Balshi Blog

What To Do When Your Eczema Flares Up

When you start to feel a flare-up of irritated, itchy, red skin. You might feel like you’ll do anything to calm it down or prevent these rashes from happening again. 

You may hear this red itchy rash referred to as dermatitis, and it may come and go as it pleases. Also referred to as eczema, keeping these flare-ups under control is entirely possible! You may have what is considered chronic or long-lasting eczema. Or you may suffer from flare ups after you touch something and trigger it. 

Common triggers for eczema can be scratchy clothing, cold weather, dry skin, harsh soaps, cleansers, or sweat. Sometimes, people who deal with eczema also deal with hay fever or asthma.

The causes for eczema are hard to determine. It is possible genetics play a role, a haywire immune system, or a weak immune system can all cause flare-ups.

Our skin is the biggest organ that protects us. Skin that becomes too dry may not be able to block out tiny allergens or bacteria that can cause eczema.

Sometimes, certain people are more prone to eczema than others. For example, African-Americans, childcare, living in cold climates, working in healthcare, or cities that deal with a lot of air pollution.

When it comes to babies and children, eczema can be common. Some children grow out of it, and some have it on and off for the rest of their life. 

When it comes to getting a diagnosis, your doctor can tell if you have eczema based on medical and family history, triggers, symptoms and outbreaks. All which can be treated with a dermatologist who specializes in skin conditions like these.

There aren’t tests to prove that you have eczema, but your healthcare provider may try to test skin patches to see if certain products or foods trigger a rash reaction.

Working with your doctor is key to finding the right treatments for you and your eczema. They can help you factor in age, other health problems, symptoms, lifestyle, and family history to help find treatments that will work for you. Unfortunately, most eczema treatments only provide short term relief. 

Controlling Your Eczema

When it comes to a treatment plan to assess your needs, there are four major components that will likely be part of any plan:

  • Skin care (baths and moisturizer)
  • Medicine (as needed)
  • Coping strategies (manage itch, stress, and other issues)
  • Trigger avoidance (to prevent flares)

Follow That Plan

When following your dermatologist’s treatment plan as prescribed, goals to get there can help you feel better:

1st goal: Control 

The first part of any treatment plan will focus on calming and controlling the skin. This can take a lot of time, medicine and bathing.

Sticking to this is important. Once the skin is able to calm down and be less irritated, you’ll be more comfortable. 

If parts of this treatment becomes painful or seems ineffective, contact your doctor immediately. They are a great resource for adjusting protocol. 

Continuing Treatment

It’s important to continue treating the eczema even after it seems under control. Many find that eczema can be controlled by:

  • Keeping their child’s skin hydrated
  • Finding out what triggers the eczema and helping their child avoid these triggers

It’s important to note that this isn’t a final solution and eczema can still flare. When certain things are out of your control like stress or change in weather, this can cause a flare. When these flares happen, medicine may be necessary. For eczema that produces frequent flares, applying a low-dose medicine to the skin a few times per week can reduce those flares.

Following your doctor’s treatment plan is worth it! Controlling your eczema and feeling better can also help reduce your need for medicine over time. 

Feeling Better

There are so many factors that could set off an eczema flare. Everyone’s triggers differ. It’s very helpful to take the time to figure out what causes your skin to act up. 

If you are someone whose skin gets too dry, that can cause the skin to become rough and itchy. Maybe even become cracked. This can allow bacteria or allergens inside. Having dry skin is a very common eczema trigger for a lot of people. As well as extreme changes in temperature and stress. 

Make sure to keep your skin moist, especially during the winter. In winter, the air can be very dry. Using a humidifier to moisten the air in your bedroom when you sleep can help keep harsh dry air at bay. It also helps to apply body lotion after you get out of a shower or bath. 

When it comes to easing eczema itching, soaking in a warm bath with small amounts of colloidal oatmeal or bath oil can help moisten your skin.

Why Baths and Moisturizer Are Important

Bathing is very important when someone has eczema. Bathing helps get rid of dead skin cells and bacteria off the skin. As well as continuing to keep the skin hydrated. With eczema comes poor outer skin function. Their skin can have trouble retaining water. 

