Eczema has a frustrating habit of flaring up at the worst possible moment, leaving your skin red, dry, itchy and sore. If you live with eczema, you'll know a flare-up can come on quickly. And knowing exactly what to do in the first day or two makes a difference to how long it lasts.
The good news? Most flare-ups are very manageable, and the right eczema treatment can usually bring one under control at home.
This practical guide explains what triggers a flare-up, how to calm one down step by step, which creams to reach for and how to keep the itch under control. It also covers the warning signs that mean it's time to speak to a pharmacist or GP.
Treat early. Getting on top of a flare-up before it spreads almost always means a quicker recovery.
What causes eczema flare-ups?
Atopic eczema is a long-term inflammatory skin condition. If you have eczema, your skin barrier doesn't hold on to moisture as well as it should. So your skin dries out and lets in irritants and allergens, which your immune system then overreacts to.
The result is the familiar cycle of dryness, redness, inflammation and intense itching.1 There's currently no cure, but flare-ups can be well controlled with the right approach.2
A flare-up is usually set off by a trigger, though the cause isn't always obvious. The most common triggers include:
- Soaps and detergents - washing-up liquid, bubble bath, shampoo and biological washing powders all strip your skin of its natural oils.
- Heat and sweat - getting too hot, central heating and exercise can all aggravate your skin.
- Rough fabrics - wool and some synthetic materials can irritate, while soft cotton tends to be better tolerated.
- Allergens - house dust mites, pet dander and pollen are frequent culprits.
- Stress - emotional stress is a well-recognised trigger for many people.
- Weather and water - cold, dry air and hard water can both dry your skin out further.1,3
Scratching makes everything worse. It damages your skin, increases inflammation and raises the risk of infection, which keeps the flare-up going.3
How to treat an eczema flare-up
During a flare-up, the aim is to rehydrate your skin, calm the inflammation and break the itch-scratch cycle. A simple step-by-step routine works for most people.
Step 1: Use emollients generously
Emollients (medical moisturisers) are the foundation of all eczema care. They soften your skin, lock in moisture and protect the barrier from irritants.
Apply them generously and often: at least twice a day, and more often during a flare-up. Use a leave-on emollient as a soap substitute when you wash, too.
Keep using them even once your skin has settled, as this helps prevent the next flare-up.1,4
Step 2: Add a topical steroid to settle inflammation
For red, inflamed areas that are actively flaring, a topical steroid (topical corticosteroid) reduces the inflammation, itching and redness that emollients alone can't.2 A few simple rules help you use them safely and effectively:
- Apply the steroid first, to the inflamed areas only. Then wait around 30 minutes before applying your emollient, so the steroid isn't diluted or spread onto skin that doesn't need it.2
- Use the fingertip unit (FTU) as a guide to how much to apply. One FTU is the amount squeezed from the tip of an adult finger to the first crease, roughly 0.5g, and it covers an area the size of two adult handprints. Spread it in a thin, glistening layer.2
- Apply once or twice a day until the flare-up settles, then step down gradually rather than stopping suddenly.2
Step 3: Protect your skin while it heals
Keep cool, wear soft cotton clothing and keep your nails short to limit the damage from scratching.
Steroid first, wait around 30 minutes, then emollient. Getting the order right helps both work properly.
What eczema treatment should you use?
Eczema treatment relies on two types of cream that do different jobs. Emollients are for everyday moisturising, and topical steroids are for bringing flare-ups under control.
Two topical steroids are available from a pharmacy without a prescription, supplied under a pharmacist's supervision for mild to moderate eczema:
- Hydrocortisone 1% is a mild topical steroid, suitable for milder eczema on the body.
- Eumovate (clobetasone butyrate 0.05%) is a moderate topical steroid. It's stronger than hydrocortisone, and an option when a mild steroid hasn't brought a flare-up under control.2
When bought over the counter, these shouldn't be used on the face or around the eyes, on broken or infected skin, on the genitals, during pregnancy, or by anyone under 10 (hydrocortisone) or 12 (Eumovate) without advice from a healthcare professional.2 They come in small tubes, and larger amounts need a prescription.
So what's the best emollient? Simply the one you're happy to use often enough. Consistency matters more than the brand on the tube.4
Do not use over-the-counter steroid creams on your face, around your eyes or on broken skin without advice.
