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. And with so many over-the-counter eczema creams and lotions to choose from, the different options can feel endlessly baffling.

So, which ingredients will help with your eczema, and which will make things worse?

“I always recommend a simple, short ingredient list,” says dermatologist John Anthony, MD. Dr. Anthony helps us sort through the confusion to determine which products are right for you.

Types of moisturizers available for eczema

Before you start looking into ingredients, it’s helpful to understand the difference among types of products.

• Lotions: These are spreadable and sink into your skin the best. But because they’re quickly absorbed, they don’t last as long as other options. 
• Creams: These options have more oil and less water than lotion. They’re a little thicker and heavier, so they won’t sink in as quickly. You also don’t need to apply them as often.
• Ointments: These are the best at locking moisture into your skin. But they’re also the greasiest — and they can get on clothes and bedsheets. 
• Oils: These contain fats that are liquid at room temperature. Most skin oils are plant-based, like argan oil, rose hip oil and olive oil. And while some people find success with oils, for the most part, Dr. Anthony doesn’t recommend them for eczema because they may irritate skin.

Key ingredients

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

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

Emollients

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 allow your skin barrier to exist, and emollients help repair your skin barrier.”

Look at a product’s ingredient list for:

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

Ceramides — fats derived from plants or animals — are especially good emollients 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,” he adds.

Humectants

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

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

Occlusives

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 hydration and moisture into place.

Occlusive ingredients good for eczema include:

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

Pure 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.”

Other ingredients to consider

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

• Licorice root: Glycyrrhizin, a compound in licorice root, has anti-inflammatory properties that may soothe skin with eczema. And Dr. Anthony says it’s unlikely to cause allergic reactions.
• Colloidal oatmeal: Made of finely milled oat kernels, colloidal oatmeal has antioxidant and anti-inflammatory properties that make it a good choice for people with eczema.

Ingredients to avoid

What works well for the general population isn’t always best for eczema. Dr. Anthony recommends avoiding:

• Fragrances and botanicals: “I always recommend fragrance-free,” Dr. Anthony says. “The botanicals used in lotions and creams can be a problem in terms of allergic contact dermatitis for people with eczema.”
• Olive oil: “We don’t recommend olive oil because it has the wrong balance of fatty acids,” he 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.
• Essential oils: While essential oils may provide relief for some people, Dr. Anthony doesn’t recommend them because they can lead to allergic reactions. 
• 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.
• Sodium lauryl sulfate (SLS): SLS may worsen eczema by causing stinging, itchiness and redness.

Moisturizing tips

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 or showering 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, lightly add a product like petroleum jelly on top to seal everything into place.

You should apply a moisturizing eczema lotion or cream to your body twice a day, says Dr. Anthony. But if you’re experiencing a flare-up, you may want to apply some to the affected area every three to four hours to help retain moisture and soothe your skin.

Key takeaways

“Finding the best eczema cream ends up being about each person’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 which ingredients to look for — can go a long way in helping you decide.

And 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.