How to Treat Eczema
Gentle Skincare Products for Eczema
Gentle, Effective Skincare
No matter how severe your eczema is or what type you have, the first line of defense is a gentle, fragrance-free skincare routine. Such a routine will help prevent (or significantly reduce) inflammation while keeping skin healthier and its protective barrier intact.  Improving the skin’s outer structure by providing it with antioxidants, ingredients that improve the skin’s barrier, anti-irritants, and emollients can have amazing results for most forms of eczema. In fact, it’s been theorized that eczema makes compromised skin more susceptible to oxidative damage, which in turn makes topical application of antioxidants even more important! 
Many Paula's Choice Skincare products are well suited to the needs of those dealing with eczema due to their inclusion of antioxidants and barrier repair ingredients. Most, if not all Paula’s Choice formulas, can be used alongside prescription or over-the-counter products used to treat this skin condition. See our article, "How to Heal Very Dry Skin" for example products + how to build a routine for your needs.
In addition to using a gentle skincare routine, avoiding things that can trigger skin reactions is also of vital importance—specifically steering clear of known irritants and prolonged contact with water. The most common to avoid are fragrances (whether natural or synthetic) as well as harsh cleansing agents. 
It also helps a great deal to reapply moisturizer within seconds of washing any part of the body, but especially your hands, because soaps and cleansers are notorious for triggering a reaction in those struggling with eczema. 
Try switching to a creamy, moisturizing body wash (fragrance-free is best) and using that throughout your home as your hand soap. It works beautifully!
The most typical (and successful) medications for eczema are prescription-strength topical steroids (hydrocortisone creams such as Eumovate, products with the active ingredient clobetasone butyrate, or experimenting with various strengths of hydrocortisone). Over-the-counter cortisone creams can be effective for very mild or transient forms of eczema, but if those fail, prescription cortisone creams can save your skin. Although there are no short-term detrimental side effects of using most strengths of cortisone cream, repeated, prolonged application of cortisone creams can cause thinning of the skin, prematurely aging it. [5,6,7]
So should you be afraid to use cortisone cream when you need it? No! When you use cortisone cream the right way it can absolutely help reduce the cascade of chronic inflammation and itching caused by eczema. Get the full scoop on how to treat eczema with cortisone cream via our article, "Hydrocortisone Cream for Eczema: Why (and How) You Should Use It".
In severe cases of eczema, when topical steroids have failed to produce any relief, oral steroids may be prescribed, but only under a doctor’s scrutiny due to the serious side effects associated with this type of medication. 
In 2000 and 2001, Protopic (active ingredient tacrolimus) and Elidel (pimecrolimus) were approved by the FDA as new topical drugs for the treatment of eczema. Not cortisones or steroids, these immunomodulators can regulate the skin’s immune response, which plays a pivotal role in treating what is thought to be the root cause of eczema. 
Also, the topical immunomodulators (pimecrolimus and tacrolimus) don’t present the risk of skin thinning that is sometimes associated with improper use of topical corticosteroids.
Regrettably, in March 2005, the FDA announced a public health advisory for Elidel (pimecrolimus) Cream and Protopic (tacrolimus) Ointment “to inform healthcare providers and patients about a potential cancer risk from use of Elidel (pimecrolimus) and Protopic (tacrolimus)…” This risk is uncertain, and more recent studies have refuted it, but the FDA’s precautions still advise that Elidel and Protopic should be used only as labeled, for patients who have failed treatment with other therapies. 
Research has shown that exposing skin to controlled wavelengths of UVA or UVB light can help reduce the symptoms of chronic eczema. Under medical supervision, the use of specially designed bulbs can allow affected parts of the body to be exposed to the specific light source. More severe or chronic eczema can be treated with UVA light in combination with a prescription medication called psoralen. Psoralen can be administered either orally or topically, increasing the skin’s sensitivity to light.  This treatment is known by the acronym PUVA (Psoralen + UVA light) and is administered more often to adults than to infants or children with eczema.
Phototherapy treatments are complicated and expensive. They are administered several times per week over a span of one week to several months at a doctor’s office. As you might have guessed, the risk of accelerated aging of the skin and increased risk of skin cancer from UV radiation therapy can be the same as for sunbathing, so this isn’t an optimal way to treat eczema, as it just replaces one problem (eczema) with another (UV damage). 
Evening primrose oil and borage oil contain gamma linolenic acid, a fatty acid that may play a part in general skin health and that has gained a reputation for reducing the occurrence of eczema when applied topically. Several studies, however, have shown that not to be the case. 
Nonetheless, if you’re interested in alternative treatments for eczema, this is one you can try with very little risk of adverse effects—so we say go for it. Other non-fragrant plant oils, like safflower or jojoba, may also be worth experimenting with, and you can add a few drops of these to your regular body moisturizer, hand cream, or facial moisturizer.
There’s also some research pointing to dietary considerations as a source of reactions—but primarily in children with atopic dermatitis. Alongside a solid skincare routine and working with your physician, it’s worth experimenting to see if eliminating certain food groups, such as dairy, gluten, processed foods, or nuts, can decrease the severity and/or frequency of eczema outbreaks. 
