What is the best moisturizer for atopic dermatitis (eczema)?

From the Guidelines

For atopic dermatitis (eczema), the best moisturizers are thick, fragrance-free creams or ointments like CeraVe Moisturizing Cream, Vanicream, Eucerin Original Healing Cream, Aquaphor Healing Ointment, or Vaseline, which should be applied at least twice daily, especially within 3 minutes after bathing while skin is still damp to lock in moisture. When selecting a moisturizer, it is essential to look for products containing ceramides, hyaluronic acid, glycerin, or petrolatum, which help repair the skin barrier and retain moisture 1. Moisturizing is crucial in managing eczema as it addresses the fundamental issue of a compromised skin barrier that allows moisture to escape and irritants to enter, thereby reducing itching, preventing cracking, and decreasing the need for stronger medications 1. Some key points to consider when choosing a moisturizer include:

• Avoiding moisturizers with fragrances, alcohol, or other potential irritants that can trigger flare-ups
• Applying moisturizers immediately after bathing while the skin is still damp to maximize moisture retention
• Using prescription options like Eucrisa (crisaborole) or topical steroids for severe cases, alongside regular moisturizing
• Recognizing that various types of moisturizers, including emollients, occlusive agents, and humectants, are commercially available, each with its own mechanism leading to improved skin hydration 1. It is also important to note that while there is evidence supporting the use of moisturizers in managing atopic dermatitis, the specific type of moisturizer or active ingredient that is most effective cannot be recommended based on the limited available evidence 1. However, studies have indicated a small but significant improvement in AD severity with the use of moisturizers containing active ingredients like hyaluronic acid, telmesteine, Vitis vinifera, and glycyrrhetinic acid 1. Overall, the use of moisturizers is a critical component of eczema management, and selecting the right moisturizer can make a significant difference in reducing symptoms and improving quality of life.

From the Research

Best Moisturizer for Eczema

The best moisturizer for eczema is a topic of ongoing research, with various studies investigating the effectiveness of different types of moisturizers.

• A study published in 2022 2 found that a moisturizer containing urea and glycerol (urea-glycerol cream; UGC) was more effective in improving the skin's barrier and protecting against irritation than a glycerol-containing moisturizer, a simple paraffin cream, and a no-treatment control.
• Another study published in 2017 3 found that moisturizers containing glycyrrhetinic acid, urea, and glycerol were more effective than their controls in improving eczema symptoms.
• A Cochrane systematic review published in 2017 4 found that moisturizers containing urea, glycerol, and oat extracts had some beneficial effects, but the evidence was generally of low or moderate quality.

Key Findings

• The use of moisturizers can help to improve eczema symptoms, reduce the frequency of flares, and decrease the need for topical corticosteroids 3, 4.
• Different types of moisturizers may have different effects on the skin, and some may be more effective than others in improving eczema symptoms 2, 3, 4.
• The combination of topical active treatment with moisturizer may be more effective than active treatment alone in reducing eczema severity and preventing flares 4.

Moisturizer Ingredients

• Urea and glycerol are ingredients that have been shown to be effective in improving eczema symptoms and protecting against irritation 2, 3, 4.
• Glycyrrhetinic acid is another ingredient that has been found to be effective in improving eczema symptoms 3.
• Oat extracts have also been found to have some beneficial effects in improving eczema symptoms, although the evidence is generally of low quality 4.