Moisturizing for Eczema

Moisturizing for Eczema Management

Why do people with eczema need to moisturize skin?

Moisturizers, including lotions, creams and ointments, help protect the outermost layer of skin known as the skin barrier. The skin barrier serves a dual purpose: It prevents irritants, bacteria, viruses and allergens from getting into our bodies, and it keeps moisture from getting out.

People with eczema have a damaged skin barrier, which makes their skin more sensitive to irritants and allergens. A damaged skin barrier also makes it harder for the skin to retain water, leading to chronic dry, itchy skin, which can cause eczema and other skin conditions to flare or get worse. It’s important to understand how and when to properly moisturize and which products are best to use when you have eczema.

When is the best time to use moisturizer?

Whether you have mild or severe eczema, basic eczema care includes:

Bathing with a gentle cleanser
Frequent moisturizing to lock moisture into the skin to help repair the skin barrier
Moisturizing at least once daily and applying moisturizer liberally

Key times to moisturize include:

After bathing
After washing hands
Whenever skin starts to feel itchy or dry

Why is moisturizing after bathing so important for eczema?

Bathing or showering can lead to increased water loss from the skin. Moisturizing after bathing helps retain or “lock in” the moisture in the skin and prevent water loss by strengthening the skin barrier. A strong skin barrier also helps keep out allergens and irritants, which can cause eczema symptoms to worsen. It can also help relieve dry, itchy skin, which are two of the most common eczema symptoms.

Types of Moisturizers

What are the different types of moisturizers?

Moisturizers are classified based on the amount of oil and water they contain. Look for these keywords on your moisturizer products to help you identify which one will work best for your skin’s needs:

Lotion: water + alcohol-based
Cream: water + oil-based
Ointment: oil-based

Lotions are mainly water and alcohol-based. They contain the least amount of oil, which means they are the most soluble in water. They are the lightest of the moisturizers and can be purchased over-the-counter. These are less effective than creams or ointments at moisturizing the skin. Due to the alcohol content, lotions can sometimes burn when applied.

Creams are water and oil-based and are very good at sealing in moisture. Because creams contain less oil than ointments, they are also less greasy to the touch. However, they are less effective at moisturizing very dry skin compared to ointments. Creams can be purchased over the counter, like ointments and lotions.

Skin barrier creams are moisturizing creams that are infused with lipids and ceramides, which are naturally occurring substances found in healthy skin barriers. The lipids and ceramides found in skin barrier moisturizers form a protective layer on the skin to help lock in moisture while keeping out impurities. This allows skin with eczema to heal and become more resistant to symptoms, including burning, dryness and itch. Skin barrier creams are available by prescription and over-the-counter.

Ointments have the highest oil content of all the products (followed by creams and then lotions), so they don’t generally burn when they’re applied to sensitive skin and they are very good at sealing in moisture.

Products high in oil content, such as petroleum jelly and mineral oil, are particularly good for treating eczema. But if you don’t like the way petroleum jelly, mineral oil or other ointments feel on your skin, the next best alternative is a cream. Apply healing ointments to the irritated skin as often as necessary. Ointments can be purchased over-the-counter, while medicated ointments can be prescribed by a doctor.

The best moisturizers to use on eczema skin are the ones that feel “greasy” (creams and ointments), because they contain more oil. These are very effective at keeping moisture in and irritants out. Ointments and emollients, such as petroleum jelly, are moisturizers that sit on top of the skin and don’t easily dissolve in water. These can be especially helpful for sealing in moisture, and can even be applied after a thinner moisturizer, like a lotion or cream.

For people with eczema, it’s a good idea to keep moisturizer near every sink in your home and always carry a small tube with you so that you can reapply it throughout the day.

The first time you use a new product, apply a small amount (about the size of a pea) to the pulse of your wrist or the crook of your elbow. Watch for any allergic reaction, such as redness, a rash, any form of breakouts on the skin, itchiness, pain or flaking. It’s also a good idea to consult with your doctor before trying a new product if you’re unsure about how it may affect your eczema.

