Atopic dermatitis, commonly known as eczema, affects millions worldwide and requires a comprehensive management approach tailored to individual needs. While there’s no single cure, effective treatment significantly reduces symptoms like itching, inflammation, and skin damage.

The cornerstone of atopic dermatitis therapy is consistent daily moisturizing, or emollient use. These non-prescription (OTC) products are essential for all patients regardless of severity. Emollients help restore the skin barrier function, lock in moisture, prevent dryness from worsening symptoms, reduce scratching, and minimize the risk of infection.

For mild flare-ups or when eczema is particularly sensitive to topical steroids (like on the face), OTC calcineurin inhibitors such as hydrocortisone 0.5% cream can provide relief without strong corticosteroids. Potent prescription topical corticosteroids remain a primary treatment for controlling inflammation during acute flare-ups, available in various strengths prescribed by dermatologists.

Prescription treatments also include non-steroidal options like tacrolimus (Protopic) and pimecrolimus, especially recommended for sensitive areas to avoid the potential side effects of long-term steroid use. Systemic therapies are reserved for moderate-to-severe cases or when topical treatment is insufficient; these can include immunomodulators like dupilumab, oral corticosteroids (for short-term acute control), biologics targeting specific immune pathways, antibiotics if skin infections occur, and proton pump inhibitors taken orally to reduce itching.

The “best” treatment often involves a combination strategy. Emollients should be used daily for long-term skin health. During flare-ups, targeted therapy with either OTC or prescription topical steroids might be needed initially. For persistent or widespread eczema requiring stronger control than OTC options, healthcare professionals may recommend prescription corticosteroids or other advanced treatments like calcineurin inhibitors or systemic immunomodulators.

Working closely with a dermatologist is crucial for diagnosis and developing an effective, personalized treatment plan based on the severity of your condition.