors such as tacrolimus or pimecrolimus, and topical phosphodiesterase 4 (PDE4) inhibitors such as crisaborole ointment. Topical Janus kinase (JAK) inhibitors are a new category of therapy for eczema. Opzelura (ruxolitinib) is the first to be approved by the U.S. Food and Drug Administration (FDA) for the treatment of atopic dermatitis. Learn more about types of topicals in the Guide to Topical Eczema Treatments.

If you are not satisfied with the results of your topical treatments, talk to your dermatologist about other treatment options. Don’t change your treatment plan without discussing your options with your doctor.

Stick To Your Treatment Schedule

Poor adherence to treatment plans is a common problem among people with eczema and other skin diseases that require ongoing care. Some of the key reasons for failing to stick with a treatment schedule are ​​frustration with a medication’s effectiveness, finding the process inconvenient, and hesitation due to potential side effects.

Some people get tired of using ointments that may feel greasy or get on clothing. If this occurs, talk to your dermatologist about other product formulations that may be easier to use. Lack of adherence to your topical treatment is associated with an increased risk of disease progression, which may also increase the need for even more treatment.

Treatment plans can be complicated, requiring several different medications multiple times daily. One MyEczemaTeam member explained what she does to maintain her eczema care with good results. “My dermatologist has me on Dupixent injections, which I do myself twice a month, and Eucrisa ointment. My hands were cured in four months. No more wearing gloves 24/7! And my heels aren’t itching or split open,” she wrote. “I still take Allegra and Benadryl and apply Caladryl, alternating with Benadryl gel, steroid ointment, numbing spray, Campho Phenique, Lanacane, etc.”

Consistent use of the medications is the best way to achieve treatment success. If you experience side effects from topical treatments, be sure to discuss them with your doctor. Your dermatologist may have suggestions about how to use your topical treatments in ways that minimize side effects. It is never advisable to stop a treatment without medical advice.

Eczema is a condition that often requires long-term treatment and rarely is resolved quickly. Discuss potential treatment outcomes with your doctors so you have realistic expectations about how long it may take for a treatment to work, particularly in cases of severe atopic dermatitis. Research suggests that long-term, low dose topical treatment, known as proactive therapy, may have better outcomes than higher dose treatment prescribed in reaction to flares.

If you are starting a new topical treatment, you can request a follow-up appointment with your doctor to monitor your progress and discuss any concerns about side effects or proper usage.

Use Treatments as Directed

Studies show that when topical treatments are used correctly, they are often effective in controlling atopic dermatitis. Using topical treatments as directed is vital. This will help you get the best results and avoid side effects.

Some topicals may be recommended for certain areas of skin, but not for others. For instance, strong topical steroids are not appropriate for use on the face. Stronger potency topicals may be appropriate for tougher skin, but may cause adverse reactions on thinner skin. Be sure you understand which affected areas or lesions should be treated with which medications.

It’s very important to understand exact directions for topical treatment. Some topicals may work best if applied directly after bathing. Other topicals may require a waiting period before you apply other skin care products or cosmetics over them, to avoid the risk of side effects. Some topicals are not appropriate for young children.

Take time to talk to your doctor about the proper usage of topicals. Take notes when discussing directions for topicals and review your notes with your doctor to be sure you understand the correct usage.

Read Do's and Don'ts of Topical Eczema Treatments.

Keep Up With Good Skin Care

Topical medications are more helpful if you maintain a good skin care routine. People with eczema need to regularly hydrate and moisturize because their skin barrier does not retain adequate moisture — causing dry skin that can become itchy, inflamed, or cracked. Avoid products for skin care, laundry, and household cleaning that have alcohol, dyes, fragrances, and chemical irritants that may interfere with your topical treatments. Look for products that are allergen-free or hypoallergenic.

Taking care of your skin can help reduce itching and scratching, which can damage skin. Good skin care can also help topical treatments work more effectively and may reduce the need for some medications.

Recommendations for skin care include the following:

Consider Lifestyle Changes

A healthy lifestyle can improve your overall well-being and quality of life. A balanced diet and healthy weight can reduce your risk for cardiovascular disease and diabetes.

Other lifestyle choices are associated with eczema more directly and may help improve eczema symptoms. For example, it’s important to identify food allergies in people with eczema, particularly children.

Here are some lifestyle changes to consider if you have eczema:

  • Quit smoking. Exposure to secondhand tobacco smoke is associated with the development of atopic dermatitis in children and adults.
  • Add vegetables, organic foods, and fish oil to your diet, which some studies show improve skin in people with atopic dermatitis.
  • Stay physically active and exercise with appropriate clothing. Drink plenty of water, and moisturize before and after exercising to reduce irritation from sweat.

Trouble Using Topicals? Talk To Your Doctor

If you are having problems using topicals or feel frustrated with the results you are getting, talk to your doctor and find out how you may improve your experience. Be sure you are adhering to your treatment plan for topicals, along with any systemic medications you may be taking. In cases of severe eczema, these may include antihistamines, immunosuppressant drugs like cyclosporine, Azasan (azathioprine), methotrexate, or the biologic drug Dupixent (dupilumab).

Work with your health care team to be sure you are aware of any allergens, such as dust mites, and triggers that may exacerbate your eczema. New types of topical medication for eczema are in clinical trials and may be approved by the FDA in the future. Ask your dermatologist about newer therapies to find out if they may be appropriate for you.

One MyEczemaTeam member explained how she has managed her eczema. “Eczema has been with me since I was a toddler. I've been able to control my hand eczema with daily 20-minute soaks in Dead Sea saltwater baths. Then I use Skinfix eczema balm and body cream. When at work, I use unscented Neutrogena hand cream after hand-washing. I've also had to cut out sugar, yeast, and dairy. I go back to Lyderm when I have uncontrollable flare-ups,” she wrote. “It takes time, patience, and money, but eventually you will find what works for you.”

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 38,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Have you found a topical treatment regimen that works for you? Do you have tips for others who are having trouble using topical medications? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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