What is the best moisturizer for people with eczema?

Not all moisturizers are created equal. In fact, there are many moisturizing products with ingredients that aren’t good at helping control your eczema and may even make it flare. Be sure to choose moisturizers that are fragrance-free. If you know you are allergic or sensitive to a particular ingredient, check a product’s label before you buy it.

In general, look for moisturizing lotions with ingredients that can help soothe eczema-prone skin, including:

Oat or shea butter
Aloe
Glycerin
Petrolatum
Vitamin E
Niacinamide

The National Eczema Association (NEA) created the Seal of Acceptance™ to help people with eczema identify eczema-friendly products. The Seal is a branded label displayed on personal care and household products that have been vetted by NEA. Only products that have applied for and pass the review process are awarded the Seal. As part of the review process, NEA identified a list of specific ingredients in its Seal Ecz-clusion list that are known irritants and allergens. Any ingredients on this Ecz-clusion list cannot be included in a product that applies for the Seal.

Before you use or purchase a skincare product, check the product label to see its ingredients. If any of the ingredients on the Ecz-clusion list are included, it’s best to avoid that product. However, not all products with the Seal may be suitable for everyone with eczema or for your individual skincare needs. Please speak with a board-certified dermatologist with any questions about personal care products.

Browse eczema-friendly moisturizers and other household products with the National Eczema Association’s Seal of Acceptance™

Tips to Stick to Your Eczema Treatment Routine

Dr. Harper Price, a pediatric dermatologist at Phoenix Children’s, provides actionable tips to help people with eczema and their caregivers stick to their eczema care routines. Topics include how to set reminders for treatments, positive reinforcement and more.

Tips for How to Moisturize

Is there a specific order or best practice for moisturizing if you have eczema?

If you use a prescription topical medication, apply it as directed before you moisturize.
Apply a thick layer of moisturizer all over your skin within three minutes of bathing or showering to “lock in” moisture and protect the skin barrier. Do not apply moisturizer over the areas with topical medication.
To prevent contamination with bacteria and other irritants in your moisturizer container, consider using a clean tool like a spatula to scoop moisturizer out instead of using your hands. Then use your hands to apply the moisturizer.
Apply moisturizer to your body using your palm in downward strokes. Avoid rubbing in the moisturizer by stroking up and down or in circles. The friction may cause further irritation.

Are there any special moisturizing methods to help eczema?

Eczema causes skin to be very dry and itchy. Two ways to help these symptoms are:

The soak and seal method
Wet wrap therapy

Learn more about these methods below.

What is the soak and seal method?

Many healthcare providers recommend the soak and seal method to combat dry skin and reduce eczema flares. This method can be done several times a week and involves three steps: bathing, applying topical medications to affected areas and moisturizing the rest of the body.

Soak and seal directions:

Fill a bathtub with lukewarm water. Soak for 5 to 10 minutes.
Use a gentle no-fragrance cleanser. Do not scrub skin.
Rinse off with lukewarm water.
Pat the skin lightly with a towel. Leave skin slightly damp.
Apply prescription topical medication as directed to affected areas of the skin.
Within three minutes, liberally apply moisturizer to the rest of your body. Do not apply moisturizer over the areas with topical medication.
Wait a few minutes for both to absorb into the skin, then get dressed or apply wet wraps.

What is wet wrap therapy?

Wet wrap therapy is a good option for when you’re having a particularly intense eczema flare with severe itch or pain. It begins with the soak and seal method and then adds the use of wet dressings on affected areas of the skin for long periods of time. Typically, for the wet layer you can use pajamas and onesies for larger areas of skin. For smaller areas, you can use socks, gloves and gauze. Wet wraps are best done in the evening before bed. This therapy can help rehydrate and calm the skin, while helping topical medications work better.