Eczema (atopic dermatitis) is a common, long-term skin condition that causes dry, itchy, red and inflamed skin that tends to flare and then settle. It most often starts in childhood and frequently improves with age, but it can persist into adulthood or return; it cannot be cured, so the goal is to control symptoms and reduce flares rather than eliminate the condition. The foundation of treatment is daily moisturizing with emollients combined with anti-inflammatory creams during flares, and a few mild options are available over the counter, while stronger and specialist treatments require a doctor.
Available without a prescription — follow each label.
Emollients (moisturizers) — e.g. petroleum jelly, ceramide-containing barrier creams, fragrance-free creams/ointments Vaseline, CeraVe, Eucerin, Aquaphor, Cetaphil Skin moisturizer / emollient (non-medicated) | The cornerstone of eczema care and the first thing to use. Apply generously at least twice daily to the whole body, even when skin looks clear, and use as a soap substitute. Ointments and ceramide barrier creams are best for very dry skin; pick fragrance-, dye- and alcohol-free products. NHS specifically advises against aqueous cream, which can irritate eczema. Safe for all ages and to use long-term. |
Hydrocortisone 1% cream/ointment Cortizone-10, Aveeno 1% Hydrocortisone, store brands Low-potency topical corticosteroid | A mild OTC steroid for short-term relief of itching and inflammation during a flare. Per the FDA OTC Drug Facts label, apply a thin layer to the affected area up to 3–4 times daily for the shortest time needed; do not use on the face or large/broken areas without advice. Do not use in children under 2 years without asking a doctor, and stop and see a doctor if it does not improve within about 7 days. Use alongside, not instead of, emollients. |
Oral antihistamines (e.g. cetirizine, loratadine, diphenhydramine) Zyrtec, Claritin, Benadryl H1 antihistamine | May be used to take the edge off itch, and a sedating type at night can help if itching disrupts sleep. Evidence that antihistamines improve the eczema itself is limited — they treat the itch, not the underlying skin inflammation, so they are an add-on rather than a main treatment. Follow the Drug Facts label; sedating types cause drowsiness. |
A doctor may prescribe these — not for self-treatment.
Moderate-to-potent topical corticosteroids (e.g. betamethasone, mometasone, clobetasol) Betnovate, Elocon, Temovate (clinician-prescribed) Mid- to high-potency topical corticosteroid | For flares that don't settle with emollients and OTC hydrocortisone, a clinician may prescribe a stronger steroid matched to the severity and body area. These are prescribed by strength and amount and should only be applied to active eczema for a defined period — do not start or source these yourself, as the wrong potency on the face or skin folds can thin the skin. |
Topical calcineurin inhibitors (tacrolimus, pimecrolimus) Protopic, Elidel Topical calcineurin inhibitor (steroid-sparing anti-inflammatory) | A non-steroid cream/ointment a doctor may prescribe for sensitive areas like the face and eyelids or when steroids are being overused. Generally for ages 2 and up, and your prescriber should discuss the labeled cautions. Prescription-only — use only under medical supervision. |
Antibiotics or antivirals for infected eczema Various (clinician-prescribed) Topical/oral antibiotic or antiviral | Eczema that is weeping, crusted, pustular or rapidly spreading may be infected (bacterial, or eczema herpeticum from the cold-sore virus) and can need antibiotics or antivirals. This requires diagnosis by a clinician — never self-treat a suspected skin infection with leftover or borrowed antibiotics. |
Start with the basics that apply to everyone: moisturize generously with a fragrance-free emollient at least twice a day, use it as a soap substitute, and identify and avoid triggers (soaps and detergents, rough fabrics like wool, heat and sweating, stress, and known allergens). For mild flares with itch and redness, OTC hydrocortisone 1% used short-term on top of emollients is reasonable for adults and children over 2; a pharmacist can advise on mild cases. Use an antihistamine only as an add-on for itch or sleep — be honest that it won't fix the underlying eczema. Keep nails short, avoid scratching (gentle rubbing or cool compresses help), and for infants anti-scratch mittens can reduce damage. If a flare is severe, widespread, on the face, or not improving after about a week of OTC steroid, see a doctor for a properly matched prescription rather than escalating OTC products on your own. Evidence is strongest for emollients and topical steroids; many add-on remedies have limited proof, so be skeptical of products promising a cure.
See a GP (routine) if: your eczema is not controlled with moisturizers and OTC hydrocortisone, it is affecting sleep or daily life, it covers large areas or the face, or you are unsure of the diagnosis. Seek urgent care the same day if the skin shows signs of infection — it becomes blistered, crusty, weeping fluid, or has pus-filled spots, or there is spreading redness, swelling, warmth, or fever. Get urgent medical help for possible eczema herpeticum: many small, painful, fluid-filled blisters or rapidly worsening eczema, sometimes with fever and feeling generally unwell — this is a medical emergency. Children under 2, and anyone needing more than short-term OTC steroid, should be assessed by a clinician.
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.
Specialist systemic & advanced treatments (oral steroids short-term, immunosuppressants, biologics, JAK inhibitors, phototherapy) e.g. Dupixent (dupilumab), among others — specialist-prescribed Systemic immunosuppressants / biologics / targeted agents / UV phototherapy |
| Reserved for moderate-to-severe eczema that fails topical treatment, and started and monitored by a dermatologist after weighing benefits and risks. These are not self-start medicines and require ongoing specialist oversight. |