Over 10 percent of Americans — that’s about 32 million people — have eczema, according to the National Eczema Association. There’s no known cure for the condition, but one oft-prescribed way to manage symptoms is via steroid cream. Here’s the thing, though: Over time, steroids can thin your skin, cause stretch marks, and even make eczema resistant to treatment — meaning, flare-ups sometimes come back stronger than they were before steroids entered the picture. Want to skip all that? No problem. There are plenty of derm-approved ways to deal with eczema — all without the help of steroids.
“Eczema, or atopic dermatitis, is a skin condition where a weakened skin barrier leads to itching, inflammation, redness, and scales,” Dr. Caroline Robinson, a board-certified dermatologist, tells The Zoe Report. She explains that eczema is genetic and can be triggered by a host of environmental, diet, and lifestyle factors. “Topical steroids can be an essential and effective treatment to help manage eczema flares,” she says — but again, they’re not without their risks.
“The skin can become dependent on topical steroids when overused,” Dr. Devika Icecreamwala of Icecreamwala Dermatology tells TZR, also citing thinned skin and stretch marks as potential complications. “Overuse of steroids has the risk of [enlarged] blood vessels in the skin or skin discoloration,” Dr. Robinson adds. “Inappropriate use of steroids leads to a phenomenon called tachyphylaxis, where a person can become used to steroids and therefore less responsive.” For reference, overuse would be anything more than 30 grams in 30 days, and most dermatologists recommend only two to three weeks of consistent steroid application at a time. In other words: Steroids will be an “effective” treatment for about a month or so before you veer into risky territory.
This isn’t to fear-monger; I’ve experienced the downside of steroid therapy firsthand. A few years ago, I was over-prescribed steroid cream to treat my perioribital and perioral dermatitis, two forms of eczema involving flaky, peeling skin around my eyes and mouth. Besides triggering new outbreaks (because, yes, steroids are bafflingly one of the main causes of dermatitis, too) the treatment permanently thinned my skin, which is a problem I'll have to deal with for the rest of my life… and it’s not fun. To be fair, this is the most extreme risk of steroid use — but if you’re struggling with the chronic condition, it’s important to know the facts, the risks, and all the options.
Ahead, everything you need to know about dealing with eczema, including how to treat it without steroids (if you’re so inclined).
Allergens & Irritants Can Cause Eczema Flares
“We know that the skin barrier changes in this condition are influenced by several factors including genetics and environmental triggers, such as allergens,” Dr. Robinson says. “Some common triggers for eczema are skin irritants like harsh fabrics, hot water, certain soaps, dust, pollen and ragweed, cat dander, and many more.”
“According to the National Eczema Society, there's a laundry list of other irritating offenders including skincare products that content alcohol (but not cetyl alcohol), acidic foods, wool, bleach, tobacco smoke, chemical fumes, paints, solvents, and industrial chemicals,” Dr. Josh Axe, a doctor of natural medicine and the founder of Ancient Nutrition, tells The Zoe Report.
Detergent Is One Of The Biggest — And Most Avoidable — Triggers
“Your clothes may smell so fresh and so clean, but is your laundry detergent behind your red and itchy skin? It's possible,” Dr. Axe says. “Consider switching to a detergent with no fragrance, or if you must have a scent, look for a brand that uses pure essential oils.”
Actually, Any Kind Of Added Fragrance Can Create Problems
“Fragrance is a common trigger and is found in soaps and lotions,” Dr. Icecreamwala tells TZR. Check the ingredient lists for all of your personal care products — skincare, body care, deodorant, and obviously, perfume — for the words “fragrance” or “artificial fragrance.” Consider cutting these products out of your routine to see if your eczema clears. (Like Dr. Axe mentioned, natural scents from essential oils are most likely non-triggering.)
Sweating Could Exacerbate Eczema, Too
“Sweating is another trigger,” Dr. Icecreamwala says. Consider it a doctor-approved excuse to lounge on the couch — at least when you’re in the midst of eczema outbreak.
Eczema Occurs On Five Main Areas Of The Body
Wondering if the dry, patchy skin you’re dealing with is actually eczema? “Common locations include the face, hands, inside the elbows, behind the knees, and the feet,” Dr. Axe says. If you’re flaking in those areas, there’s a good chance it’s eczema (but of course, you should visit a dermatologist to get an official diagnosis).
It’s More Common In Children
7.2 percent of adults in the U.S. have eczema, compared with 13 percent of children — and since kids’ skin is typically more delicate and sensitive, many parents don’t feel comfortable with the thought of steroid treatment. “My children’s doctor did prescribe hydrocortisone and various other ‘harsher’ or ‘stronger’ medications, but that didn't work for us,” Minesh Patel, the co-founder of Eczema Honey, tells The Zoe Report. “We were just afraid to put it on both of our kids' skin, because it was complicated.”
Patel took to experimenting with at-home remedies, which led to the launch of Eczema Honey, a cult-favorite brand that uses all-natural ingredients like beeswax, colloidal oatmeal, and vitamin E to tend to outbreaks. (Its Original Skin Soothing Cream has over 4,000 near-perfect reviews.) “Our products have worked for both of my kiddos,” Patel says.
