Eczema Care: Doctor Certified New Parental Guide

Written By Sarah Van Houten

What is Eczema?

Atopic dermatitis is the medical name for eczema. Eczema causes your skin to become, dry, itchy, and inflamed, and it tends to last a long time (chronic condition). The good news is that it usually only flares up from time to time, for example, after exercise, changes in weather, or contact with irritants. These flareups can be uncomfortable, but with the right care, they can be managed.

Daily moisturizing and healthy skin care habits are some of the best ways to relieve itching and prevent new breakouts – more on that later.

Eczema can happen at any age, but it is most common in young children. It’s important to know that eczema is not contagious; your child cannot “catch” it or pass it to others. People, especially children, with eczema do have a higher change of also developing food allergies, hay fever, or asthma, so it’s a good idea to watch for those signs.

Now that we’ve covered the basics, let’s take a closer look at the new eczema treatment guidelines, the safe use of steroid creams, and other treatment options available today. 

New Guidelines for Eczema

Staying up to date on the latest research allows doctors and patients to make the most informed decisions for their or their child’s care (see Evidence-Based Medicine article). After reviewing the latest research studies new guidelines to treat eczema were published in Annals of Allergy, Asthma and Immunology, a prominent peer-reviewed journal.

THE NEW GUIDELINES FOCUS ON:

  • Moisturizers First

  • Steroid Creams

  • New Non-Steroid Options

  • Maintenance Therapy

  • When to Step-up Care

  • Shared Decision Making

Moisturizers First

  • Moisturizing is the #1 treatment recommended for eczema.

  • Using a thick, fragrance-free cream or ointment every day helps restore the skin, reduce itching, and prevent new flareups.

  • New guidelines emphasize applying moisturizer right after bathing (“soak and seal”) to lock in water.

  • Regular moisturizing can reduce how often stronger medicine are needed.

Steroid Creams

  • Steroid creams (topical corticosteroids) are still a main treatment for flareups.

  • They should ONLY be used on active eczema patches, NOT on normal skin

  • Choose the lowest strength that works - stronger for thick patches (like hands/feet), gentler on sensitive areas (face, eyelids, diaper area). 

  • Overuse can cause thinning of skin, stretch marks, or, rarely, hormone changes. Following instructions and talking with your doctor about side effects is important.

  • Talk to your doctor about tailoring treatments: 

    • “How often should we revisit steroid strength?” 

    • “When can we can start moving away from steroid cream to daily moisturizers?” 

    • “Can we try other treatment options before using steroid cream?” 

    • Answers will vary based on severity, so ask follow-up questions to make sure everyone understands and is comfortable with the treatment plan going forward.

  • Once skin clears, stop daily steroid use and return to moisturizers.

New Non-Steroid Options

  • Calcineurin inhibitors (tacrolimus, pimecrolimus) – good for delicate skin areas

  • PDE-4 inhibitor (crisaborole) – mild option for kids

  •  Topical JAK inhibitor (newer creams) – help with inflammation when other treatments aren’t enough

  • These can be used alone or with steroids and are especially useful if long-term treatment is needed.

  • Talk to your doctor about these options when coming up with a treatment plan.

Maintenance Therapy

  • Once eczema flareups are under control, it’s time to start proactive treatments to prevent flareups.

  • Apply non-steroid medicine to problem spots a few times a week, even when the skin looks clear.

    • Combined with daily moisturizing, this reduces the chance of sudden flareups.

When to Step-Up Care

If moisturizers, steroid creams, and non-steroid creams aren’t enough, the guidelines recommend moving to stronger options:

  • Wet wrap therapy for tough flare-ups.

  • Light therapy (phototherapy) for older kids/teens and adults.

  • Biologic injections (like dupilumab) for moderate-to-severe eczema.

  • Oral medicines (such as cyclosporine, methotrexate, or JAK pills) for severe, hard-to-control cases.

Systemic steroid pills are not recommended long-term because of side effects.

Shared Decision Making

  • The new guidelines stress that parents and doctors should make treatment decisions together.

  • Families are encouraged to share their concerns (for example, fears about steroid creams or struggles with daily routines).

  • Doctors should explain risks and benefits clearly, and help create a plan that fits your family’s lifestyle and your child’s specific needs.

TLDR

The new eczema guidelines give parents more tools than ever:

  • Daily skin care and moisturizers are still the foundation of treatment.

  • Steroid creams remain safe and effective when used correctly.

  • New medicines are available if you need/want alternatives.

With these updated options, you can work with your doctor(s) to create a plan that keeps eczema under control and kids feeling comfortable.

References:

Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE– and Institute of Medicine–based recommendations. Chu, Derek K. et al. Annals of Allergy, Asthma & Immunology, Volume 132, Issue 3, 274 - 312
Sarah Van Houten

Sarah is a biomedical Engineer, PhD, advocate for evidence-based medicine, MPF summer intern and most importantly, a mom

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