From the Research
If 0.5% triamcinolone is not effectively managing your eczema, consider stepping up to a more potent topical steroid such as clobetasol propionate 0.05%, as it is ranked among the most effective treatments for eczema, according to the most recent and highest quality study 1. Apply a thin layer to affected areas twice daily for 1-2 weeks, then taper to once daily for another week before discontinuing to prevent rebound flares. For facial or genital eczema, use lower potency options like hydrocortisone 1% or desonide 0.05%. Some key points to consider when treating eczema include:
- Combine steroid treatment with regular moisturizing (apply within 3 minutes after bathing) and trigger avoidance.
- Non-steroid alternatives include tacrolimus (Protopic) 0.03% or 0.1% and pimecrolimus (Elidel) 1%, which work by inhibiting inflammatory cytokines rather than through steroid mechanisms, making them suitable for long-term use without the skin-thinning effects of steroids.
- Janus kinase inhibitors, such as ruxolitinib 1.5%, are also effective treatments for eczema, as shown in a recent study 1.
- If symptoms persist despite these measures, consult a dermatologist as you may need oral medications or phototherapy. Some important considerations when using topical steroids include:
- Local adverse effects, such as application-site reactions, are more common with tacrolimus 0.1% and crisaborole 2% than with topical steroids 2.
- Skin thinning is a potential side effect of long-term topical steroid use, but the risk is low with short-term use 2.