What to know about nonsteroid creams for eczema

Eczema refers to a wider group of skin conditions that cause irritation, itching, and dryness. Treatment for eczema typically includes topical products, like creams and ointments, and avoiding strong soaps, which can cause more skin irritation.

Topical steroids are a common treatment, but some people may want to avoid these and use nonsteroid options, like creams, for their eczema. Different types of nonsteroid creams are available, each with different benefits and side effects. Nonsteroid creams for eczema may include:

• topical calcineurin inhibitors (TCIs)
• crisaborole
• JAK inhibitors

Nonsteroid creams have many benefits but also some possible side effects. Other nonsteroid options — including natural remedies — are also available to help manage your symptoms.

Topical calcineurin inhibitors (TCIs)

TCIs are medications that block the release of certain chemicals and overactive cells that can cause inflammation and skin irritation. People with eczema apply TCIs to affected areas of their skin.

TCIs can help eczema by suppressing the overactivity of the immune system — particularly of T-cells — when exposed to allergens that trigger your eczema.

Doctors often prescribe TCIs to treat eczema in areas of the body where the use of steroids is not recommended, such as the eyelids, genitals, and neck. TCIs for treating eczema include tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel).

Benefits

TCIs help with eczema by stopping certain cells of the immune system from causing symptoms such as:

• discoloration
• itchiness
• inflammation

Risks and side effects

The side effects and risks of using TCIs may include:

• burning sensation on the application site
• itching
• skin irritation
• skin coloration
• stinging sensation
• folliculitis
• viral skin infections
• facial flushing on lighter skin

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Crisaborole

Crisaborole (Eucrisa) is a topical phosphodiesterase 4 (PDE4) inhibitor. PED4 is an enzyme that works inside the cells of the immune system and produces proteins called cytokines. These proteins can cause inflammation and eczema when the immune system triggers them by mistake.

Topical PED4 inhibitors can help eczema by blocking the production of cytokines that can cause eczema. Doctors typically recommend using crisaborole to treat mild to moderate forms of eczema.

Benefits

Crisaborole may improve eczema by relieving symptoms such as:

• itchiness
• skin rash
• skin inflammation

Risks and side effects

The side effects of crisaborole may include a burning or stinging sensation in the area where you applied it.

JAK inhibitors

The immune system messengers, called cytokines, cause part of the inflammation that people with eczema experience. Janus kinase (JAK) inhibitors can block the inflammatory process that cytokines can cause when they go through a chemical pathway inside cells known as the JAK-STAT pathway.

One of the most common topical JAK inhibitors for treating eczema is ruxolitinib (Opzelura).

Benefits

JAK inhibitors can improve eczema by preventing cytokines from causing symptoms such as:

• inflammation
• itchiness
• skin rashes

Risks and side effects

The side effects of JAK inhibitors may include:

• nausea
• headaches
• upper respiratory tract infections
• swelling of the nasal passages or the back of the throat

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Other medications

Nonsteroid creams are not the only treatment options available for people with eczema. Other medications may include the following:

Injectables

People with eczema who have found other treatments ineffective or who cannot take other medications can receive injections of dupilumab (Dupixent). This can help relieve the symptoms of eczema, including dry skin.

However, people may experience side effects, including:

• cold-like symptoms
• mouth or lip sores
• rash
• toothache
• redness on lighter skin or pain at the injection site
• difficulty sleep
• facial redness on lighter skin
• dizziness
• diarrhea
• muscle pain
• joint pain

Phototherapy

Phototherapy may help improve eczema. A 2021 review found that using narrowband ultraviolet B (NB‐UVB) to treat eczema helped relieve symptoms. There were some side effects, but very low rates of people stopped treatment as a result.

Oral medications

Antibiotics, antihistamines, and anti-inflammatory oral medications can help people with eczema relieve their symptoms. Antihistamines can treat someone who experiences hives, while antibiotics can improve eczema when there is clear evidence of an infection.

Doctors can recommend the most appropriate treatment depending on your health conditions and the causes of your eczema.

Topical steroids

Steroids, also known as corticosteroids, are substances that help regulate the immune system. Corticosteroids can help reduce and manage your immune system’s response to your eczema triggers. This results in reducing inflammation and other symptoms you may experience with eczema.

You should use topical steroids if a doctor has prescribed them. It is also important to strictly follow the information on where and how to apply them to your skin.

Natural remedies

Natural remedies that may help relieve eczema symptoms may include:

• Hypnosis: Hypnotherapy treatment may help reduce the uncomfortable feelings associated with eczema, like pain and itching.
• Acupuncture: This may relieve itchiness and decrease stress levels.
• Diet: Avoiding foods you are allergic to can help reduce the risk of eczema. Eating an organic, balanced diet and avoiding processed foods may also be beneficial.
• Vitamin D supplements: This may help with eczema as the more severe cases often correlate to low levels of this vitamin in the body. Only take these supplements if a doctor recommends them, and be careful about how much you take.
• Natural therapies: Coconut oil may help moisturize your skin. Applying sunflower seed oil to your skin might improve itchiness, which may help improve blisters and rashes.

Summary

Nonsteroid creams may help people with eczema relieve their symptoms. However, these medications may also cause side effects. People typically experience only mild side effects, such as a burning or stinging sensation.

Moisturizing your skin, eating a healthy diet, taking vitamin supplements, and avoiding your eczema triggers can help improve your symptoms. Doctors can recommend the most appropriate treatment for your eczema, depending on any health conditions and the severity of your symptoms.

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