How To Choose the Best Eczema Cream

If you have atopic dermatitis, the most common type of eczema, you’re probably always in search of the holy grail of skin care products. Your skin is extra-sensitive and prone to itchiness, dryness and other uncomfortable symptoms — but the aisle full of lotions and creams seems endlessly baffling.

Which ingredients will help, and which will make things worse? When it comes to treating eczema, bland, minimalist products are best. “I always recommend a simple, short ingredient list,” says dermatologist John Anthony, MD.

Dr. Anthony helps you sort through the confusion to determine which products are right for you.

What kind of products treat eczema?

From creams and lotions to ointments and oils, it can be hard to know what’s what — and what’s best. Before you start looking into ingredients, it’s helpful to understand the difference among products.

• Lotions are spreadable and sink into your skin the best. But because they’re quickly absorbed, they don’t last as long as other options. “They also have a bit higher risk of stinging raw skin,” Dr. Anthony warns.
• Creams have more oil and less water than lotion, and they’re a little thicker/heavier. They won’t sink in as quickly, but you also don’t need to apply them as often.
• Ointments are the most occlusive option, meaning they’re the best at locking moisture into your skin. But they’re also the greasiest. “They spread well and last longer, but they get on things like clothes and bedsheets,” Dr. Anthony notes.
• Oils are fats that are liquid at room temperature. Most skin oils are plant-based; think argan oil, rose hip oil and tea tree oil, among others. And while some people find success with oils, for the most part, Dr. Anthony doesn’t recommend them for eczema. (More on that in a bit.)

If you’re looking for a one-size-fits-all answer to the best product for your eczema, you won’t find one. “It ends up being about each patient’s preference and tolerance,” Dr. Anthony says. “What feels good on your skin is probably the best product for you.”

But knowing your options — including what products are available, what they do and what ingredients to look for — can go a long way in helping you decide.

What to look for in an eczema cream

Hydration makes for happy skin. “If you have eczema, it’s extremely important to keep your skin hydrated,” Dr. Anthony says.

In looking for an eczema product, there are three categories of ingredients to know about:

1. Emollients help repair your skin barrier.
2. Humectants draw moisture into your skin.
3. Occlusives lock in moisture and hydration.

“You see all three of them in some of the products we use for eczema,” Dr. Anthony explains. And some popular ingredients pull double duty, acting, for example, as both humectant and occlusive, or emollient and occlusive, which can make things confusing.

He walks us through the categories, including ingredients to look for.

1. Emollients help repair your skin

Emollients fill in the cracks in dry skin, which helps soothe, soften and ultimately heal. “They restore some of the natural fats in the skin,” Dr. Anthony says. “Fats are important in enabling the skin barrier to exist, and emollients help repair your skin barrier.”

But some emollients are better than others for eczema. Good choices include:

• Ceramides.
• Cocoa butter.
• Coconut oil.
• Fatty acids.
• Paraffin.
• Petrolatum (petroleum jelly).
• Shea butter.

Ceramides — fats derived from plants or animals — are especially good for eczema. “Data shows that products that are high in ceramides work well for a lot of patients with eczema due to their anti-inflammatory effects,” Dr. Anthony says.

2. Humectants bring in moisture

“Humectants are designed to try and draw moisture into the skin,” Dr. Anthony explains. They attract and bind to water, pulling it from the air and from deeper within your skin. They include:

• Aloe vera.
• Glycerin.
• Alpha hydroxy acids, like glycolic acid and lactic acid.
• Hyaluronic acid.
• Urea (sometimes called carbamide).

Applied on their own, humectants can cause stinging and burning. Instead, eczema creams combine these ingredients with more soothing emollients and occlusives.

3. Occlusives lock in the good stuff

Occlusives are like a sealant, keeping moisture and hydration where they belong — in your skin. Without an occlusive, some of that goodness is lost to evaporation. But adding an occlusive on top seals the deal by literally sealing hydration and moisture into place.

Occlusive ingredients good for eczema include:

• Coconut oil.
• Mineral oil.
• Petrolatum (petroleum jelly).
• Silicone derivatives, like dimethicone.

Vaseline®, which is made of petroleum jelly, is both an emollient and an occlusive. For the most part, it’s safe to use on eczema. But like other occlusives, petroleum jelly alone won’t moisturize your skin.

“You have to get the moisture in there first, whether from other ingredients or from water, and then seal it in with a topcoat,” Dr. Anthony explains. “That’s what we call occlusive therapy.”

4. Other ingredients to soothe eczema

Research continues to evolve to identify the best ingredients for treating eczema. Dr. Anthony shares two ingredients that have been found to be particularly soothing.

• Licorice root: Studies show that glycyrrhizin, a compound in licorice root, has anti-inflammatory properties that can soothe skin with eczema. And Dr. Anthony says it’s unlikely to cause allergies.
• Colloidal oatmeal: Made of finely milled oat kernels, this ingredient has antioxidant and anti-inflammatory properties that make it a good choice for people with eczema.

