Eczema has a frustrating habit of flaring up at the worst possible moment, leaving your skin red, dry, itchy and sore. If you live with eczema, you'll know a flare-up can come on quickly. And knowing what to do in the first day or two makes it easier to get back on top of it.
The good news? Many flare-ups are manageable, and the right eczema treatment can often 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.
Plenty of emollient, the right steroid cream and a bit of patience can often settle a mild flare-up.
What causes eczema flare-ups?
Atopic eczema is a long-term inflammatory skin condition. If you have eczema, your skin barrier doesn't hold on to moisture as well as it should. So your skin dries out and lets in irritants and allergens, which your immune system then overreacts to.
The result is the familiar cycle of dryness, redness, inflammation and intense itching.1,2 There's currently no cure, but treatment can help you manage the symptoms.1
A flare-up is usually set off by a trigger, though the cause isn't always obvious. The most common triggers include:
- Soaps and detergents - washing-up liquid, bubble bath, shampoo and washing powders can all strip your skin of its natural oils.
- Heat and sweat - getting too hot, or exercise that makes you sweat, can aggravate your skin.
- Rough fabrics - wool and some synthetic materials can irritate, while soft cotton tends to be better tolerated.
- Allergens - house dust mites, pets and pollen are frequent culprits.
- Stress - emotional stress can make symptoms worse for many people.
- Temperature changes - sudden changes in temperature can set off a flare-up too.1,2,3
Scratching makes everything worse. It damages your skin, makes the itch worse in the long run and can let infection in, which keeps the flare-up going.1,2
How to treat an eczema flare-up
During a flare-up, the aim is to rehydrate your skin, calm the inflammation and break the itch-scratch cycle. A simple step-by-step routine works for most people.
“Emollients are the foundation of eczema care. Apply them regularly throughout the day, including when your skin is clear, and whenever it feels dry. Leave 20 to 30 minutes between an emollient and a steroid cream, following advice on which to apply first. If you buy hydrocortisone without a prescription, follow the leaflet and do not use it for more than 7 days without professional advice. Seek advice sooner if your eczema worsens.
Ana Carolina GoncalvesSuperintendent Pharmacist
Step 1: Use emollients generously
Emollients (medical moisturisers) are the foundation of all eczema care. They soften your skin, lock in moisture and protect the barrier from irritants.
Apply them as often as you can: at least twice a day, and more often during a flare-up. Wash with an emollient instead of soap, too.1
Keep using them even once your skin has settled. For some people, a daily emollient routine can reduce how much steroid cream they need.1,4
Step 2: Add a topical steroid to settle inflammation
For red, inflamed areas that are actively flaring, a topical steroid (topical corticosteroid) reduces the inflammation, itching and redness that emollients alone can't.4 A few simple rules help you use them safely:
- Apply the steroid first, to the inflamed areas only. Then wait around 30 minutes before applying your emollient, so the steroid isn't diluted or spread onto skin that doesn't need it.4,5
- Use the fingertip unit as a guide to how much to apply. One fingertip unit is the amount that fits on the end of an adult finger, from the tip to the first crease. It's enough to cover an area twice the size of the palm of an adult's hand. Spread it in a thin layer so your skin glistens.4,6
- For a steroid cream bought from a pharmacy, use it once or twice a day for up to 7 days. Stop once the flare-up has cleared. If it isn't better within 7 days, gets worse, or you still need treatment after 7 days, see a doctor.6,7,8
- If a doctor has prescribed a longer course, follow their plan, including how to cut down. Do not stop a long-term steroid suddenly without their advice.6
Step 3: Protect your skin while it heals
Keep cool, wear soft cotton clothing and keep your nails short to limit the damage from scratching.1,2
Steroid first, wait around 30 minutes, then emollient. Getting the order right helps both work properly.
What eczema treatment should you use?
Eczema treatment relies on two types of cream that do different jobs. Emollients are for everyday moisturising, and topical steroids are for bringing flare-ups under control.
Two topical steroids are available from a pharmacy without a prescription:4
- Hydrocortisone 1% is a mild topical steroid, suitable for milder eczema on the body.
