Eczema treatment: using moisturisers and topical steroids

Eczema tends to be recurrent with periods of flares and remissions. Topical steroid creams and moisturisers are the cornerstone of treatment for eczema. Attendance to aggravating factors is also important. This involves lifestyle changes.

Moisturisers and steroids come as lotions, creams or ointments and have varying water and oil content. Lotions are easy to apply over large areas of skin and are suitable for hairy or weepy areas. Creams and ointments ​​are thicker and can be messy to apply. They are suitable for very dry skin.

Dr Pang Shiu Ming​, Senior Consultant at the Department of Dermatology at Singapore General Hospital (SGH), a me​mber of the SingHealth​ group, offers eczema sufferers the following tips on the use of moisturisers and steroid creams:

Moisturisers for eczema

To help relieve the itchy rash, choose a moisturiser that:

  • Keeps the skin hydrated for at least eight to 12 hours.
  • Feels pleasant on the skin, so you want to apply it.
  • Suits your skin type.

​Strong antibacterial and exfoliating moisturisers with glycolic acid should be avoided.

How to use moisturisers:

Use a moisturiser a minimum of twice a day, after a shower and before bedtime. Applying a moisturiser 3-4 times a day is optimal. The moisturiser should be applied all over the body. This prevents the eczema from developing elsewhere.

  • Apply a hand cream every time you wash your hands to counter the drying and itchy effects of washing.
  • Apply the moisturiser generously. The skin should feel slick after an application.
  • Do not use a moisturiser if the eczema is in an acute stage, with weeping and oozing. It will not stay on the skin even if you apply it. Instead, use wet compresses soaked in a diluted potassium permanganate solution, to quickly dry up.

Topical steroids for eczema

Your doctor will prescribe the steroid formulation that is best suited to your condition. A lotion is likely to be recommended for a hairy area of the body such as the scalp or armpit. An ointment is likely to be recommended for red and itchy patches on thickened skin, such as the palms and soles of the feet.

Doctors prefer to prescribe weaker steroids for areas of thin skin such as the eyelids and folds. A weak steroid formulation is also advised for eczema sufferers who are very young or very old.

How to use steroids:

Apply the steroid cream after using a moisturiser.

  • Use as recommended by your doctor. Overuse of steroids can lead to thinning and discolouration of skin.

Read on for tips to treat severe flares and prevent the recurrence of eczema.

Ref. S13