Eczema Action Plan 

Green Zone: Daily Skin Care Regimen (skin with very mild redness/irritation)

  1. Avoid irritating factors in soaps, detergents, fabric softeners, dryer sheets, dyes, or perfumes. Be sure all products are scent and dye free (read labels!). Examples include:
    • Detergent – All Free & Clear, Dreft
    • Skin Cleanser – Cetaphil, CeraVe Hydrating Cleanser, Aquaphor (wash), Aveeno Eczema Wash
    • Moisturizer – Vaseline, Aquaphor, CeraVe, Cetaphil Restoraderm, Aveeno Eczema Cream, or even some natural oils (i.e. coconut oil, however keep in mind some may be allergic to this)
  • Give a SHORT daily lukewarm bath of 5-10 minutes with a mild skin cleanser. Don’t rub with a washcloth – this can lead to irritation. Remember that water is actually drying to our skin (it can remove the essential oils that protect us from dryness), thus long baths are not recommended.
  • Immediately after the bath, pat the child relatively dry, then apply ointment or cream generously from head to toe. In children with eczema, one of the most important steps in their care is using moisturizers; lotion must be applied multiple times every day for best results.
  • When the child is itchy/scratching give Claritin (OTC) or Zyrtec (OTC) in the morning and give Benadryl (OTC) or Atarax (Prescription) at night. Trim nails on a regular basis to minimize scratch injury. Put gloves on at night for severe scratches.
  • Remember that eczema is a chronic condition and will come and go for several months/years. Our goal is to get it under control, but the child who has this predisposition will probably always need a little “extra moisture” and skin care. Also, viral infections or fevers or other illnesses as well as changes in weather or certain foods might precipitate an outbreak of eczema temporarily. Helpful website: nationaleczema.org

Yellow Zone (skin starting to flare with mild to moderate redness/itching)

  • Facial Eczema
  • Apply Moisturizing Ointment/Cream 4-6x/day all over the face.
  • To all RED areas apply Hydrocortisone 1% 2x/day in addition to the above Ointment/Cream for no more than 2 weeks at a time. For example: 2 weeks on and then 2 weeks off, then 2 weeks on, etc.
  • Body Eczema
  • Apply Moisturizing Ointment/Cream 4-6x/day all over the body.
  • To all RED areas apply Hydrocortisone 1% 2x/day in addition to the above Ointment/Cream for no more than 2 weeks at a time. For example: 2 weeks on and then 2 weeks off, then 2 weeks on, etc.

 Red Zone (skin with SEVERE redness/itching/oozing)­

  • Facial Eczema
  • Apply Moisturizing Ointment/Cream 4-6x/day all over the face.
  • To all RED areas Hydrocortisone 1% 2x/day for no more than 2 weeks at a time. For example: 2 weeks on and then 2 weeks off, then 2 weeks on, etc.
  • Body Eczema
  • Apply Moisturizing Ointment/Cream 4-6x/day all over the body.
  • To all RED areas apply Triamcinolone 0.1% ointment or cream (if prescribed) 2x/day for no more than 2 weeks at a time. For example: 2 weeks on and then 2 weeks off, then 2 weeks on, etc. Never use Triamcinolone on the face/groin!
  • Apply Mupirocin or Neosporin 2x/day to any open wounds until they heal.
  • If you feel that, despite application of the moisturizer 6x/day and occasional use of hydrocortisone or triamcinolone (if prescribed), the eczema is progressing or failing to get “under control,” then please give us a call or make an appointment to see what the next steps should be.

Potency Ranking of Commonly Used Corticosteroid Groups

Group I

Superpotent

Group II

Potent

Group III

Midpotent

Group IV

Midpotent

Group V

Midpotent

Group VI

Mild

Group VII

Mild

DiproleneÒ cream, 0.05% (betamethasone dipropionate) Cyclocort® ointment, 0.1% (amcinonide) Aristocort A® ointment, 0.1% (triamcinolone acetonide) Cordran® ointment, 0.05% (flurandrenolide) Cordran® SP cream, 0.05% (flurandrenolide) Aclovate® cream, 0.05% (alclometasone dipropionate) Topicals with hydrocortisone, dexamethasone, flumethasone, prednisolone, methylprednisolone
DiproleneÒ ointment, 0.05% (betamethasone dipropionate) Diprolene® AF cream, 0.05%

(betamethasone dipropionate)

Cutivate® ointment, 0.005% (fluticasone propionate) Elocon® cream, 0.1%

(mometasone furoate)

Cutivate® cream, 0.05%

(fluticasone propionate)

Aclovate® ointment, 0.05% (alclometasone dipropionate)
PsorconÒ ointment, 0.05% (diflorasone diacetate) Diprosone® ointment, 0.05% (betamethasone dipropionate) Cyclocort® cream, 0.1%

(amcinonide)

Kenalog® cream, 0.1% (triamcinolone acetonide) Diprosone® Ointment/Cream, 0.05% (betamethasone dipropionate) Aristocort A® cream, 0.1% (triamcinolone acetonide)
TemovateÒ cream, 0.05%

(clobetasol propionate)

Elocon® ointment, 0.1% (mometasone dipropionate) Cyclocort® Ointment/Cream, 0.1%

(amcinonide)

Synalar® ointment, 0.025% (fluocinolone acetonide) Kenalog® Ointment/Cream, 0.1% (triamcinolone acetonide) DesOwen® cream, 0.05%

(desonide)

TemovateÒ ointment, 0.05% (clobetasol propionate) Florone® ointment, 0.05% (diflorasone diacetate) Diprosone® cream, 0.05% (betamethasone dipropionate) Topicort LP® cream, 0.05% Locoid® cream, 0.1% (hydrocortisone butyrate) Locorten® cream, 0.03% (flumethasone pivalate)
TemovateÒ gel, 0.05%

(clobetasol propionate)

Halog cream, 0.1% (halcinonide) Florone® cream, 0.05%

(diflorasone diacetate)

Westcort® ointment, 0.2% (hydrocortisone valerate) Synalar® cream, 0.025% (fluocinolone acetonide) Synalar® cream, 0.01% (fluocinolone acetonide)
Temovate eÒ emollient, 0.05%

(clobetasol propionate)

Lidex® cream, 0.05% (fluocinonide) Halog ointment, 0.1%

(halcinonide)

Valisone® cream, 0.1% (betamethasone valerate) Synalar® topical solution, 0.01% (fluocinolone acetonide)
Ultravate® cream, 0.05%

(halobetasol propionate)

Lidex® gel,

0.05% (fluocinonide)

Lidex-E® cream, 0.05%

(fluocinonide)

Westcort® cream, 0.2% (hydrocortisone valerate) Tridesilon® cream, 0.05%

(desonide)

Ultravate® ointment, 0.05% (halobetasol propionate) Lidex® ointment, 0.05% (fluocinonide) Maxiflor® cream, 0.05%

(diflorasone diacetate)

Valisone® Ointment/Cream, 0.05% (betamethasone valerate)
Maxiflor® ointment, 0.05% (diflorasone diacetate) Valisone® ointment, 0.1% (betamethasone valerate)
Psorcon® cream, 0.05%

(diflorasone diacetate)

Topicort® cream, 0.25% (desoximetasone)
Topicort® gel, 0.05% (desoximetasone)
Topicort® ointment, 0.25% (desoximetasone)
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