Hydrating the skin, medicated management, and education make up the triangle of control.

The Three Main Strategies to Achieve Well Controlled Eczema:

Step 1: Hydrating the Skin

  • Bathing allows moisture to enter the skin. Coating the skin after every bath or shower, with an emollient, (moisturizer) helps to seal that moisturizer into the skin. This is necessary for eczema sufferers because there natural skin barrier, which would normally trap moisture in the skin doesn’t work well. This impaired barrier leaves the skin dry, rough, and sensitive to irritants. It is a common myth that drinking adequate amounts of water will help to hydrate the skin. It is in fact with the bathing and moisturizing regimen that the skin becomes hydrated.. Decades ago, doctors often recommended that eczema sufferers limit baths and showers; however, experts now recommend bathing as an important part of controlling eczema.

  • Apply a rich moisturizer several times throughout the day, as flares occur or increase in response to itching. Moist skin will reduce itchiness, which in turn helps to control the disease.

  • Frequent bathing (even 2 to 3 times per day) followed by a moisturizer should be your first defence in managing your eczema!

Step 2: Medicated Management

  • Medicated management is an important part of controlling eczema, and includes:

  • Topical Corticosteroids are prescribed to reduce inflammation and itching. Strengths range from mild to very strong. When used under the direction of a physician, topical corticosteroids are very effective and safe. Fearing side effects, eczema sufferers, or their care givers, often use the treatment too sparingly, or too infrequently. Possible side effects are thinning of the skin if strong preparations are used for extended periods. Follow your physician’s recommendations exactly, and address any questions or concerns you have with your physician.

  • Topical Immunomodulators (e.g. Elidel ®, Protopic ®) are prescribed for inflammation and itching, and can be used for short or repeated periods of time. A possible side effect is a mild to moderate burning sensation. These treatments are not recommended for children under the age of 2 years.

  • Combination Topical Treatments (e.g. Fucidin H ®) combine Fucidin ® with a mild hydrocortisone, which helps to both reduce inflammation and clear secondary infection with a single application.

  • Topical Antibiotics are prescribed for secondary infection, which can worsen the eczema and may make it more difficult for the eczema to respond to treatment until the bacterial infection has been cleared. Localized patches of infected or resistant eczema may be treated by topical antibiotic creams and ointments. Mupirocin (e.g. Bactroban) or Fucidic Acid( e.g. Fucidin) ointment have shown to be beneficial.

  • Oral Antibiotics are prescribed for more significant skin infections. There is often secondary inflection on eczema patches, even when there may be no other obvious signs of infection. Oral antibiotics are preferred over topical antibiotics when the infection is extensive.

  • Oral Corticosteroids (E.g. Prednisone) are rarely used except in the most severe cases. There are long-term side effects with prolonged use, and because eczema is a chronic condition, this is not a permanent solution for severe chronic eczema.

  • Antihistamines are used to relieve itching and aid in sleep. As you increase hydration of the skin (through bathing and regular moisturizing) and manage your eczema, you will decrease the need for sleep aids, as night time itching decreases when the skin is moist and healthy. Use of antihistamines for children 6 years of age and under should be discussed with your physician.

Step 3: Education

  • Understanding the disease will help to control it! Learn about the disease and the ways to control it.

  • Avoidance of triggers. Avoiding common triggers such as harsh soaps, fragrances and perfumes and certain foods, may help to reduce your flares. Use our trigger chart (link) to better understand your triggers.

  • Seek support! Talking with others who understand what you are going through is very important. Eczema exists as a spectrum, meaning that there are patients with very mild conditions, and then there are patients with moderate and severe conditions that have significant physical and psychological impacts. Often the impact of eczema is minimized. Contact us for information about support in your area.

  • Eczema impacts quality of life for the sufferer and their whole family. Social interactions, relationships, work, family, comfort, and self image can all be negatively affected when eczema is not well-controlled.


It is extremely important to follow all three parts to maximize effectiveness!