Eczema has a mind of its own. One week it's a flaky patch on your arm; the next, it's a stinging red spot near your eyes or behind your ears. And somehow, what works for one flare only makes another worse. That's because the skin on different parts of your body varies in thickness and sensitivity, meaning eczema needs to be treated differently depending on where it appears.
To help decode what works (and what doesn't), board-certified dermatologists Tiffany Clay-Ramsey, MD, FAAD, and Chinonso Kagha Abisogun, MD, FAAD, explain how to tailor your routine based on location - plus the small, everyday mistakes that can make flare-ups worse.
Experts Featured in This Article
Tiffany Clay-Ramsey, MD, FAAD, is a board-certified dermatologist based in Georgia.
Chinonso Kagha Abisogun, MD, FAAD, is a board-certified dermatologist based in Los Angeles.
Treating Eczema on the Face and Eyelids
Facial eczema is tricky because the skin is thinner and more reactive, especially around the eyes. According to Dr. Clay-Ramsey, one of the biggest mistakes people make is trying to cover it up. "People will come in with eczema on their eyelids and they've covered it with concealer or eyeshadow," she says. "When that happens, it just irritates the skin more." Translation: your flare does not need a smoky eye on top of it.
Both dermatologists agree that when eczema flares on your face, less is more. Dr. Abisogun notes that delicate areas like the eyelids "require much gentler medications than thicker areas such as the arms or legs." She typically recommends low-potency topical steroids for short durations or non-steroidal options like tacrolimus or pimecrolimus.
Dr. Clay-Ramsey says to "put the anti-aging stuff on pause" - no exfoliants, acids, or retinols until your skin has calmed down. Instead, reach for barrier-repair moisturizers that restore the skin's natural balance.
Treating Eczema on the Scalp
Scalp eczema often masquerades as dandruff or psoriasis, but the causes are different. "Eczema tends to be drier," Dr. Clay-Ramsey explains. "Dandruff or seborrheic dermatitis looks creamier or stickier because of excess oil production, and psoriasis can cause really thick plaques that sometimes lead to hair loss."
Treatment depends largely on hair type. "For straight hair, I'll use a liquid steroid; it's easy to drop onto the scalp without making hair greasy or heavy," she says. "For textured or tightly coiled hair, a lotion, oil, or foam works better because it won't dry out the hair or cause breakage." Dr. Abisogun adds that steroid foams or oils designed for the scalp can calm inflammation fast, but even the best prescription won't help if your shampoo is too harsh. Remember, our scalp has skin, too. Treat it like you would your face.
Treating Eczema on Arms and Legs
Because the skin on your arms and legs is thicker, it often takes stronger products to calm a flare. "I usually go with a stronger-potency topical steroid on those areas," Dr. Clay-Ramsey says. "If someone's fully covered, I'll give them the big jar of the medicine."
Dr. Abisogun agrees, explaining that medium- to high-potency steroids can be used briefly to bring down inflammation, followed by a steady moisturizing routine. "Ointments tend to lock in moisture best," she says, "but whatever you'll actually use consistently is the right choice." She also recommends wet wraps, especially for children, to help medication absorb and speed healing.
Treating Eczema on Creases and Folds (Elbows, Knees, Neck)
If your eczema tends to settle in body folds, you're not alone. Those areas are particularly vulnerable. "They're more sensitive, and if the skin touches skin, it helps the medication penetrate deeper," Dr. Clay-Ramsey says. "It's almost like putting lotion on your hand and then wearing gloves over it - that's called occlusion."
Because these areas tend to trap heat and moisture, both dermatologists say to stick with milder steroids and use them for as little time as possible. Once the redness fades, switch to a fragrance-free moisturizer to keep the barrier strong. It's not glamorous, but it works - and it beats a week of scratching your elbows through your sweater.
Treating Eczema on the Torso and Chest
Eczema on the torso can be difficult simply because of how much skin it covers. "Applying prescription creams everywhere isn't always practical," Dr. Abisogun says. Instead, she suggests focusing on gentle care: fragrance-free cleansers, lukewarm showers, and consistent moisturizing.
For more severe or widespread cases, Dr. Abisogun notes that topical products might not be enough. "If eczema is widespread or significantly impacts quality of life despite optimized topical treatment, we consider options like phototherapy or systemic treatments," she says.
One important caveat: not every rash on your body is eczema. "Under the breasts or abdomen, people often get a rash called intertrigo," Dr. Clay-Ramsey says. "It's red, sometimes moist, and happens when those areas get hot. We treat that completely differently." If you're sure it's eczema, go easy - use mild steroids sparingly and then swap in a non-steroidal repair cream once you're in the clear. Consider this your reminder that your torso needs TLC, too, even if it doesn't get as much attention as your face routine.
Treating Eczema on Hands
For many adults, eczema eventually shows up on the hands. "We're washing our hands a lot more, cleaning, touching all types of stuff," Dr. Clay-Ramsey explains. "Over time, those irritants add up."
Dr. Abisogun's says the key is consistency. Keep a fragrance-free lotion at every sink, wash with lukewarm water, and reapply immediately after drying. "Moisturizing daily, even when your skin looks clear, helps maintain the barrier," she explains.
And yes, your bedtime set-up counts, too. "Sleeping with a humidifier can help your skin stay hydrated while you sleep," Dr. Clay-Ramsey says (bonus points if you slather on your favorite balm before bed and let your hands marinate overnight).
Olivia Tauber is a freelance writer based in New York, pursuing her Master's in Journalism at NYU. She's the contributing assistant beauty editor at PopSugar and contributor to New York Magazine's The Cut, Interview, Bustle, SELF, and HuffPost. Her career began in corporate publicity at Showtime, followed by production for "The Pivot," an Emmy-nominated series.