How to Treat Eczema: Your Guide to OTC Remedies, Prescription Creams, Pills, and More

Eczema is a common skin condition that affects many people of all ages. The itchy, irritating, and even painful symptoms can be annoying. But eczema can also affect your ability to do the things you love. 

There are many treatment options for eczema, from over-the-counter (OTC) lotions and creams to prescription-strength treatments and phototherapy (light therapy). 

For most people, eczema treatment takes a layered approach, starting with hydration and working up to stronger treatments as needed. It all depends on your unique eczema symptoms, and what works for you. So let’s walk through eczema treatments, from moisturizers and creams all the way up to biologics and immunosuppressants.  

Emollients

For anyone with eczema, the first step to keeping flares at bay is to keep your skin moisturized. No matter which type of eczema you have, dry skin can lead to itchiness and an eczema flare. So it helps to have a dual approach. First, avoid anything that dries or irritates the skin. Second,  find a good emollient. An emollient is a substance that forms a film on the skin and traps in moisture. Moisturizers can contain different types of emollients. 

Choosing the right emollient and moisturizer

Your emollient should be free of fragrance and dye. Many good emollient creams are available OTC at the pharmacy or supermarket. There’s no evidence that these work any less well for eczema than prescription emollients.

Popular brands of emollients include: 

• Eucerin

• Cetaphil

• Aquaphor

• CeraVe

• Lubriderm

• Vaseline

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Emollients come in different formats. You’ll likely need one of each, for different uses. 

Steroid creams

No matter how diligent you are about keeping up with barrier creams, at some point you’re likely to have an eczema flare. This is when you’ll most likely want to reach for topical steroid creams.

Topical steroids come in many strengths and as lotions, creams, and ointments. Steroids will calm the inflammation from your eczema flare and let your skin heal. But if they’re too strong or used for too long, they can cause permanent side effects, like skin thinning and discoloration. That’s why you want to stick with the lowest possible dose for the shortest time needed. The recommendation is to use topical steroids no more than 2 to 4 times per day, for no more than 1 to 2 weeks. 

Low-potency steroid creams

For mild flares, a low-strength steroid is usually enough: 

• Hydrocortisone 1% is available OTC.

• Desonide 0.05% and hydrocortisone 2.5% are prescription-only. 

Medium- to high-potency topical steroids

If low-strength steroids don’t heal a flare, or you have certain types of eczema (like nummular or dyshidrotic eczema), you may need a higher-strength steroid. Popular options include:

• Fluocinolone 0.025% cream or ointment

• Triamcinolone 0.1%

• Betamethasone dipropionate 0.05%

Other prescription creams for moderate-to-severe eczema

If you have moderate-to-severe eczema, steroids and emollients may only take you so far. There are many new prescription eczema creams that can treat eczema flares, and reduce the need for steroid creams.  

Topical calcineurin inhibitors

Calcineurin inhibitors are creams that don’t contain steroids, so they won’t cause skin thinning. They’re a popular option to treat mild-to-moderate flares on sensitive areas like the face, eyelids, and genitals. Studies show that they work as well as medium-strength steroids to stop eczema flares.

Calcineurin inhibitors work by blocking the immune system’s attack on the skin. Popular medications in this class include tacrolimus 0.1% (Protopic) and pimecrolimus 1% (Elidel). They’re FDA approved for anyone over 2 years old but have been used off label in younger children. 

Phosphodiesterase 4 (PDE4) inhibitors

Crisaborole 2% (Eucrisa) is a PDE4 inhibitor that’s FDA approved to treat mild-to-moderate eczema in anyone over 3 months old. Crisaborole can help improve skin itchiness, redness, and thickening. 

Studies show that people who used crisaborole twice a day for a month had fewer eczema symptoms. In these studies, people used the medication off and on over the course of a year. Participants reported very few side effects, too. 

Aryl hydrocarbon receptor (AhR) agonists

Vtama (tapinarof) is the first AhR agonist that’s FDA approved to treat eczema. It works by lowering inflammation and improving your skin’s barrier function. 

Vtama is applied to the skin once a day, and studies show that it can start relieving itch as early as 24 hours. After the skin is cleared, some people stay free of symptoms without treatment for over 2 months. 

JAK inhibitors

JAK (Janus kinase) inhibitors are another newer class of medications that treat eczema. They are available as either pills or creams, and can improve eczema in as little as a few days. So far, three JAK inhibitors are FDA approved to treat eczema:

• Ruxolitinib (Jakafi, Opzelura) cream

• Abrocitinib (Cibinqo) pills

• Upadacitinib (Rinvoq) pills

Immunosuppressant pills

Even though the exact cause of eczema isn’t yet fully understood, research shows that the immune system plays a role in eczema flares. Immunosuppressant medications stop the immune system from attacking the skin. Some of the immunosuppressant treatments that are used for eczema symptoms are:

• Cyclosporine

• Methotrexate

• Azathioprine

• Mycophenolate

Because these medications weaken the immune system and increase the risk of developing serious infections, they’re usually reserved for people who haven’t had success with other treatment options. If you need immunosuppressant medication, you’ll need to see a dermatologist for treatment. 

Biologics

Biologics are a new class of medication used to treat eczema. They are made from living sources (like animal cells) rather than chemicals. Biologics work by blocking one or more proteins in the immune system that are overactive in eczema. Here are the biologics used to treat eczema: 

• Dupilumab (Dupixent)

• Tralokinumab (Abdry)

• Lebrikizumab (Ebglyss)

• Nemolizumab (Nemluvio)

These biologics are all given as shots, and can be used alone or with topical treatments. Common side effects include skin reactions at the injection site and eye inflammation. 

Phototherapy

Phototherapy, or light therapy, is an option for eczema treatment when topical therapies (creams) haven’t been effective. It’s also a good option when large areas of skin are involved and it’s hard to apply prescription creams. You’ll usually need to use phototherapy with other treatment options to keep your eczema under control. 

Phototherapy uses various wavelengths of ultraviolet (UV) light to help decrease skin itch and inflammation. Narrowband ultraviolet B (NB-UVB) light is the most common, but healthcare professionals may recommend other options, such as ultraviolet A (UVA). 

How to use phototherapy

You can get phototherapy at home or in your dermatologist’s office. People usually need 2 to 3 treatments per week, so this is a time-intensive option if you can’t get a unit for home use. It can take 1 to 2 months to notice improvement. After that, you may be able to reduce the frequency of your treatments, or even stop altogether once your eczema has cleared.  

Side effects of phototherapy include skin redness, drying, and itching. It’s not entirely clear yet if long-term phototherapy can increase the risk of developing skin cancer. So far, some studies show that NB-UVB treatment doesn’t seem to be associated with skin cancer. 

At-home eczema treatments

Good skin care practices and some simple at-home treatments can help you keep eczema flares at bay. Here are some tips:

• Use warm (not hot) water in the shower or bath. 

• Apply a moisturizer right after you shower or bath, while your skin is still damp. 

• Keep your fingernails cut short to prevent scratching your skin.  

• Use a humidifier at home to keep the air from getting too dry. 

• Avoid skin irritants, including soaps and products with fragrances, dyes, or preservatives. 

• Avoid wool clothing, and wear breathable fabrics, like cotton. 

Frequently asked questions

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Written by:

Meredith Grace Merkley, DO, FAAP

Dr. Merkley is a licensed, board-certified pediatrician who has over a decade of experience working in community health. She is currently a National Health Services Corp scholar, and is serving as the medical director of a school-based health clinic at a federally funded health center.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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