Ingredients to avoid if you have eczema

Remember: What works well for the general population isn’t always best for eczema. There are lots of products that can be hydrating, soothing and overall beneficial to people who have standard dry skin — but many of those same products can worsen dry skin caused by eczema.

Dr. Anthony says his eczema recommendations are informed by his work with patients who have contact dermatitis (basically, allergic reactions affecting the skin). Skin with eczema is especially sensitive, so although you may not currently be allergic to any of the products he recommends avoiding, it certainly can’t hurt to go without them.

“For patients with atopic dermatitis, there’s more chance of exposure to possible allergens, which can complicate their condition and treatment,” he says. “So while none of these are absolutes, I usually start with some general rules.”

Avoid fragrances and botanicals

A good rule of thumb is that if you love the way it smells, don’t use it on your eczema. “I always recommend fragrance-free,” Dr. Anthony says. “Some people love scented products, but the botanicals used in lotions and creams can be a problem in terms of allergic contact dermatitis for people with eczema.”

He encourages eczema patients to use bland products that don’t have fragrances or floral-based ingredients and to avoid ingredients like:

• Calendula.
• Chamomile.
• Feverfew.
• Lavender.

Skip the olive oil

Products with higher linoleic acid and lower oleic acid levels are best for eczema, but olive oil has the wrong ratio. “We don’t recommend olive oil because it has the wrong balance of fatty acids,” Dr. Anthony explains.

In fact, olive oil can actually make eczema worse by damaging your skin barrier. So, keep it where it’s most helpful — in the kitchen, not on your skin.

Don’t risk it with essential oils

While essential oils may provide relief for some people, Dr. Anthony doesn’t recommend them because they can lead to allergic reactions. Even if you’ve used them in the past without issue, you can develop an allergy over time. “It’s usually best not to go down that path,” he cautions.

Be careful with lanolin

Also called “wool oil,” lanolin is a common ingredient in lotions and creams. Some people with eczema may find it helpful, but Dr. Anthony doesn’t typically recommend it because it can be (or can become) an allergen for people with eczema.

Say no to sodium lauryl sulfate (SLS)

Once a common ingredient in aqueous creams, SLS is now thought to worsen eczema by causing stinging, itchiness and redness. Studies show that non-SLS aqueous creams are less likely to irritate skin than aqueous creams that contain SLS. These days, many products have been reformulated to remove the ingredient.

Organic isn’t always better

“We have a tendency in our culture to want to use organic, vegan products,” Dr. Anthony says, “and while they may have benefits, they often have a negative impact on skin with eczema.”

Organic, vegan products tend to be botanical-heavy, and scented with nature’s most appealing fragrances. But skin with eczema is more reactive to allergens, and organic doesn’t equal hypoallergenic. You can still be allergic or sensitive to a natural ingredient.

“Oftentimes patients say, ‘I don’t know why my skin is getting worse. I only use organic vegan products,’” Dr. Anthony recounts. “But they just happen to be allergic to those products.”

Tips for applying your eczema cream

Dr. Anthony shares some of the key steps in applying your eczema products of choice.

1. Wet your skin. “Bathing gets moisture into the skin,” he says. If you’re not bathing before putting on your eczema cream, wet your skin with a warm washcloth to moisturize it first.
2. Apply to wet skin. Eczema products should go on top of clean, moist skin.
3. Add an occlusive. Ointments are already occlusive, but if you’re using something less occlusive, like a lotion or cream, add a product like Vaseline on top to seal everything into place.

What to know about prescription eczema creams

If your eczema isn’t letting up, see your dermatologist, who may write you a prescription for something stronger.

• Hydrocortisone cream: Hydrocortisone is an anti-inflammatory corticosteroid that can soothe severely dry skin. The strongest you can buy over the counter is 1% hydrocortisone, but your doctor can prescribe up to 2.5%. And there are even stronger prescription steroid products that might be prescribed in certain situations.
• Nonsteroidal anti-inflammatories: Prescription-strength hand creams and lotions may better hydrate and repair your skin barrier than products you buy on your own.
• Calcineurin inhibitors: These topical medications help suppress your overactive immune system, which can decrease inflammation caused by eczema.
• Crisaborole ointment: Sold under the brand name Eucrisa®, crisaborale is a boron-based medication that helps reduce redness, itching and swelling.

There are other eczema treatment options, too, like JAK inhibitors (medications that prevent inflammation from inside of your cells) and biologics (injections or infusions that block functions of your immune system that affect eczema).

In short, there are a variety of ways to treat and control your eczema, so if over-the-counter products aren’t doing the trick, seek guidance from your dermatologist about what might work best for you. “There are new products coming out all the time,” Dr. Anthony encourages.