You may need to switch treatments for severe eczema (atopic dermatitis) if your symptoms often disrupt your daily activities or are getting worse.

You apply moisturizer around the clock and avoid allergens. Yet you haven’t experienced relief from the itching, scaling, and dryness of eczema as you’d hoped.

This may be a sign it’s time to reevaluate your treatments. While it’s true there’s no cure for eczema right now, many treatments are available to help manage symptoms.

Eczema treatment isn’t a one-size-fits-all approach. It’s important to know when your treatment isn’t working, even if it has worked well in the past.

Here are some signs it’s time to contact your dermatologist or change your home regimen.

When you’ve been a little lax with your treatment regimen, you can expect to have some periods of dry, itchy skin. Sticking with your current regimen can help ease some symptoms.

Sometimes, eczema treatment may work for a while, but your eczema may stop responding to it as well. In this case, you may need another treatment.

You may need to talk with your dermatologist if you have certain symptoms despite treatment. These can include:

  • itchiness or symptoms that disrupt your sleep or daily activities most days of the week
  • new symptoms associated with your eczema
  • less time between flare-ups
  • worsening symptoms
  • eczema appearing in new locations
  • blisters, sores, fever, or other symptoms that suggest a staph infection

If you feel your dermatologist isn’t managing your eczema as well as they could, talk with them. You could also look for a new dermatologist who specializes in eczema treatments.

Innovations and research on treatments for eczema are ongoing, which means there are a growing number of treatments available.

Sometimes, finding a new treatment can be a matter of trying different options. It can also mean trying combinations of treatments to find the ones that are the most effective.

Emollients (moisturizers)

People with eczema typically need to apply moisturizers at least twice a day. Depending on your occupation and eczema type, you may need to apply moisturizers more often.

If you’re currently using a lotion as a moisturizer, consider upgrading to a cream or ointment. The thicker consistency means there’s more oil that holds moisture in it. The moisturizer should be free of fragrances and dyes.


When choosing a moisturizer for eczema management, what ingredients should I avoid?



When people with eczema choose moisturizers, it’s important that they avoid products containing ingredients that trigger inflammation and eczema flare-ups.

Known culprits include fragrances, essential oils, urea, lanolin, retinoids, cocamidopropyl betaine, ethanol, and propylene glycol. Many of these ingredients are commonly added to moisturizers.

While they may smell nice, fragrances are often a trigger for eczema. They’re common allergens, causing sensitive skin to react. Essential oils are just as likely as synthetic fragrances to cause allergies and can also be found in moisturizers.

Lanolin has softening qualities, making it a very common additive to creams. But it’s more likely to cause problems for people with eczema when compared with creams that don’t contain lanolin.

Propylene glycol can be found in many skin care products, including moisturizers, and is a leading allergen. For people with eczema, it has been noted to cause skin issues even if there are no allergies to it.

It’s helpful to read your labels and know what your triggers are.

Cynthia Cobb, DNP, APRN, WHNP-BC, FAANPAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Topical steroids

Doctors may recommend topical steroids alone or in combination with light therapy. These medications help reduce inflammatory skin reactions that can lead to eczema symptoms. But using topical steroids frequently can make them less effective over time.

Topical immunomodulators

Pimecrolimus (Elidel) and tacrolimus (Protopic) are two immunomodulatory medications applied to the skin. They interfere with inflammatory compounds and can be especially helpful in treating eczema on the face, genitals, and areas of folded skin.

However, they can have more side effects than topical corticosteroids.

Wet wraps

Wet wrap bandages are a special wound care approach to treating severe eczema.

Doctors recommend only using this treatment under the supervision of a trained medical professional, such as a doctor or nurse. It may require admission to a hospital.


Antihistamines can lower the amount of histamine in your body. Histamine causes your skin to itch. Antihistamines are usually more effective in treating eczema in children, but they may also be effective in reducing symptoms in adults.


Phototherapy involves exposing the skin to UV light to help ease symptoms. Medical professionals perform phototherapy in a medical setting, so it may require frequent appointments, such as several days a week for a few months.

After the symptoms go away, people undergoing phototherapy often have less frequent appointments.

Oral medications

The Food and Drug Administration (FDA) has approved many oral eczema treatments, including oral corticosteroids for short-term flare-ups and immunosuppressing medications for treating moderate to severe eczema.

Injectable medications

In March 2017, the FDA approved the use of dupilumab (Dupixent), an antibiotic that helps lower inflammation, for eczema. Doctors use this drug to help treat moderate to severe eczema.

Clinical trials for additional injectable medications are currently underway.

Behavioral counseling

Some people take part in behavioral counseling sessions to change their itching and scratching behaviors. You can also use these sessions to learn about stress reduction and management, as stress can worsen eczema symptoms in some people.

If a treatment sounds particularly promising to you, talk with a doctor. Questions you may wish to ask about treatment options include:

  • Do you think I could benefit from a different or extra medication?
  • Are there treatments you’d rule out for me due to my eczema type or health?
  • What’s a realistic treatment outlook for my particular eczema type?
  • What are some newer topical, oral, or injectable medications that could be helpful to me?

Checking in with your doctor about your eczema can ensure your treatment plan effectively treats your eczema. While eczema may not go away fully, a change in treatment may improve your quality of life.

If you’re still regularly having bothersome symptoms of eczema despite treatment, it may be time to talk with a doctor about changing your treatment plan. A doctor may recommend a change in dosage or a new medication altogether.

If you’re going to be starting a new medication, be sure to ask your doctor about possible side effects and what to look out for.

Researchers are currently exploring additional treatments for severe eczema that may help reduce flare-ups and improve your quality of life.