September 25, 2026 ยท Updated September 25, 2026
How to treat eczema: what a doctor may offer
Moisturizer is the base of every eczema plan. A doctor may add steroid or non-steroid creams, light treatment, pills or injections. What each one does.
By Nick, Founder of Skinli. Not a doctor. General education only.
Part of the Eczema, which puts every step in order.
Eczema is a group of skin conditions that make skin dry, itchy and inflamed, and a doctor should confirm the diagnosis before treatment starts, because other rashes look similar and need different care. This guide describes the treatments a doctor may offer for atopic eczema (atopic dermatitis), the most common type, based on the NHS, the American Academy of Dermatology (AAD) and US national guidelines. It gives no doses. Your own doctor sets the plan, and you should keep to it. The NHS says not to stop a steroid medicine without talking to your doctor first. For the condition as a whole, see the complete guide to eczema.
What treatment can and cannot do
The NHS says there is currently no cure for atopic eczema, and that treatments can help manage it and improve symptoms. The AAD says the condition cannot be cured, and that proper treatment can control it. The guide can eczema be cured? looks at that question in depth.
The US National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) lists the goals of treatment:
- manage and control dry skin
- reduce skin inflammation
- control itching
- promote healing
- prevent infections
- prevent flares
The AAD adds that a treatment plan can lower the risk of thickened skin that itches all the time, and help keep the skin hydrated.
The base of every plan: daily skin care
Moisturizer comes first. The NHS lists moisturizers, which it calls emollients, as one of the two main treatments for atopic eczema. The AAD says dermatologists recommend moisturizer for everyone who has atopic dermatitis, because well moisturized skin is less likely to crack and develop a worse rash, itching or infection. The AAD's 2023 guideline for adults gives moisturizers a strong recommendation. NICE, the UK body that writes guidance for doctors, says emollients are the basis of eczema care for children and should always be used, even when the skin is clear.
MedlinePlus, the health site of the US National Library of Medicine, says daily skin care may cut down on the need for medicines. The AAD says a skin care plan involves bathing, applying moisturizer and being gentle with your skin, and that your dermatologist will explain how to use baths and moisturizers. The guide to moisturizing and bathing for eczema covers this step by step.
Finding and avoiding triggers
The AAD calls anything that makes eczema flare a trigger. Common triggers include skin care products, cold or hot weather, wool clothing, stress, fragrance and harsh detergents. The AAD says different people have different triggers, that avoiding yours can reduce flare-ups, and that some people may not be able to find specific triggers. Your dermatologist can help you work out yours. The guide to eczema flare-up triggers goes through the common ones.
Medicines applied to the skin
The AAD says that with the right skin care and trigger management, many people can control atopic dermatitis with medicine they apply to their skin.
Steroid creams (topical corticosteroids)
Steroid creams are the most common eczema medicine. The NHS lists them as the second main treatment. The AAD says many treatment plans include them because they can quickly relieve symptoms, and its 2023 guideline news calls them the first-line treatment for atopic dermatitis on all areas of skin. NIAMS says they help to decrease inflammation. Because eczema involves an overactive immune system, several newer medicines act on it, as the guide is eczema an autoimmune disease? explains.
Steroid creams come in many strengths, from low to strong. The AAD says side effects are rare when a steroid cream is used as directed by a dermatologist. It also says even a non-prescription steroid like hydrocortisone can cause side effects, and that skin thinning, the most serious skin side effect, is more likely when a strong steroid is used on the face or neck. For that reason a doctor chooses the strength for each area of skin. The guide to eczema on the face explains why the face needs extra care.
Using a medicine cream and a moisturizer together
Most people use a moisturizer and a medicine cream in the same routine. The NHS says to wait 20 to 30 minutes between putting on a moisturizer and putting on a steroid cream or other skin treatment, and to ask a doctor which one to use first. It says the gap stops the moisturizer from diluting the medicine and spreading it onto skin that does not need it.
Creams and ointments without steroids
When steroid creams stop working, do not work, or are not a good option, the AAD says a dermatologist may prescribe a non-steroid medicine. These include:
| Medicine | What the AAD says about it |
|---|---|
| Pimecrolimus cream, tacrolimus ointment | Prescribed when steroids stop working, fail, or are not a good option; burning and stinging are the most common side effects and tend to fade as the skin heals |
| Crisaborole ointment | Can be used on many areas of the skin |
| Roflumilast cream | FDA approved for mild to moderate atopic dermatitis; can reduce itch |
| Ruxolitinib cream | FDA approved for mild to moderate atopic dermatitis |
| Tapinarof cream | Approved for mild, moderate or severe atopic dermatitis; can relieve itch |
The AAD's 2023 guideline for adults makes strong recommendations for steroid creams, for tacrolimus and pimecrolimus, and for the newer non-steroid creams it reviewed. A doctor decides which one fits.
