Ointments such as petroleum jelly are best unless they’re too thick and cause discomfort. Creams may be fine for moderately dry skin or in hot, humid weather. Apply them to wet skin, immediately after bathing. Lotions are not rich enough and often have a net drying effect on AD skin. The NEA Seal of Acceptance™ Product Directory provides suggestions for appropriate moisturizers for eczema.
Often called topical (“applied to the skin”) steroids, these are cortisone-like medications used in creams or ointments that your doctor may prescribe (e.g. hydrocortisone, mometasone, desonide, triamcinolone). They are not the same as the anabolic steroids some athletes misuse.
Corticosteroids are very helpful. Often they are the only treatment that can calm the inflamed skin. Use of steroid ointments and creams requires good judgment and careful supervision. They come in many strengths from mild to super-potent. Hydrocortisone, a very mild steroid, is quite safe. The more potent ones can cause thinned skin, stretch marks and even growth retardation or suppression of the adrenal gland if used too many days in the same areas of the body. Parents should monitor the child’s use. Ask the doctor about potency and side effects of prescribed corticosteroid medicines and follow the product insert instructions carefully.
This family of topical medications has been available for the past 12 years. TCIs work to inhibit the skin’s inflammatory response (which is what causes the redness and also contributes to itching). At this time there are two FDA approved non-steroid drugs: tacrolimus and pimecrolimus. TCIs are not steroids and do not cause thinning of the skin but they can suppress the immune system in the skin so that the use of sun protection for the children receiving this therapy is recommended.
For children less than two years of age these medications are only used off-label and as always, with any medication, they should be used with careful supervision of a physician. Tacrolimus and pimecrolimus both currently have a “black box” warning, which is a precautionary statement given to the medication by the Food and Drug Administration.
Tar creams or bath emulsions can be helpful for mild inflammation.
Oral or topical antibiotics reduce the surface bacterial infections that may accompany flares of AD.
Often prescribed to reduce itching, these medicines may cause drowsiness but seem to help some children, largely due to their sleep-inducing side effects.