The best eczema creams for sensitive skin prioritise the restoration of the skin barrier by utilising a specific ratio of lipids—ceramides, cholesterol, and free fatty acids—which are often depleted in atopic skin [1]. For Australian consumers, therapeutic moisturisers (emollients) that are fragrance-free, soap-free, and hypoallergenic are essential to minimise the risk of contact dermatitis. Formulations containing petrolatum or paraffin are considered the 'gold standard' for occlusive protection, as they create a physical shield that prevents transepidermal water loss (TEWL) and allows the stratum corneum to repair itself [2].
Additionally, high-quality eczema creams often incorporate humectants like glycerine or urea. While urea is a potent keratolytic that helps hydrate the skin, it may cause stinging on broken or highly sensitised skin, so individuals with severe flares might prefer 'bland' emollients with colloidal oatmeal. Colloidal oatmeal contains avenanthramides, which exhibit potent anti-inflammatory and anti-itch properties, providing symptomatic relief for the pruritus commonly associated with eczema flares [3].
Atopic dermatitis, or eczema, is characterised by a dysfunctional skin barrier and an overactive immune response. Scientists have identified that mutations in the filaggrin gene (FLG) often lead to a deficiency in natural moisturising factors (NMFs), making the skin vulnerable to environmental allergens and microbial colonisation [1]. This barrier breakdown initiates a cycle of inflammation and itching that further damages the cutaneous surface.
From a formulation science perspective, the goal of an eczema cream is not merely to add moisture, but to mimic the skin's natural architecture. Modern dermatological preparations use lamellar technology to deliver lipids in a structure that resembles the intercellular matrix of the skin [4]. By stabilising the pH of the skin at a slightly acidic level (around 4.5 to 5.5), these creams also support the skin's acid mantle, which is vital for antimicrobial defence and enzyme function [5].
For those exploring ways to support a compromised skin barrier, our Balance Biome Crème is formulated with Bifida Ferment Lysate and Niacinamide to encourage microbiome resilience and a balanced complexion. To ensure the cleansing process remains non-stripping, many of our customers also incorporate Surface Calm, a specialised ceramide-rich cleanser designed to replenish essential lipids and soothe sensitised skin.
FAQ
What is the difference between an ointment, a cream, and a lotion for eczema?
Ointments are the most effective for extremely dry eczema as they are primarily oil-based (80% oil, 20% water), providing a heavy occlusive barrier that maximizes hydration [2]. Creams contain a balance of oil and water, making them more aesthetically pleasing for daytime use while still providing significant barrier support. Lotions have the highest water content and evaporate quickly; they are generally less effective for eczema management as they may contain preservatives or alcohols that can further irritate sensitised skin [4].
Can I use creams with steroids for long-term eczema maintenance?
Topical corticosteroids (TCS) are intended for short-term management of acute flares to reduce inflammation, not for long-term maintenance. Overuse of potent steroids can lead to skin thinning (atrophy) and telangiectasia [5]. For long-term management, 'steroid-sparing' methods using high-quality emollients or topical calcineurin inhibitors are preferred to maintain the skin barrier without the side effects associated with hormonal treatments [1].
Why does my eczema cream sting when I apply it?
Stinging is often a result of a severely compromised skin barrier, where nerves are more exposed to the environment. It can also be caused by specific ingredients like urea, lactic acid, or certain preservatives found in lighter creams. If stinging occurs, switching to a preservative-free, petrolatum-based ointment can often provide the necessary hydration without the chemical irritation associated with thinner formulations [2][3].
References:
[1] Nutten S. Atopic Dermatitis: The Role of Barrier Repair. Ann Nutr Metab. 2015;66(suppl 1):8-16. doi:10.1159/000370220
[2] Moncrieff G, et al. Use of emollients in dry-skin conditions: consensus statement. Clin Exp Dermatol. 2013;38(3):231-8. doi:10.1111/ced.12104
[3] Reynertson KA, et al. Anti-inflammatory activities of colloidal oatmeal (Avena sativa) contribute to the effectiveness of oats in treatment of itch associated with dry, irritated skin. J Drugs Dermatol. 2015;14(1):43-48.
[4] Purnamawati S, et al. The Role of Moisturizers in Addressing Various Kinds of Dermatitis: A Review. Clin Med Res. 2017;15(3-4):75-87. doi:10.3121/cmr.2017.1363
[5] Danby SG, et al. Effect of different emollient formulations on skin barrier function in atopic dermatitis. J Invest Dermatol. 2016;136(3):589-591. doi:10.1016/j.jid.2015.12.016
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any new skincare regimen. Content reviewed by a biomedical scientist.