It can help to keep a food journal for several weeks, noting what you ate and, in that same period of time, whether your eczema improved, stayed the same, or worsened. Eventually you may see a pattern of which dietary choices help or seem to make eczema symptoms worse.
If you’re looking for an alternative treatment for atopic dermatitis, an interesting (but limited) study demonstrated that two-thirds of the patients with this form of eczema improved after a month of drinking a liter of oolong tea daily. 
According to the study, "118 patients … were asked to maintain their dermatological treatment. However, they were also instructed to drink oolong tea made from a 10-gram teabag placed in 1000 milliliters of boiling water and steeped for 5 minutes. After 1 month of treatment 74 (63%) of the 118 patients showed marked to moderate improvement of their condition. A good response to treatment was still observed in 64 patients (54%) at 6 months." 
The study concluded that "The therapeutic efficacy of oolong tea may well be the result of the anti-allergic properties of tea polyphenols." While the study didn't look at the effect of tea drinking if the topical treatments were stopped, the patients did receive some benefit. 
So perhaps by combining topical treatments (moisturizers loaded with anti-inflammatory ingredients and possibly cortisone cream) with some oolong tea, the benefits may add up so those with eczema can breathe a sigh of relief. We haven’t seen additional research to support whether or not oolong tea may be beneficial, but it’s worth experimenting with for those who feel they have tried everything to manage their eczema symptoms.
With any of these treatment options, we always recommend consulting with your physician first.
We’ll close with this bit of encouraging news: Many young people diagnosed with eczema eventually, for the most part, outgrow it! To learn more about what causes eczema and the different types, see our article, "What Causes Eczema and What Type Do I Have?"
The Best Skin of Your Life Starts Here: The same type of in-depth scientific research used to create this article is also used to formulate Paula’s Choice Skincare products. You’ll find products for all skin types and a range of concerns, from acne and sensitive skin to wrinkles, pores, and sun damage. With Paula’s Choice Skincare, you can get (and keep) the best skin of your life! See Paula's Choice Products for Eczema.
- Cheong W. Gentle cleansing and moisturizing for patients with atopic dermatitis and sensitive skin. Am J Clin Dermatol. 2009;10(S1):13-7
- Sivaranjani N, Rao S, Rajeev G. Role of reactive oxygen species and antioxidants in atopic dermatitis. J Clin Diagn Res. 2013;7(12):2683-5.
- Walling HW, Swick BL. Update on the management of chronic eczema: new approaches and emerging treatment options. Clin Cosmet Investig Dermatol. 2010; 3: 99–117.
- Williams C, Wilkinson S, McShane P, Lewis J, Pennington D, Pierce S, Fernandez C. A double-blind; randomized study to assess the effectiveness of different moisturizers in preventing dermatitis induced by hand washing to simulate healthcare use. Br J Dermatol. 2010;162(5):1088-92.
- Chong M, Fonacier L. Treatment of Eczema: Corticosteroids and Beyond. Clin Rev Allergy Immunol. [Internet]. 2015 Apr [cited 2015 July]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25869743.
- Watson W, Sandeep K. Atopic dermatitis. Allergy Asthma Clin Immunol. 2011;7(S1):S4.
- Zoller N, Kippenberger S, Thaci D, Mewes K, Spiegel M, Sattler A, Schultz M, Bereiter-Hahn J, Kaufmann R, A. B. Evaluation of beneficial and adverse effects of glucocorticoids on a newly developed full-thickness skin model. Toxicol In Vitro. 2008;22(3):747-59.
- Nguyen T, Zuniga R. Skin conditions: new drugs for managing skin disorders. FP Essent. 2013;407:11-6.
- Ando T, Matsumoto K, Namiranian S, Yamashita H, Glatthorn H, Kimura M, Dolan B, Lee J, Galli S, Kawakami Y, et al. Mast cells are required for full expression of allergen/SEBinduced skin inflammation. J Invest Dermatol. 2013;133(12):2695-705.
- U.S. Food and Drug Administration. Public Health Advisory for Elidel and Protopic (3/10/2005). [Internet]. 2005 [cited 2015 July]. Available from: http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm153956.htm.
- Dogra S, Mahajan R. Phototherapy for atopic dermatitis. Indian J Dermatol Venereol Leprol. 2015;81(1):10-5.
- Adisen E, Karaca F, Oztas M, Gurer M. Efficacy of local psoralen ultraviolet A treatments in psoriasis; vitiligo and eczema. Clin Exp Dermatol. 2008;33(3):344-5.
- Archier E, Devaux S, Castela E, Gallini A, Aubin F, LeMaitre M, Aractingi S, Bachelez H, Cribier B, Joly P, et al. Carcinogenic risks of psoralen UV-A therapy and narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2012;26(3):22-31.
- Williams H. Evening primrose oil for atopic dermatitis. BMJ. 2003;327(7428):1358-1359.
- Greenhawt M. The role of food allergy in atopic dermatitis. Allergy Asthma Proc. 2010;31(5):392-7.
- Uehara M, Sugiura H, Sakurai K. A trial of oolong tea in the management of recalcitrant atopic dermatitis. Arch Dermatol. 2001 Jan;137(1):42-3.