Many people find that topical medications—creams, gels, or ointments applied directly to the skin—relieve itching and reduce redness and swelling. Topical medications may also prevent a rash from spreading.
Corticosteroids are anti-inflammatory medications that can be very effective in relieving symptoms of eczema and dermatitis. Corticosteroids suppress the activity of some immune cells, which can interrupt the inflammatory process and prevent itching, redness, and swelling.
Topical corticosteroids are available in different strengths, including some low-potency anti-itch creams such as hydrocortisone that are available over the counter at drugstores. But moderate-to-severe eczema and dermatitis may not respond to over-the-counter products. Our dermatologists recommend and prescribe a topical corticosteroid based on your age, the location and surface area of a rash, and the severity of symptoms.
Topical corticosteroids are applied directly to the affected areas of skin once or twice a day, depending on the type of corticosteroid prescribed. Doctors recommend maintaining this schedule until symptoms improve or a specified time has elapsed. Typically, corticosteroids relieve symptoms within a few weeks, or sometimes within a few days. At that time, doctors may recommend reducing the frequency of application to once or twice a week to keep symptoms under control and prevent flare-ups.
Your dermatologist determines the duration of topical corticosteroid treatment, which varies depending on factors such as the severity of flare-ups and the age of the person being treated. For severe eczema or dermatitis, topical corticosteroids may be used intermittently for months or years. Continued use requires regular evaluation by your dermatologist.
Side effects of topical corticosteroids may include thinning of the skin, stretch marks, lightening of the skin, and acne. They may also affect the eyes when used for prolonged periods.
Topical Calcineurin Inhibitors
Topical calcineurin inhibitors are a type of anti-inflammatory medication. They are formulated to block an overactive immune system response to the skin, which may reduce itching, redness, and swelling.
Doctors typically prescribe calcineurin inhibitors when topical corticosteroids are ineffective or if eczema or dermatitis affects sensitive areas of skin that can’t be treated with topical corticosteroids for long periods. A dermatologist may recommend this medication for a rash on the eyelids, face, or other sensitive areas where skin touches skin, such as the underarms or groin.
Topical calcineurin inhibitors are available in different formulations and concentrations. Our dermatologists determine which is appropriate based on a number of factors, such as the age of the person being treated and the severity and location of symptoms.
Topical calcineurin inhibitors are applied directly to the affected areas of skin once or twice a day, depending on the formulation prescribed. Doctors recommend maintaining this schedule until symptoms improve. Typically, calcineurin inhibitors relieve symptoms within one to six weeks. After symptoms improve, doctors recommend reducing the frequency of application to once or twice a week to keep symptoms under control and prevent new flare-ups.
These regimens require ongoing follow-up and evaluation. Your dermatologist determines the duration of treatment, depending on such factors as the severity of outbreaks and the age of the person being treated. Topical calcineurin inhibitors generally have fewer long-term side effects than corticosteroids and may be used safely for months or years.
Side effects may include a small risk of infection, and some people may experience a stinging sensation when the medication is first applied, but it generally fades over time.