When creams are not enough
The AAD says that if medicine applied to the skin is not effective, a dermatologist may prescribe light treatment or a medicine that works throughout the body.
Light treatment (phototherapy)
Light treatment uses special light bulbs or a laser. The AAD says it can safely and effectively treat atopic dermatitis, even in children, and that it usually means going to a clinic 2 to 3 times a week for at least a few months. The AAD says not to try tanning beds, sunlamps or sitting in the sun instead, because overheating or sunburn can cause a flare and raise the risk of skin cancer.
Injections and pills
The AAD says the FDA approved the first medicine that works throughout the body for atopic dermatitis in 2017. These medicines are for moderate to severe eczema that creams have not controlled:
- Biologic injections. Dupilumab, tralokinumab, lebrikizumab and nemolizumab. The AAD says biologics target or quiet the part of the immune system that is overactive. They are given as an injection just under the skin, and patients can be taught to inject at home.
- Pills that calm inflammation. Abrocitinib and upadacitinib are FDA approved for atopic dermatitis. Baricitinib is approved for it in Europe. The AAD calls them JAK inhibitors and says they work by reducing inflammation.
- Older medicines that suppress the immune system. Azathioprine, cyclosporine, methotrexate and mycophenolate. The AAD says these may still be the preferred treatment for some patients.
The AAD's 2024 guideline for adults makes strong recommendations for dupilumab, tralokinumab, abrocitinib, baricitinib and upadacitinib. It recommends against steroid pills or injections for eczema. NIAMS explains why: after steroid pills are stopped, atopic dermatitis can flare or come back worse than before.
Treating infections
People with atopic dermatitis get skin infections more easily. The AAD says a dermatologist may prescribe a medicine for the infection, applied to the skin or taken by mouth, and that this medicine treats the infection and leaves the eczema to its usual treatment. The AAD says a bleach bath may reduce bacteria and inflammation on the skin, and both the AAD and NIAMS say to use one only when your doctor recommends it. The NHS says signs of infection, such as crusting, leaking fluid, pain, warmth or a fever, need an urgent appointment.
Treatments with little or no proof
Some popular treatments lack evidence:
- Antihistamine creams and antiseptics. The AAD's 2023 guideline makes conditional recommendations against topical antimicrobials, antiseptics and antihistamines for adults.
- Allergy shots. MedlinePlus says allergy shots are not used to treat atopic dermatitis.
- Herbal and alternative remedies. NICE guidance for children says homeopathy, herbal medicine, massage and food supplements have not been properly tested for eczema in clinical trials. It also warns that steroids are deliberately added to some herbal products sold for children's eczema.
- Shop and internet allergy tests. NICE advises against them, saying there is no evidence of their value in managing eczema.
Wet wraps
The AAD says dermatologists occasionally recommend wet wrap therapy. Moisturizer or medicine goes on the skin, the skin is wrapped in wet bandages or damp pajamas, and a dry layer goes on top. It helps the skin absorb medicine, keeps it hydrated and protects it from scratching. NIAMS says to use wet wraps only after speaking with your doctor.
Getting the most from treatment
The AAD says it sometimes takes trying a few different medicines or light treatments to find the one that works best. NIAMS says to use skin treatments as directed and to follow up with your doctor regularly. The NHS says to see a doctor if treatments are not helping. If eczema affects your mental health, the NHS says you may be referred to a mental health specialist, and NIAMS suggests counseling for anyone who feels overwhelmed, embarrassed or anxious about their skin.
Frequently asked questions
How is eczema treated?
Eczema is treated with daily skin care plus medicine when needed. The NHS says the main treatments are moisturizers, which it calls emollients, and steroid creams, called topical corticosteroids. The American Academy of Dermatology says plans usually combine skin care, avoiding triggers and medicine applied to the skin, and that a dermatologist may add light treatment, pills or injections when creams are not enough.
What do doctors recommend for eczema?
Doctors recommend moisturizer for everyone with eczema, and usually a medicine for flare-ups. The American Academy of Dermatology's 2023 guideline for adults makes strong recommendations for moisturizers, steroid creams, and non-steroid creams such as tacrolimus, pimecrolimus, crisaborole and ruxolitinib. Its 2024 guideline makes strong recommendations for dupilumab, tralokinumab, abrocitinib, baricitinib and upadacitinib when creams do not control eczema.
Is eczema cream a steroid?
