Eczema in Hard-to-Treat Places: What Helps?

If you or your child has eczema, you’re probably no stranger to the itchiness, inflammation, and rash-like symptoms it can bring on. You can get eczema anywhere on your body. Exactly where depends partly on how old you are, says Kalyani Marathe, MD, a pediatric dermatologist and director of the Division of Dermatology at Cincinnati Children’s Hospital.

Infants tend to get eczema on their:

• Face
• Backs of the arms or legs
• Back
• Chest
• Belly

Older children and teens tend to get symptoms in creases or on places where they sweat, like their:

• Neck
• The insides of elbows
• On the backs of knees
• Sometimes, on hands or feet

Adults are more likely to get eczema on their hands, Marathe says, perhaps because they wash their hands and do the dishes more. It’s also common for symptoms to show up on the:

Adults are less likely to get facial and scalp eczema, Marathe says.

Both adults and children can get eyelid eczema, she says. That’s often due to an allergic reaction to something touching the skin.

The amount and type of treatment that’s right for you or your child also depends on where the eczema is, Marathe says. Some areas are harder to treat than others.

Treatment can be trickier when eczema flares up on parts of your body with thinner skin, like your lips, the areas around your eyes, and your groin.

Steroids, the most common treatment, can thin out your skin if you overuse them, which could lead to bruising and tearing, says Steve Daveluy MD, an associate professor and program director at Wayne State Dermatology in Michigan. Accidentally getting steroids in your eyes can also raise your chances for a temporary type of glaucoma, which could affect your vision, he says.

Still, you can safely use low-strength (weaker) steroids on your face and groin, Daveluy says. You just have to be careful. Work with your dermatologist to make sure you’re using the right strength for the right amount of time, and call them right away if you have side effects.

Your dermatologist might also recommend nonsteroid drugs, like ones called topical calcineurin inhibitors. “They’re great because they don’t have the same side effects as steroids — they don’t thin the skin, there’s no risk of glaucoma — so they’re super-safe to use on the face and on the genitals,” Daveluy says. The only possible drawbacks, he says, are that they can sting a bit at first, and getting your insurance to cover them might be a hurdle. Nonsteroid medications also include crisaborole (Eucrisa) ointment, ruxolitinib (Opzelura) cream, and abrocitinib (Cibinqo) or upadacitinib (Rinvoq) pills.

Want to try home remedies to ease your symptoms? The kinds that might help also depend partly on where the eczema shows up. (Note: Talk to your doctor before you try home remedies on a baby.)

Wet wraps, which can help medicines work better, work well on body parts where the skin is thicker, like the legs, feet, hands, wrists, and forearms, Marathe says. To make a wet wrap:

• Put on your medication.
• Cover your affected body part with plastic wrap for 30 minutes.
• Take off the wrap and moisturize your skin. 

You can do the same thing with store-bought tubular dressings. The only difference is that you soak them in warm water and wring them out, so they’re damp when you put them on, Marathe says.

If your small child has eczema, you can do something similar if they wear long-sleeved pajamas at night: Soak the PJs in warm water, then put them in the dryer for a few seconds so they’re damp but warm. “Sometimes kids will sleep in them, so [parents] put dry pajamas on top of that,” Marathe says. “Some kids really like that because it has a bit of a cooling sensation, but for other kids it’s too cold for them, so they don’t really like it.”

Other ways to ease the itch in tough-to-treat areas include:

Moisturize. To keep your skin from getting dry, inflamed, and irritated, your daily moisturizer is a must, Daveluy says. Choose one with no fragrance, which can irritate the skin. The most important thing is to find one that you like and that you’ll use at least once a day, he says. “Most people need it more than once a day.”

Wash off pollen. If you notice your eczema flares up during pollen season, rinse your face after you’ve been outside for a while, Daveluy says. Put on moisturizer right after.

Cool off. Instead of scratching or rubbing a lot, which can damage skin, ease the itch with an ice pack or a bag of frozen peas. “Ice actually soothes itch really well, because the same nerves that feel itch feel cold,” he says. You can also put your moisturizing cream in the refrigerator.

Make a soothing mask. “You can make a facial mask out of rice paper, like the kind they use to make spring rolls or fresh rolls,” Daveluy says. “You basically cut eye holes and a mouth hole … and then you get it wet [with water]. You can put that on to soothe the skin, because it has some natural moisturizing effects in it from the starch in the rice. Some people even wear it to bed.” You may want to cut the rice paper in two before you wet it, because it can be hard to handle.

Try massage. If your child’s face itches at night, massage some moisturizer into their skin before bedtime, Daveluy says. “They’ve done some studies that found massage can be soothing for kids with eczema and help them fall asleep. And it can actually help improve the eczema, probably by helping it calm down a little.”

Shop safely. Talk to your dermatologist before you use over-the-counter products for your groin, especially for women’s genitals. Many of these products have a lot of ingredients that can irritate eczema, Daveluy says.