People from our Eczema Citizen Science Community have helped to choose the next topic to be answered by research.

Best ways to keep control of eczema between flare-ups

This topic could be looked at in different ways.

Please read the three summaries below and then vote for the question that you’d most like to know the answer to. 

1. How often should moisturisers be used to keep eczema under control between flare-ups?  

People with eczema are often told to use moisturisers. These are sometimes also called emollients. Moisturisers include products such as Diprobase, Zerobase, Epaderm and Hydromol. 

Many people find it challenging to use moisturisers. They can be greasy or sticky, putting them on takes time, and they can sting. Children with eczema sometimes don’t like their parents putting moisturisers on them.

Guidelines used by doctors and other health professionals recommend using moisturisers. But the guidelines don’t agree on how often to apply moisturisers. Most recommend using large amounts of moisturiser 2 to 3 times a day.

What is the evidence?  

We know that using moisturisers can help control eczema, but it is not clear how often we should use them. 

Why is this study needed?  

There are no studies that help us know how often to use moisturiser. People need advice on whether they need to put it on a set number of times a day or just when their skin feels dry. 

2. Can using a steroid cream for longer during a flare-up help keep eczema clear for longer? 

People with eczema are often told to use steroid creams when their eczema flares up. These are sometimes also called topical corticosteroids. They can be creams or ointments. They include products such as hydrocortisone, mometasone and betamethasone. 

People can worry about using steroid creams for too long, but not using enough steroid cream can also be a problem. If a flare-up is not fully treated, people might have to use more in the long-term because flare-ups coming back. 

What is the evidence?  

There has been one small study in children aged 1 to 11 years. Using a steroid cream for more than 5 days to treat a flare-up worked better than using a steroid cream for 5 days or less. However, the evidence from this study is low quality. 

Why is this study needed?  

We need good quality research to help people know how long to use their steroid creams for when they have a flare-up. This could help them reduce the chance of a flare-up returning. Whilst also not having to put on more than is necessary.  

3. If flare-ups keep happening… can using a milder steroid cream twice a week between flare-ups help keep eczema under control? 

Some people find eczema keeps flaring up. This can have a big impact on people. It also leads to people having to keep visiting the doctor or other health professionals. 

What is the evidence?  

There is good evidence that using strong steroid creams twice a week prevents eczema flare-ups. This is sometimes called ‘weekend’ therapy. This approach can be useful for people who have frequent eczema flare-ups.  

Nine studies have tested the use of strong steroid creams being used in this way. These studies showed that using strong steroid creams twice a week more than halved the chance of having another flare-up 

Why is this study needed?  

All of the existing studies used a strong steroid cream. But not all people with eczema are given a strong steroid cream to use. 

People need advice on whether this strategy also works with a milder steroid cream, such as hydrocortisone. 

The information above is based on these references 

Teasdale E, Muller I, Sivyer K, Ghio D, Greenwell K, Wilczynska S, et al. Views and experiences of managing eczema: systematic review and thematic synthesis of qualitative studies*. British Journal of Dermatology. 2021;184(4):627-37. 

LePoidevin LM, Lee DE, Shi VY. A comparison of international management guidelines for atopic dermatitis. Pediatric Dermatology. 2019;36(1):36-65. 

van Zuuren EJ, Fedorowicz Z, Christensen R, Lavrijsen APM, Arents BWM. Emollients and moisturisers for eczema. Cochrane Database of Systematic Reviews. 2017(2). 

Pecoraro L, Florile M, Piazza M, Comberiati P, Clemente M, Tadiotto E, et al. Duration of topical therapy in the maintenance of atopic dermatitis remission in pediatric age. Minerva Pediatr (Torino). 2021;73(4):294-300. 

Lax SJ, Harvey J, Axon E, Howells L, Santer M, Ridd MJ, et al. Strategies for using topical corticosteroids in children and adults with eczema. Cochrane Database of Systematic Reviews. 2022(3).