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Courtney O. has tried more than a dozen treatments for her adult-onset eczema, all with varying degrees of success.

Roughly 5 years ago, Courtney O. experienced an eczema flare on her face for the first time. It was an alarming and particularly visible evolution of a condition she experienced somewhat mildly for years, with isolated patches on her elbows, hands, feet, and above one ear.

“The flares on my face are absolutely the worst — sometimes huge red patches, especially around my eyes and chin,” she says. “I’m not exaggerating that it can give me a positively clown-like appearance.”

Atopic dermatitis, or eczema, is sometimes considered a childhood disease.

But adult-onset eczema is more common than you might think, and cases are on the rise. That makes Courtney, 41, one of the 16.5 million U.S. adults navigating a chronic condition synonymous with excessively dry, sensitive skin that can quickly become itchy, scaly, painful, and red.

Eczema and its symptoms are different for everyone, which makes managing the condition a very individual experience and very much a trial-and-error process.

In Courtney’s case, it’s meant consulting various doctors and specialists and exploring a mix of over-the-counter and prescription medications, alternative therapies, supplements, lifestyle changes, and other potential remedies — so many, she says she can’t even remember them all.

Now, Courtney’s sharing what’s worked, what hasn’t, and why she’s more motivated than ever to identify the “why” behind her eczema.

For such a common condition, eczema is still surprisingly mysterious. Researchers have yet to identify the exact cause, but they can point to a genetic predisposition compounded by environmental triggers.

It can be a vicious cycle — itchy, inflamed skin that people scratch in a bid for relief, which unfortunately only worsens the sensitivity and redness and creates a heightened risk for infection.

Finding a way to control symptoms can be just as mysterious, and many people start by seeking medical advice.

Courtney has seen several dermatologists, an allergist, a naturopath, and an acupuncturist, all in pursuit of an answer about the real cause of her eczema.

“I want to figure out why this happens, not just make the symptoms go away,” she says.

And it’s been a journey. While one dermatologist pushed prescriptions with side effects Courtney wasn’t willing to tolerate, another recommended over-the-counter (OTC) products she continues to use to this day.

Managing symptoms while she searches for answers is part of the process, particularly when Courtney experiences a flare on her face.

“In addition to being unsightly, it can get pretty uncomfortable and itchy. And, frankly, when my flares are really bad, it’s alarming to people,” she says. “The patches can be red and raw and then flake — not the best look for a night on the town or even for a normal workday.”

Topical treatments

Courtney has cycled through a medley of treatments, including both prescription and OTC medications and ointments, alternative therapies, and holistic remedies, all with varying degrees of success.

Here are just a few things she’s tried:

“You name it, I have likely tried it,” she says, also noting that she was prescribed an ointment called Desonate. But at $700 a tube, she opted not to fill the prescription.

Lifestyle changes

Lifestyle changes are another avenue she’s explored, albeit in a somewhat limited way.

“I do think stress makes it worse. Sleep, exercise, water, good nutrition (including lots of fruits and veggies): Those classic staples don’t hurt. But I have four kids and an exciting but busy career, so eliminating all stress is not an option I am pursuing too seriously.”

In spite of all these medications, therapies, and lifestyle tweaks, Courtney’s eczema only truly cleared once, and it’s not what she calls a management strategy.

“My eczema disappeared completely when I was pregnant with my last baby,” she says. “It was glorious! But about a year after he was born, the flares started again.”

Managing her eczema is very much a learning process.

“Most recently, I’ve been working with a naturopath to narrow down what’s going on and why,” she says. “I think these issues require a holistic approach. You can’t just treat the symptom, you have to figure out the root cause and deal with that.”

That’s also why she makes a point of listening to podcasts and following Instagram accounts that discuss holistic treatments of eczema.

That holistic approach is Courtney’s preferred method of dealing with her symptoms.

As far as products go, she says, “My favorite products are really simple: Vanicream bar to wash my face and Vanicream lotion as my moisturizer. I also use the [Vanicream moisturizing] ointment for flares.”

She describes these products as both budget-friendly and gentle.

Even though her flares are on her face and parts of her body, she tends to use the same products everywhere.

“Honestly, the OTC hydrocortisone cream really works to clear it up.” The drawback, she says, is that she doesn’t want to use it too much or long term, particularly on her face, because it can thin the skin and cause other problems.

Interestingly, Courtney stopped using eczema products made with colloidal oatmeal.

“I have a suspicion that those actually make my eczema worse,” she says.

Courtney’s best advice comes from her own desire to pinpoint the cause of her eczema.

“Find a naturopathic or allopathic doctor who is willing to help you be a detective about your root causes, so you can address that,” she says.

Otherwise, her tips are sensible: “Be patient. Be gentle with your skin. Wear sleeves to avoid itching. Wear big sunglasses if you have eczema around your eyes. And have a sense of humor if people make comments about your condition!”

Vanicream Cleansing Bar

  • Price: around $10 for two bars

Courtney uses this cleansing bar to wash her face.

Vanicream Lotion

  • Price: around $12–$15

Courtney uses this moisturizer, which has the Seal of Acceptance from the National Eczema Association.

Vanicream Moisturizing Ointment

  • Price: around $10–$15

Another product with the National Eczema Association’s Seal of Acceptance, this ointment can be used all over the body.

Jessica Timmons has been working as a freelance writer since 2007, covering everything from pregnancy and parenting to cannabis, chiropractic, stand-up paddling, fitness, martial arts, home decor, and much more. Her work has appeared in mindbodygreen, Pregnancy & Newborn, Modern Parents Messy Kids, and Coffee + Crumbs. See what she’s up to now at jessicatimmons.com.