How to stop eczema itching
Itching is the most distressing part of a flare-up, and scratching only feeds the cycle.
To bring it under control, keep applying emollients. A cooled emollient from the fridge can be especially soothing.
Keep rooms cool, wear cotton clothing and keep your nails short. A cool compress over an itchy patch can help too.
Antihistamines aren't generally effective for the itch of eczema itself. A short course of a sedating antihistamine at night may occasionally help you sleep through a bad flare-up. Non-sedating antihistamines are only useful if you also have hay fever.3
When to see a pharmacist or GP
A pharmacist can give advice and recommend treatments for small areas of dry, itchy eczema.1 It's worth seeking further advice if:
- Your eczema is not improving despite regular emollients and an over-the-counter steroid
- Large or widespread areas are affected, or the eczema is on your face or another sensitive area
- The skin shows signs of infection (weeping, yellow crusting, increasing redness, swelling or pain), which may need antibiotics^1^
- You develop a painful, rapidly spreading rash with clusters of small blisters and feel unwell, which can be a sign of eczema herpeticum, a serious infection that needs urgent medical attention^4^
Painful, spreading blisters and feeling unwell could be eczema herpeticum. Get urgent medical help the same day.
Some people worry about skin reactions after stopping steroids, sometimes called topical steroid withdrawal. It's linked to long-term or inappropriate use of stronger steroids.
Using them correctly, in short bursts at the lowest effective strength and alongside emollients, keeps the risk low. Speak to a clinician before stopping long-term steroid use.2
If your eczema is severe or keeps coming back, a GP may refer you to a dermatologist. Options for harder-to-treat eczema include light therapy (phototherapy) and prescription medicines that calm the immune system, including biologic treatments for moderate to severe eczema.5
Frequently asked questions
What causes eczema flare-ups?
Eczema flare-ups happen when something triggers inflammation in skin that already struggles to hold on to moisture. Common triggers include soaps and detergents, heat and sweat, rough fabrics like wool, allergens such as house dust mites, pet dander and pollen, stress, and cold or dry weather. The trigger is not always obvious, and it can vary from person to person.
How do you treat an eczema flare-up at home?
Start by applying emollients generously and often to rehydrate the skin. For red, inflamed areas, add a topical steroid such as hydrocortisone or Eumovate to settle the inflammation. Apply your emollient first and wait around 20 to 30 minutes before the steroid, use a thin layer, and treat in short bursts until the flare-up calms down.
How do you stop eczema itching?
Keep applying emollients, as an emollient cooled in the fridge can be especially soothing. Keep rooms cool, wear soft cotton clothing, use a cool compress on itchy patches, and keep your nails short to limit damage from scratching. Antihistamines are not generally effective for the itch itself, though a sedating one at night may occasionally help you sleep through a bad flare-up.
What is the best cream for eczema?
There are two types of cream that do different jobs: emollients for everyday moisturising, and topical steroids for calming flare-ups. The best emollient is simply the one you are happy to use often enough, as consistency matters more than the brand. For active episodes, a mild steroid like hydrocortisone 1% or a moderate one like Eumovate can help.
Can you buy steroid cream for eczema over the counter?
Yes. Hydrocortisone 1% (mild) and Eumovate (clobetasone butyrate 0.05%, moderate) can be supplied from a pharmacy without a prescription, under a pharmacist's supervision, for mild to moderate eczema. They come in small tubes, and should not be used on the face, around the eyes, on broken or infected skin, on the genital area or in pregnancy without professional advice. Larger quantities need a prescription.
What is topical steroid withdrawal?
Topical steroid withdrawal refers to skin reactions, such as intense redness and burning, that some people experience after stopping topical steroids. It is associated with prolonged or inappropriate use of stronger steroids. Using them correctly, in short bursts at the lowest effective potency and alongside emollients, keeps the risk low. Always speak to a clinician before stopping long-term steroid use.
References
- NHS. Atopic eczema. National Health Service. Reviewed 2025. nhs.uk
- National Eczema Society. Topical steroids. 2025. eczema.org
- British Skin Foundation. Eczema. 2026. britishskinfoundation.org.uk
- Great Ormond Street Hospital. Eczema. NHS Foundation Trust. gosh.nhs.uk
- Allergy UK. Managing severe eczema symptoms. allergyuk.org
This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.