Eczema has a frustrating habit of flaring up at the worst possible moment, leaving skin red, dry, itchy and sore. If you live with eczema, you will know a flare-up can come on quickly, and that knowing exactly what to do in the first day or two makes a difference to how long it lasts. The good news is that most flare-ups are very manageable, and the right eczema treatment can usually bring one under control at home.
This practical guide explains what triggers a flare-up, how to calm one down step by step, which creams to reach for, and how to keep the itch under control. It also covers the warning signs that mean it's time to speak to a pharmacist or GP.
What Causes Eczema Flare-Ups?
Atopic eczema is a long-term inflammatory skin condition. In people with eczema, the skin barrier doesn't hold on to moisture as well as it should, so the skin dries out and lets in irritants and allergens that the immune system then overreacts to. The result is the familiar cycle of dryness, redness, inflammation and intense itching.1 There is currently no cure, but flare-ups can be controlled well with the right approach.2
A flare-up is usually set off by a trigger, although the cause isn't always obvious. The most common triggers include:
- Soaps and detergents - washing-up liquid, bubble bath, shampoo and biological washing powders all strip the skin of its natural oils.
- Heat and sweat - getting too hot, central heating and exercise can all aggravate the skin.
- Rough fabrics - wool and some synthetic materials can irritate, whereas soft cotton tends to be better tolerated.
- Allergens - house dust mites, pet dander and pollen are frequent culprits.
- Stress - emotional stress is a well-recognised trigger for many people.
- Weather and water - cold, dry air and hard water can both dry the skin out further.1,3
Scratching makes everything worse. It damages the skin, increases inflammation and raises the risk of infection, which keeps the flare-up going.3
How to Treat an Eczema Flare-Up
The aim during a flare-up is to rehydrate the skin, calm the inflammation and break the itch-scratch cycle. A simple step-by-step routine works for most people.
Step 1: Use Emollients Generously
Emollients (medical moisturisers) are the foundation of all eczema care. They soften the skin, lock in moisture and protect the barrier from irritants. Apply them liberally and often - at least twice a day, and more frequently during a flare-up - and use a leave-on emollient as a soap substitute when you wash. Keep using them even once the skin has settled, as this helps prevent the next episode.1,4
Step 2: Add a Topical Steroid to Settle Inflammation
For red, inflamed, actively flaring areas, a topical steroid (topical corticosteroid) reduces the inflammation, itching and redness that emollients alone cannot.2 A few simple rules help you use them safely and effectively:
- Apply your emollient first and wait around 20 to 30 minutes before applying the steroid, so the steroid is not diluted.5
- Use the fingertip unit (FTU) as a guide to how much to apply. One FTU is the amount squeezed from the tip of an adult finger to the first crease, roughly 0.5g, and is enough to cover an area the size of two adult handprints. Spread it in a thin, glistening layer.2
- Apply once or twice a day until the flare-up settles, then step down gradually rather than stopping abruptly.2
Step 3: Protect the Skin While It Heals
Keep cool, wear soft cotton clothing, and keep nails short to limit the damage from scratching. Treating a flare-up early, before it spreads, almost always means a shorter recovery.
What Eczema Treatment Should You Use?
Eczema treatment rests on two types of cream that do different jobs: emollients for everyday moisturising, and topical steroids for bringing flare-ups under control.
Two topical steroids are available from a pharmacy without a prescription, supplied under a pharmacist's supervision for mild to moderate eczema:
- Hydrocortisone 1% is a mild topical steroid, suitable for milder eczema on the body.
- Eumovate (clobetasone butyrate 0.05%) is a moderate topical steroid, roughly twice as potent as hydrocortisone, and is an option when a mild steroid has not brought a flare under control.2
When bought over the counter, these should not be used on the face or around the eyes, on broken or infected skin, on the genital area, during pregnancy, or by anyone under 10 (hydrocortisone) or 12 (Eumovate) without advice from a healthcare professional.2 They come in small tubes - larger quantities need a prescription.
