Creams and treatments for eczema

Eczema is a group of conditions that are associated with dry, itchy, inflamed, and/or irritated skin.

It can occur anywhere on the body including the face, scalp, and eyelids.¹ Although this disease can seem challenging to manage, there are many treatment options on the market.

Over-the-counter eczema treatment

There are multiple treatments available over the counter to help improve eczema. Options include ointments, creams, and lotions. Ointments are the thickest and most hydrating of these options. Some patients prefer creams as they are less thick and "greasy" compared to ointments. However, creams usually have more preservatives than ointments, which means they are more likely to be irritating to the skin. Lotions are the thinnest option and usually need to be applied multiple times throughout the day.² In addition, various bath soaks can be used to provide relief for eczema symptoms.

• Topical steroids³
• An example of an over-the-counter topical steroid is hydrocortisone.
• These agents work to diminish redness, reduce inflammation, and subside itchiness.
• It is important to wash hands thoroughly after application to prevent unnecessary distribution of product.
• For best results, apply to affected area before applying a moisturizer. Avoid applying to sensitive areas such as around the eyes or genitalia. Do not use for more than seven days without advising a doctor.
• Side effects that may occur from long-term use of steroid creams are skin thinning, skin thickening or darkening of the skin.
• Do not use in children under 2 years of age, unless advised by a doctor.
• Moisturizers
• Moisturizers help lessen eczema symptoms by providing hydration and protecting the skin's barrier. Studies have shown that when people increased their moisturizer use, it decreased the amount of steroid cream used and decreases the severity of eczema symptoms.⁴
• When choosing a moisturizer, it is important to choose one that is fragrance-free and has the least amount of preservatives. Common preservatives seen in cosmetics include methylparaben and benzoic acid.⁵ These extra ingredients can cause irritation to the skin.
• Common ingredients included in moisturizers for eczema relief include glycyrrhetinic acid, urea, glycerol, oats, and coal tar.⁴
• Bath treatments⁶
• Colloidal oatmeal
• Adding colloidal oatmeal to a bath can be used to relieve itching related to eczema.
• Baking soda
• Adding ¼ cup of baking soda to a bath can be soothing and help relieve itching.
• Bleach or vinegar
• Bleach baths improve eczema by decreasing the amount of bacteria on the skin.
• Add a teaspoon of bleach for every gallon of water in the tub. For areas of the skin that may not be submerged in the water (head and neck), bleach water can be applied with a wash cloth.
• Adding one cup of vinegar to the tub may provide some benefit by killing bacteria on the skin.

Eczema treatment for the face⁷

Face eczema can be frustrating or embarrassing for a person, as it can be hard to disguise or cover up. However, since this skin is very delicate and sensitive, it is important to be gentle when treating eczema on the face. When washing the face, be sure to avoid harsh cleansers and moisturizers with fragrances and lots of preservatives. Instead of rubbing, pat the skin dry softly with a towel. Exfoliating scrubs or toners may seem like an effective way to get rid of patchiness or texture. However, these products can actually be drying and irritating to the skin, so it is best to avoid use. Makeup can also aggravate the skin, especially for people with eczema; mineral makeup is a less irritating option.

Scalp⁸

Scalp eczema can be triggered by stress, hormones, harsh shampoos or cold/dry weather. The most common symptom seen in these patients is dandruff. Alternating your regular hair care with a medicated shampoo can help treat this condition. Common ingredients to look for in medicated shampoo include ketoconazole, selenium sulfide, coal tar, and zinc pyrithione.

Eyelids⁷

The thinnest skin on our bodies is skin on the eyelids. Therefore, when eczema presents in this area, it can be very sensitive and painful. As mentioned earlier, washing and moisturizing the skin with appropriate products can help provide relief to the area. If symptoms persist, consider talking to a physician for further consultation.

Treatment of eczema in babies

Approximately 9.6 million children in the US have eczema.⁹ As this disease is accompanied with bothersome symptoms such as itchiness or inflammation, it can be quite irritating for an infant. However, there are multiple ways to help treat your baby's condition.

When eczema presents, it is important to protect the skin's barrier. This can be done by taking short baths with lukewarm water on a regular basis and moisturizing the entire body at least once daily. When bathing, it is important to use a fragrance-free, mild soap to prevent irritation. Adding bath treatments¹⁰, such as colloidal oatmeal baths, may also provide some relief. Similarly, to avoid irritation, the moisturizer used should be fragrance-free and have the least amount of preservatives.

Natural Eczema Treatment

If you are interested in using natural remedies to help target your eczema, there are options available. For example, coconut oil is commonly used for patients with this condition. Not only does it provide hydration and protection as a moisturizer, but it also lowers the risk of infection by decreasing the amount of bacteria on the skin.¹¹ Another oil that may provide relief is sunflower oil as it boosts the skin’s barrier. If relief of itchiness is needed, a medicinal plant called cardiospermum is commonly used. In addition to reducing itch, it has anti-inflammatory effects.¹² Cardiospermum is sold over the counter in the form of a cream. It is important to note that these options are not FDA approved for the use of eczema relief.

Published on April 30, 2020

References:

1. What is Eczema? National Eczema Association. https://nationaleczema.org/eczema/ Accessed: January 28, 2020.

2. Controlling Eczema by Moisturizing. National Eczema Association. https://nationaleczema.org/eczema/treatment/moisturizing/ Accessed: January 28, 2020.

3. Prescription Topical Treatments. National Eczema Association. https://nationaleczema.org/eczema/treatment/topicals/ Accessed: January 28, 2020.

4. Van Zuuren EJ, Fedorowicz Z, Christensen R, Lavrijsen A, Arents BWM. Emollients and Moisturizers for Eczema. Cochrane Database Syst Rev. 2017;2(2):CD012119. Published 2017 Feb 6. doi:10.1002/14651858.CD012119.pub2.

5. Five Most Common Types of Preservatives Used in Cosmetics. Microchem Laboratory. https://microchemlab.com/information/five-most-common-types-preservatives-used-cosmetics. Accessed: January 28, 2020.

6. Eczema and Bathing. National Eczema Association. https://nationaleczema.org/eczema/treatment/bathing. Accessed: January 28, 2020.

7. Facial Eczema Factsheet. National Eczema Society. file:///C:/Users/tabrah3c/Downloads/Facial%20eczema%20(Sep%2019)%20(1).pdf. Accessed: January 28, 2020.

8. Seborrheic Dermatitis. National Eczema Society. https://nationaleczema.org/eczema/types-of-eczema/seborrheic-dermatitis. Accessed: January 28, 2020.

9. Eczema Facts. National Eczema Society. https://nationaleczema.org/research/eczema-facts. Accessed: January 28, 2020.

10. Paller A. Should I Add Anything to the Bath of a Child who has Eczema? American Academy of Dermatology Association. https://www.aad.org/public/diseases/eczema/childhood/itch-relief/add-bath. Accessed: January 28, 2020.

11. Verallo-Rowell VM, Dillague KM, Syah-Tjundawan BS. Novel Antibacterial and Emollient Effects of Coconut and Virgin Olive Oils in Adult Atopic Dermatitis. Dermatitis. 2008; 19(6): 308-315. doi: 10.2310/6620.2008.08052.

12. Sheeba MS, Asha VV. Cardiospermum Halicacabum Ethanol Extract Inhibits LPS Induced COX-2, TNF-alpha and iNOS Expression, which is Mediated by NF-kappaB Regulation in RAW264.7 Cells J. Ethnopharmacol. 2009; 124(1): 39-44. doi: 10.1016/j.jep.2009.04.020.