Top Ways to Manage an Eczema Flare

woman with lotion on arm

By Elizabeth Krieger

Living with eczema can feel like having an unwanted houseguest—one who keeps showing up, sometimes without warning, and stays far too long. Eczema is a chronic inflammatory skin disease that can cause inflamed, irritated, and often itchy skin. Seven types of conditions are within the umbrella of eczema, per the National Eczema Association (NEA), but the most common is atopic dermatitis. According to the American Academy of Dermatology (AAD), atopic dermatitis affects one in 10 Americans. It typically develops before the age of 5, per the NEA.

Symptoms of an Eczema Flare

Itchy skin is a hallmark of eczema. According to the NEA, more than 85% of people with the condition experience it, which can cause the skin to feel sore, bleed when scratched, and become dry and discolored. “Luckily, effective medications—as well as a raft of at-home lifestyle strategies—can help you manage even severe cases,” says Rachel Nazarian, M.D., a dermatologist at Schweiger Dermatology in New York City. The itch becomes more pronounced when your condition flares. Let’s dive into how your doctor can help you through an eczema flare, and what you can do, too.

Consider OTC Medications

To prevent flares in the first place, many doctors will suggest you first treat eczema with an over-the-counter topical steroid, such as hydrocortisone cream, says Jeremy Brauer, M.D., a clinical associate professor in the department of dermatology at New York University and a dermatologist in New York City. “This can be used for a short period of time to treat mild eczema anywhere on the body, and especially in areas of thinner skin such as the face, around the eyes, neck, under the arms, and in the groin/genitalia.”

Move to an Rx Medication

During flares that can’t be controlled by an OTC steroid, your doc might suggest a prescription steroid for two weeks, and in certain circumstances longer. If that doesn’t work, your derm may turn to stronger meds, such as a calcineurin inhibitor (a topical cream), PDE4 inhibitors, and Janus kinase (JAK) inhibitors. “These work by interfering with the processes that produce the inflammatory responses,” says Dr. Brauer. You may need to use medication often, even daily, notes Dr. Nazarian: “These non-steroid options can treat the underlying factors that cause the disease. Plus, they avoid some of the issues that steroids have, such as thinning and blanching (whitening) of the skin.”

Dress (and Launder) With Care

With clothing, look for softer, lightweight fabrics, says Dr. Nazarian, and “avoid those with irritating, stiff fibers, such as wool, which can be too abrasive for skin and increase inflammation.” Additionally, lighter-weight fabrics tend to allow skin to stay cooler and don’t trap sweat, which can also flare eczema. Whenever possible, avoid tight clothing that causes rubbing, irritation, and perspiration, says Dr. Brauer. And be mindful of what goes into your washing machine and dryer: Opt for dye-free, fragrance-free detergents to reduce the risk that an irritating ingredient can exacerbate or set off a flare, says Dr. Brauer.

Shower Smarter

You may want to linger but keep your shower or tub-time short. Longer, hotter, more frequent showers can irritate eczema-prone skin. “Decrease the length of your shower, the temperature of the water, and the frequency with which you bathe and shower,” says Dr. Brauer. Aim for a shower temp around what you’d imagine a heated pool to be in the summer, says Joshua Zeichner, M.D., an associate professor of dermatology and the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Never rub the skin aggressively while cleansing, and pat dry gently, says Dr. Zeichner.

Fight Flare With Oatmeal

Not the sort you eat—topical oatmeal has long been used to soothe and moisturize the skin and a 2020 study in Journal of Drugs in Dermatology found that baths containing colloidal oatmeal can ease flares. In the study, 71% of participants saw their itching disappear almost entirely after three months of taking oatmeal baths and washing with an oatmeal cleanser. Just be careful when standing up, notes Dr. Zeichner—it can make the tub slippery! Not a fan of baths? A 2015 study in Journal of Drugs in Dermatology found that a cream containing colloidal oatmeal can improve dry skin, reduce symptoms, and extend time between flare-ups.

Soak and Seal

After bathing or showering (a.k.a. soaking), dry skin gently, leaving it slightly damp, and apply a prescription topical (if your doc issued one) to the affected areas. To seal in the moisture, apply a hydrating body lotion—ideally one free of fragrance or dyes or other potentially irritating ingredients—on top of the medication and all over your body before your skin completely dries, usually within three minutes. You can look for products that have earned the Seal of Acceptance from the National Eczema Association here or check out the picks that won HealthCentral’s Sensitive Skin Awards.

Try a Bleach Bath

Bathing in small amounts of diluted bleach (yes, actual bleach) can also help, according to research—especially if severe flare-ups have led to skin infections, says Dr. Zeichner. A study in Pediatrics found that twice-weekly bathing with diluted bleach can improve moderate to severe eczema, thanks to the bleach’s antiseptic and anti-staphylococcal properties. Follow this recipe for bleach baths, from an eczema treatment guide in American Family Physician: Add ½ cup of regular 6% bleach to 40 gallons of water. (That’s about a full bathtub, according to the Pediatrics report.)

Just Chill

During a flare up—especially when it’s hot outside or when you live in a humid climate— consider storing your topicals (creams, lotions, and the like) in the fridge to help decrease inflammation, says Dr. Nazarian. “Heat, in general, tends to flare many people—not only because it strips this skin of natural moisturizers, or even because of inclination to sweat, but more so because the vasodilation increases blood flow to the skin, and triggers the inflammatory cascade,” says Dr. Nazarian.

Try Wet Wrapping

If you’re having a bad flare up, wet wrap therapy may be a huge help. Wet wrap therapy for eczema is just what it sounds like: After applying your topical medication, you take cotton medical gauze or even just light cotton strips, soak them in warm water so they’re damp, and then wrap the affected area. On top of that, you’ll wrap a separate dry layer of gauze to lock in the moisture, then leave them on for several hours or even overnight. You can follow a step-by-step guide on wet wrapping from the National Eczema Association.

Eat to Fight Flare Inflammation

While there’s no single “anti-eczema” diet, inflammation and eczema go hand-in-hand—so it makes sense to consider adopting a diet high in foods that can tamp down inflammation and low in foods that stoke the flames. According to the National Eczema Association, research has also found that up to 30% of people who have eczema have food allergies as well. A study in the Journal of Dermatology Treatment found that adding vegetables, organic foods and fish oil all led to skin improvements, and removing white flour, gluten and nightshades (like eggplants, peppers, potatoes, and tomatoes) also helped.

Less Stress, Fewer Flares

Plenty of research has found that stress worsens all health conditions, including skin issues such as eczema. “When the body is under stress it increases its cortisol production, which suppresses the immune system and causes inflammation in the body,” says Dr. Brauer. Ironically, “eczema, and its associated itch can lead to loss of sleep, and poor performance in school, and at work,” says Dr. Zeichner, all of which can instigate stress. Cultivate some go-to stress-fighting eczema strategies, and try to be attuned to early signs that you’re stressed, because it’s much easier to calm a flare in the initial stages than further along.



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