When you need advanced therapy for your eczema, there are some key questions about treatments, creams, and other important issues that you may wonder about severe cases of eczema. Find answers to those questions below.

Your doctor may recommend several treatments for severe cases of eczema. Some of the most common treatments include:

Photo or light therapy

The National Eczema Association states that a doctor may recommend light or phototherapy for eczema that is widespread (over the whole body) or localized (on hands, feet, or other areas).

This treatment may help to reduce inflammation. It’s often used when eczema doesn’t respond to topical medications.

Topical calcineurin inhibitors

Topical calcineurin inhibitors are immune system-altering medications used to treat mild cases or eczema in delicate areas such as on the face or genitals. They may also be prescribed in place of steroids for children. As the name suggests, they are applied to the skin as an ointment or cream that works to block a certain chemical partially responsible for the immune system’s response that causes eczema.

According to the National Eczema Society, a doctor can prescribe them to those ages 2 and up for both the treatment and prevention of eczema flares. They may help reduce inflammation and itchiness.

Wet wraps

You can use wet wraps to help alleviate severe eczema flares that cause pain and itchiness. According to the National Eczema Association, you can make wraps at home easily.

To do so, use warm water to dampen a cloth or piece of clothing. Next, wrap the dampened cloth over the affected area and then wrap a dry cloth around it. You can then carefully put clothing over the wrap and leave it on for several hours to overnight.


In 2017, the Food and Drug Administration (FDA) approved dupilumab (Dupixent) injections for use in moderate to severe cases of eczema. They recommend the use of Dupixent when topical medications don’t help eczema symptoms.

Dupixent works by reducing inflammation under the surface of the skin. A doctor may or may recommend using corticosteroids along with the injections.

Oral medications

Your doctor may prescribe oral medications to help with severe eczema flares. Acitretin, a vitamin A derivative, can help with severe cases of eczema, particularly on the hands or feet.

Other medications can include:

  • cyclosporine
  • methotrexate
  • mycophenolate mofetil

However, oral medications often cause side effects. Your doctor may only recommend them for a short duration to avoid issues.

Keeping up with regular routines

Unless your doctor directs you to do otherwise, you should continue with your regular skin care routines. This may involve:

  • moisturizing the skin regularly
  • avoiding substances that trigger eczema including harsh soaps, cleaners, and other chemicals

If you’re living with eczema, you have probably used several moisturizing creams and other topical medications to help reduce the severity of your symptoms.

Corticosteroid creams

You can purchase corticosteroid creams over the counter or get a prescription from your doctor for a stronger cream. Research indicates there are various levels of topical steroids to choose from. Which you use will depend on the severity of your symptoms and your doctor’s recommendations.

The only nonprescription form is 1% hydrocortisone. Any other type needs a doctor’s prescription.


Daily moisturizing plays an important role in treating eczema. But not all moisturizers are good for treating eczema.

According to the National Eczema Association, you should look for moisturizers with high concentrations of oil. The oil helps keep moisture in and irritants (triggers) out. They also recommend using ointments and creams over lotions due to the higher concentrations of oils in the ointments and cream.

Eczema is different for everyone. Your eczema treatment may be very different from others as a result.

Your doctor may recommend using topical steroids and continuing to moisturize the skin. Or they may recommend the use of systemic treatments, such as injections or oral medications.

For example, NYU Langone Hospitals states that dermatologists often recommend treatments that may include the use of:

  • oral or injected immunosuppressants
  • topical calcineurin inhibitors
  • oral or topical corticosteroids
  • oral antibiotics (to treat complications such as bacterial infections)

If you or a loved one’s treatment is no longer working or preventing flares, you should talk with a dermatologist about additional treatment options to help get the flare under control.

No. Severe eczema doesn’t have a cure. But with proper treatment, you can reduce the severity of a flare and prevent new flares from occurring. Also, the American Academy of Dermatology Association states that as a child gets older their symptoms will likely improve or they may outgrow their eczema altogether.

When left untreated, eczema flares can last a while and may not go away unless the trigger is removed. Treatment helps control the flare and, in some cases, prevent flares from occurring.

Eczema makes you more susceptible to skin infections. About 60 to 90 percent of people living with eczema have Staphylococcus bacteria on their skin, which may lead to infection. The National Institute of Allergy and Infectious Diseases also states you are much more likely to develop viral or fungal infections when living with eczema.

You should talk with your doctor right away if you notice signs of infection on your skin.

Severe eczema often requires the use of stronger topical, oral, or injected medications to manage the flares. Your doctor will tailor your or your child’s treatment plan and help you determine what the best medications for you are. Many of the stronger medications may cause side effects. If they occur or symptoms get worse, you should let your doctor know so they can make necessary adjustments.