As for the best cream for eczema in general, the most effective emollient is simply the one you're happy to use often enough. Consistency matters more than the brand on the tube.4
How to Stop Eczema Itching
Itching is the most distressing part of a flare-up, and scratching only feeds the cycle. To bring it under control, keep applying emollients (a cooled emollient from the fridge can be especially soothing), keep rooms cool, opt for cotton clothing, and keep fingernails short. A cool compress over an itchy patch can also help.
Antihistamines are not generally effective for the itch of eczema itself. A short course of a sedating antihistamine at night may occasionally help you sleep through a bad flare-up, and non-sedating antihistamines are only useful if you also have hay fever.3
When to See a Pharmacist or GP
A pharmacist can give advice and recommend treatments for small areas of dry, itchy eczema.1 It's worth seeking further advice if:
- Your eczema is not improving despite regular emollients and an over-the-counter steroid
- Large or widespread areas are affected, or the eczema is on your face or another sensitive area
- The skin shows signs of infection - weeping, yellow crusting, increasing redness, swelling or pain - which may need antibiotics1
- You develop a painful, rapidly spreading rash with clusters of small blisters and feel unwell, which can be a sign of eczema herpeticum, a serious infection that needs urgent medical attention4
Some people worry about skin reactions after stopping steroids, sometimes called topical steroid withdrawal. This is associated with prolonged or inappropriate use of stronger steroids - using them correctly, in short bursts at the lowest effective potency and alongside emollients, keeps the risk low. Speak to a clinician before stopping long-term steroid use.2
If eczema is severe or keeps coming back, a GP may refer you to a dermatologist. Options for harder-to-treat eczema include phototherapy and prescription medicines that calm the immune system, including biologic treatments for moderate to severe cases.6
Frequently Asked Questions
What causes eczema flare-ups?
Eczema flare-ups happen when something triggers inflammation in skin that already struggles to hold on to moisture. Common triggers include soaps and detergents, heat and sweat, rough fabrics like wool, allergens such as house dust mites, pet dander and pollen, stress, and cold or dry weather. The trigger is not always obvious, and it can vary from person to person.
How do you treat an eczema flare-up at home?
Start by applying emollients generously and often to rehydrate the skin. For red, inflamed areas, add a topical steroid such as hydrocortisone or Eumovate to settle the inflammation. Apply your emollient first and wait around 20 to 30 minutes before the steroid, use a thin layer, and treat in short bursts until the flare-up calms down.
How do you stop eczema itching?
Keep applying emollients, as an emollient cooled in the fridge can be especially soothing. Keep rooms cool, wear soft cotton clothing, use a cool compress on itchy patches, and keep your nails short to limit damage from scratching. Antihistamines are not generally effective for the itch itself, though a sedating one at night may occasionally help you sleep through a bad flare-up.
What is the best cream for eczema?
There are two types of cream that do different jobs: emollients for everyday moisturising, and topical steroids for calming flare-ups. The best emollient is simply the one you are happy to use often enough, as consistency matters more than the brand. For active episodes, a mild steroid like hydrocortisone 1% or a moderate one like Eumovate can help.
Can you buy steroid cream for eczema over the counter?
Yes. Hydrocortisone 1% (mild) and Eumovate (clobetasone butyrate 0.05%, moderate) can be supplied from a pharmacy without a prescription, under a pharmacist's supervision, for mild to moderate eczema. They come in small tubes, and should not be used on the face, around the eyes, on broken or infected skin, on the genital area or in pregnancy without professional advice. Larger quantities need a prescription.
What is topical steroid withdrawal?
Topical steroid withdrawal refers to skin reactions, such as intense redness and burning, that some people experience after stopping topical steroids. It is associated with prolonged or inappropriate use of stronger steroids. Using them correctly, in short bursts at the lowest effective potency and alongside emollients, keeps the risk low. Always speak to a clinician before stopping long-term steroid use.
References
- NHS. Atopic eczema. National Health Service. Reviewed 2025. nhs.uk
- National Eczema Society. Topical steroids. 2025. eczema.org
- British Skin Foundation. Eczema. 2026. britishskinfoundation.org.uk
- Great Ormond Street Hospital. Eczema. NHS Foundation Trust. gosh.nhs.uk
- NHS. Discoid eczema: Treatment. National Health Service. nhs.uk
- Allergy UK. Managing severe eczema symptoms. allergyuk.org
This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.