What Types of Eczema Should Not Be Treated with Topical Medications

Eczema is a chronic, inflammatory skin disease characterized by symptoms such as redness, swelling, itching, dryness, scaling, and even blisters and erosions. For mild to moderate eczema, topical medications are the first-line treatment, but not all types of eczema are suitable for topical therapy.

When the affected area exceeds 20% of the body surface, topical medications alone may be insufficient to effectively control inflammation, and oral anti-inflammatory drugs or immunosuppressants may be needed as adjunctive treatment. Additionally, some eczema patients, especially those with broken skin, significant exudation, or evident infection, may experience worsened skin irritation and infection if topical medications are applied directly, leading to deterioration of the condition.

If pustules, pus formation, or clear signs of bacterial infection develop at the eczema site, topical medications alone may be inadequate to control the infection, and antibiotics may be required. For patients not suitable for topical treatment, moisturizing methods are recommended to relieve symptoms. Mild moisturizing creams or lotions can be used, while moisturizing products containing irritants such as fragrances and alcohol should be avoided.

In addition, using hot water, soap, or other irritating substances to wash the skin should be avoided to prevent worsening of eczema symptoms. Wearing soft, breathable clothing to avoid friction and pressure on the skin is also recommended.