Eczema Is Often Connected To Food Allergies
“According to the American Academy of Dermatology, about 40 percent of babies and youth with eczema will have a food allergy,” Dr. Robinson says. However, she notes that “foods should not be stopped or eliminated without discussing with a physician,” especially in the case of young children, since an elimination diet could interfere with development.
These Are The Most Common Food Triggers To Avoid
“Consider getting tested for food allergies, because something you're eating regularly may be contributing to your flare-ups,” Dr. Axe agrees. He says gluten, dairy, shellfish, and peanuts are some of the most common food-related eczema triggers. “Eczema is an inflammatory skin condition, so removing any inflammatory foods — like refined sugar and refined oils — may also help to improve symptoms,” the doctor adds. “It's also wise to avoid foods with synthetic additives (like artificial colors) or preservatives found in packaged products.”
But Adding These Foods To Your Diet Could Help
“Adding foods rich in Omega-3 fatty acids (like wild caught salmon, chia seeds, and walnuts) and probiotics (yogurt, kefir, and cultured veggies like kimchi) can be very helpful to improving this common skin condition,” Dr. Axe says.
Probiotics May Be The Most Important Part Of Your Anti-Eczema Routine
“Increased microbial diversity within the gut has been associated with reduced flares in inflammatory skin diseases, such as atopic dermatitis,” according to the World Journal of Dermatology. In layman’s terms: Ingesting probiotics, or “good” bacteria, can ease symptoms of eczema.
This is exactly what inspired Adam Grossman, the founder of soon-to-launch skincare line Sea Calm Skin — made specifically for those with eczema and psoriasis — to include the Daily Rebalance Healthy Probiotic in the brand’s product lineup. “The combination of internal gut health (probiotics) and external skin barrier health has allowed me to live a normal life without constantly worrying about side effects and my long-term health,” he says.
Speaking Of External Skin Barrier Health...
As Dr. Robinson said, eczema happens when the skin barrier is weakened (that’s how allergens and irritants infiltrate in the first place). In return, it makes sense that using products to boost your barrier may help soothe eczema . Consider adding a topical probiotic, like Mother Dirt AO+ Mist to your daily routine, per Dr. Axe. The flip side: Avoid barrier-weakening substances, like sulfates, alcohol, and exfoliators.
There Are A Lot Of Natural, Plant-Based Topical Treatments To Try
There’s no one-size-fits-all approach when it comes to calming an eczema rash with topical treatments, but patients have seen success with a few key naturals. “Look for natural ingredients like colloidal oatmeal, Manuka honey, aloe vera, coconut oil, lavender essential oil, Omega-3 fatty acids, witch hazel, and vitamin E,” Dr. Axe says. Eczema Honey’s products fit the bill, as do the forthcoming releases from Sea Calm Skin.
Studies Show Topical Vitamin B Can Help, Too
According to this scientific study, “Topical vitamin B is an approach that has been shown to successfully treat atopic dermatitis in adults.” Many have had found relief with topical B12, but Grossman says, “I found products that contained high levels of vitamin B3 to be particularly effective." (The vitamin will feature heavily in the Sea Calm Skin line.)
A Lukewarm Bath Can Calm Outbreaks — & Prevent Them In The Future
“Lifestyle things that you can do for eczema include taking short, lukewarm showers or baths,” Dr. Icecreamwala says. A mild temperature is key, since hot water is a known trigger. “When you get out, pat yourself dry and moisturize with a thick cream that is fragrance-free,” she says.
Even Better? Add Oatmeal To Your Bath
“You can take a colloidal oatmeal bath to help calm irritated skin caused by eczema,” Dr. Axe says. “To make colloidal oatmeal at home, simply take uncooked whole oats and use a food processor or spice grinder to turn them into a very fine powder. You can then add them to a bath to calm symptoms.” He notes you can also combine the ground oats with water to create a paste-like mask, and leave the mixture on affected areas for 10 minutes before rinsing off.
… Or Seaweed
“After experiencing the side-effects of prescription medications, I spent a lot of time researching and trying more natural alternative treatments,” Grossman says. “Bathing in seaweed was the beginning of my journey to creating Sea Calm Skin. It is an ancient ritual for health that has been used in other cultures for generations. It was effective for me and opened my mind to a more holistic approach.” To see for yourself, try the Sea Calm Skin Soothing Bath Soak, which will be released in August.
… Or Apple Cider Vinegar
Doctors Say Not To Scratch — Apply Aloe Vera Gel Instead
Use Moisturizer All Over
“Always use a well-formulated moisturizer to help lock in hydration,” Dr. Robinson says. “I like Vaseline Clinical Care Eczema Calming Body Lotion because it has 1 percent colloidal oatmeal to help with itching and irritation, as well as a blend of good fats and lipids, Vaseline jelly, and glycerin to attract water.”
Try To Reduce Your Stress Levels
“Reducing stress can also make a huge difference, since stress is a known eczema trigger,” Dr. Axe says. I personally find meditation helpful, but do what works for you — whether that’s going for a walk or binge-watching Netflix.
You Can Get A Non-Steroid Prescription, Too
“There are now also many non-steroid prescription options that I reach for to help control eczema flares,” Dr. Robinson says. “It is important to consult with your board-certified dermatologist to discuss what treatments are right for you.”