But, baths aren’t any help without the support of a good moisturizer. In fact, people can become drier from baths unless a moisturizer is applied immediately after the bath.

Moisturizer after a bath is key. This provides the skin with an artificial protective barrier that helps keep the skin from losing water and keep bacteria, irritants, allergens, and viruses out. 

Before applying the moisturizer, gently pat the excess water off the skin, leaving it damp to keep the moisture from the water. 

Next, apply a moisturizer that is an ointment or cream . Ointments and creams generally contain more oil than water and do a better job keeping the moisture in the skin than a water based moisturizer.

The duration of the bath isn’t specified. There isn’t any scientific evidence that shorter or longer baths make a difference with eczema. However, what is known is that if you stay in a bath too long, it can dry the skin out and have the opposite effect. As a good rule of thumb, limit a bath to 5 or 10 minutes.

Some dermatologists could suggest a 20 minute bath, which may not be a problem at all. 

These two things, baths and moisturizers play a pivotal role in controlling and treating eczema. With bathing and moisturizing you can:

  • Ease your discomfort
  • Decrease eczema flares
  • Improve your response to treatment
  • Reduce the need for medicine


How to use moisturizer to reduce eczema flares:

  • Apply eczema medicine when it’s needed.
  • Be sure to apply within 3 minutes of my bath
  • Apply a thick layer to my skin without medicine

Slather on my eczema friendly moisturizer. Your doctor can tell if you need medicine and where to apply it. People who flare a lot may need eczema medicine applied a couple of times a week. This may help reduce the amount of flares.

How to select an eczema friendly moisturizer.

When looking for an eczema friendly moisturizer, you want to select one with these qualities:

  • Fragrance free (instead of unscented)
  • Perfume free
  • Dye free
  • Cream or ointment (instead of lotion)
  • You like it and you will use it
  • Fits your budget

Fragrance free vs. unscented: What’s the difference?

  • Fragrance free – the product doesn’t contain fragrance
  • Unscented – the product contains fragrance, but it is masked so you cannot smell it. Unscented moisturizer can irritate eczema prone skin

Why use moisturizer? Research shows that an eczema friendly moisturizer can:

  • Help skin heal
  • Reduce the itch by relieving dry skin
  • Decrease the need for eczema medicine
  • Prevent eczema from getting worse and more difficult to treat

Eczema Cream

Your doctor may prescribe you a steroid cream to help stop any itching or clear up a rash that occurs with your eczema flare ups. They may also prescribe a topical cream called calcineurin inhibitors like pimecrolimus or tacrolimus that help protect your skin and prevent eczema outbreaks. Hydrocortisone cream is also available to help mild itching. As well as a Eucrisa ointment that is a nonsteroidal anti-inflammatory topical treatment that may help reduce redness and itchiness in mild to moderate atopic dermatitis. 

For outbreaks that tend to be more severe, a doctor may have you apply a steroid cream and wrap it in a wet bandage to keep it moist. For strong eczema itching, your doctor may supply oral antihistamines. Diphenhydramine can help stop the itching and help you sleep and ease flares. Other over the counter medications like fexofenadine, cetirizine, and other antihistamines can be taken to help with symptoms but don’t make you drowsy.

Your doctor may also prescribe oral corticosteroids or a steroid shot for strong eczema flares. When it comes to itchy skin, if you scratch your rash and break the skin. Your doctor may prescribe you antibiotics to prevent any infections.

For any eczema breakouts that are moderate to severe, that cannot be controlled by topical medications or if topical medications cannot be used. Your doctor may prescribe dupilumab. This is an injection under the skin that is given every two weeks. 

In addition, light therapy from the sun or from a UV ray device may also help ease outbreaks.

When it comes to eczema outbreaks, no matter the severity, it’s in good practice to avoid irritants like harsh cleansers, make sure to wear light fabrics, and find ways to relax in times of stress. 

Call Dr. Balshi in South Florida For All Your Dermatology Needs

To schedule a preliminary consultation about your eczema skin questions and concerns, call board-certified dermatologist in Delray Beach, contact Balshi Dermatology at (561) 272-6000 or send us a message on our Contact Page to set up your appointment.