- Eumovate (clobetasone butyrate 0.05%) is a moderate topical steroid. It's stronger than hydrocortisone, and an option when a mild steroid hasn't brought a flare-up under control.4
When bought from a pharmacy, these shouldn't be used on your face, around your eyes, on broken or infected skin or on your genitals without advice from a pharmacist or doctor.6,7,8 Hydrocortisone isn't for children under 10, and pharmacy Eumovate isn't for children under 12, unless a doctor or pharmacist advises it. If you're pregnant, check with a pharmacist or doctor first.7,8
So what's the best emollient? Simply the one you're happy to use often enough. Using it regularly matters more than the brand on the tube.2
Do not use pharmacy steroid creams on your face, around your eyes or on broken skin unless a pharmacist or doctor has said it's OK.
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 your emollient. When the urge to scratch hits, try gently rubbing the itchy spot with your finger instead.1,2
Keep rooms cool, wear cotton clothing and keep your nails short. Being hot can make eczema itchier.1
Antihistamine tablets don't usually help with the itch of eczema itself. A doctor may sometimes suggest a sedating antihistamine for a short time, to help you sleep through a bad flare-up.3
Rub, don't scratch. It takes practice, but it protects your skin while the treatment gets to work.
When to see a pharmacist or GP
A pharmacist can give advice and recommend treatments for small areas of dry, slightly itchy eczema.1 It's worth seeking further advice if:
- Your eczema is not improving despite regular emollients and a pharmacy steroid cream
- Large or widespread areas are affected, or the eczema is on your face or another sensitive area
- The skin is blistered, crusty, leaking fluid or has spots filled with pus, or it's painful, swollen or feels warm. These can be signs of infection, which may need antibiotics.1
- Your eczema suddenly gets worse and you have a high temperature or feel generally unwell, which can be a sign of eczema herpeticum, a serious infection that needs urgent medical help.1,2
Infected-looking skin, or feeling unwell during a flare-up, is not something to wait out. Ask for an urgent GP appointment or call 111.
Some people worry about skin reactions after stopping steroids, sometimes called topical steroid withdrawal. It's more likely after long-term, continuous use of stronger steroids.4
Using them correctly, in short courses at the lowest effective strength and alongside emollients, keeps the risk low. If you've been prescribed a steroid for a long time, do not stop it without speaking to your doctor first.4,6
If your eczema is severe or keeps coming back, a GP may refer you to a skin specialist (dermatologist).1 Options for harder-to-treat eczema include light therapy (phototherapy) and prescription medicines that calm the immune system, including biologic treatments for severe eczema.3
Frequently asked questions
What causes eczema flare-ups?
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, pets and pollen, stress and sudden changes in temperature. The trigger isn't 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. For red, inflamed areas, add a pharmacy steroid cream such as hydrocortisone 1% or Eumovate. Apply the steroid to the inflamed areas first, then wait around 30 minutes before your emollient. Use a thin layer once or twice a day for up to 7 days, and see a doctor if it isn't better by then. Follow any personal plan your clinician has given you.
How do you stop eczema itching?
Keep applying your emollient regularly, keep rooms cool, wear soft cotton clothing and keep your nails short. When you feel the urge to scratch, try gently rubbing the area with your finger instead. Antihistamine tablets don't usually help the itch of eczema itself, though a doctor may suggest a sedating one for a short time to 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're happy to use often enough, as using it regularly matters more than the brand. For a flare-up, 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) are available from a pharmacy without a prescription. Do not use them for more than 7 days unless a doctor or pharmacist advises it. Do not use them on your face, around your eyes, on broken or infected skin or on your genitals without advice, and check with a pharmacist first if you're pregnant.
What is topical steroid withdrawal?
Topical steroid withdrawal describes skin reactions, such as redness, burning and stinging, that some people get after stopping topical steroids. It's more likely after long-term, continuous use of stronger steroids. Using them correctly, in short courses at the lowest effective strength alongside emollients, keeps the risk low. If you've been prescribed a steroid for a long time, do not stop using it without speaking to your doctor first.
References
- NHS. Atopic eczema. NHS website; 2024. nhs.uk
- British Skin Foundation. Eczema. British Skin Foundation; 2026. britishskinfoundation.org.uk
- Allergy UK. Managing Moderate to Severe Eczema Symptoms. Allergy UK; 2023. allergyuk.org
- National Eczema Society. Topical steroids. National Eczema Society; 2025. eczema.org
- NHS. Emollients. NHS website; 2023. nhs.uk
- NHS. Clobetasone. NHS website; 2026. nhs.uk
- Haleon UK Trading Limited. Eumovate Eczema & Dermatitis 0.05% Cream: Summary of Product Characteristics. Electronic Medicines Compendium; 2024. medicines.org.uk/emc
- NHS. Hydrocortisone for skin. NHS website; 2025. nhs.uk
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.