Some eczema creams are steroids and some are not. Steroid creams, called topical corticosteroids, are the most common eczema medicine, and the American Academy of Dermatology calls them the first-line treatment. Moisturizers contain no medicine. Prescription creams without steroids include tacrolimus, pimecrolimus, crisaborole, roflumilast, ruxolitinib and tapinarof. Check the label or ask a pharmacist which kind you have.
Is eczema cream over the counter?
Some eczema products are sold over the counter. The NHS says you can buy moisturizers from a pharmacy without a prescription, and that a pharmacist can recommend treatments for small areas of dry, itchy eczema. The American Academy of Dermatology names hydrocortisone as a non-prescription steroid cream and says even it can cause side effects. The NHS says most steroid medicines must be prescribed.
Is eczema cream supposed to burn?
Some eczema creams sting at first. The American Academy of Dermatology says burning and stinging are the most common side effects of tacrolimus and pimecrolimus, and that they tend to disappear as the skin heals. The NHS says a moisturizer that causes burning or stinging that does not settle after a few days may be reacting to an ingredient, and to talk to a doctor, nurse or pharmacist.
Can eczema cream make it worse?
An eczema cream can sometimes make skin worse. The NHS says moisturizers can cause stinging, blocked hair follicles or rashes on the face, and that aqueous cream can irritate the skin and make eczema worse. The American Academy of Dermatology lists a rash, often from contact dermatitis, among possible side effects of steroid creams. Ask your doctor before stopping any prescribed treatment.
What should you not put on eczema?
The NHS says not to use aqueous cream on eczema, because it can irritate the skin. The American Academy of Dermatology advises fragrance-free products and says products labeled unscented can still contain a covered-up fragrance. MedlinePlus advises avoiding products with alcohol, scents or dyes, and irritants such as wool and lanolin. NICE warns that some herbal eczema products for children contain added steroids.
Should you cover eczema?
Cover eczema only when a doctor recommends it. The American Academy of Dermatology says dermatologists occasionally recommend wet wrap therapy, in which treated skin is wrapped in wet bandages or damp pajamas, and that the routine is planned for each person. The AAD's page for parents says not to cover skin treated with a steroid cream with a bandage or plastic wrap unless the dermatologist says to.
Is eczema treatment effective?
Eczema treatment controls symptoms for most people. The American Academy of Dermatology says that by sticking to a treatment plan, most people can ease symptoms and reduce flare-ups, and that it sometimes takes trying a few medicines or light treatments to find the one that works best. NIAMS advises using treatments as directed and following up with your doctor regularly to make sure the plan is working.
What newer eczema treatments has the FDA approved?
The American Academy of Dermatology says the FDA approved the first medicine that works throughout the body for eczema in 2017. Its list now includes injected medicines such as dupilumab, tralokinumab, lebrikizumab and nemolizumab, and pills such as abrocitinib and upadacitinib, for moderate to severe eczema. Newer creams include roflumilast, ruxolitinib and tapinarof. A dermatologist decides whether any of them fit.
What is wet wrap therapy?
Wet wrap therapy is a treatment in which moisturizer or medicine goes on the skin, the skin is wrapped in wet bandages or damp pajamas, and a dry layer goes on top. The American Academy of Dermatology says it helps the skin absorb medicine, keeps it hydrated and protects it from scratching. NIAMS says to use wet wraps only after speaking with your doctor.
Sources
- Eczema types: Atopic dermatitis diagnosis and treatment (American Academy of Dermatology)
- Atopic eczema (NHS)
- Atopic Dermatitis: Diagnosis, Treatment, and Steps to Take (National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH))
- Guidelines of care for the management of atopic dermatitis in adults with topical therapies (Journal of the American Academy of Dermatology, PubMed record (PMID 36641009))
- Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies (Journal of the American Academy of Dermatology, PubMed record (PMID 37943240))
- Steroids (NHS)
- American Academy of Dermatology issues updated guidelines for the management of atopic dermatitis in adults with topical therapies (American Academy of Dermatology)
- Eczema treatment: Corticosteroids applied to the skin (American Academy of Dermatology)
- Emollients (NHS)
- Atopic dermatitis (MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine)
- Atopic eczema in under 12s: diagnosis and management (CG57) (National Institute for Health and Care Excellence)
Copies a ready-to-post summary, then opens LinkedIn.
A doctor can tell you what this is.
Skin that hurts, spreads, bleeds, weeps or does not get better needs a doctor or a dermatologist. They can confirm what it is and offer treatment that needs a prescription.
Skinli gives general education about eczema and cannot diagnose eczema or any other rash. See a doctor for any rash on a baby, and get urgent care for a rash that spreads fast, blisters, weeps, crusts, feels hot or painful, or comes with a fever.