# Atopic Eczema in Adults - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Betamethasone Valerate 0.1%w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 102491) · Eumovate (clobetasone butyrate 0.05%) Cream SmPC sections 4.2 and 4.4 (eMC product 3807) · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · NICE CKS: Eczema - atopic 2025 · NICE Technology Appraisal TA82: Tacrolimus and Pimecrolimus for Atopic Eczema 2004 · No labelled dose - emollient applied liberally and as often as needed, to effect · Protopic 0.1% ointment SmPC sections 4.1 and 4.2 (eMC product 1608) - Verified date: 2026-08 ## Verified against - Betamethasone Valerate 0.1%w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 102491) - Eumovate (clobetasone butyrate 0.05%) Cream SmPC sections 4.2 and 4.4 (eMC product 3807) - Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) - No labelled dose - emollient applied liberally and as often as needed, to effect - Protopic 0.1% ointment SmPC sections 4.1 and 4.2 (eMC product 1608) ## Treatment metadata - Liquid paraffin — topical - Hydrocortisone — topical - Clobetasone — topical - Betamethasone — topical - Tacrolimus — topical ## Complete treatment card ```text ATOPIC ECZEMA IN ADULTS Sources: Betamethasone Valerate 0.1%w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 102491) · Eumovate (clobetasone butyrate 0.05%) Cream SmPC sections 4.2 and 4.4 (eMC product 3807) · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · NICE CKS: Eczema - atopic 2025 · NICE Technology Appraisal TA82: Tacrolimus and Pimecrolimus for Atopic Eczema 2004 · No labelled dose - emollient applied liberally and as often as needed, to effect · Protopic 0.1% ointment SmPC sections 4.1 and 4.2 (eMC product 1608) Review status: REVIEWED against 5 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - Itching severe enough to disturb sleep, with a history of the rash's onset and spread [itching · rash] - Personal or family history of atopic conditions such as asthma, hay fever or eczema [allergic rhinitis] - Flares may be triggered by dust mites, animal dander, soaps, fragrances, synthetic fabrics, sweating or certain foods [sweating] SIGNS - what you find (5) - Adults typically show thickened, lichenified plaques with exaggerated skin lines, often on the hands [plaques] - In the acute stage, lesions are swollen red papules and plaques that may weep or crust [papules · plaques] - Subacute lesions show redness, scaling and variable crusting [crusting · redness · scaling] - Chronic lesions are thick plaques with lichenification and scale [plaques] - Keratosis pilaris may be an associated finding supporting the diagnosis TESTS (3) - Diagnosis is usually made clinically from the typical presentation, without routine testing - A skin biopsy, if done, typically shows an eczematous pattern - In hard-to-treat pediatric cases, IgE testing by immunoassay or skin prick may look for specific allergens IF NOT THIS - what else fits (4) - Allergic contact dermatitis rather than atopic disease - Lichen simplex or lichen planus - Psoriasis, scabies, or a fungal (tinea) infection - Seborrheic dermatitis, a distinct scaly rash Source StatPearls "Atopic Dermatitis" - disease-level clinical article Status traced to the source above Rx: Emollient - use throughout | Topical steroid - face and flexures | Topical steroid - trunk and limbs | Topical steroid - potent, short flare | Steroid-sparing alternative EMOLLIENT - USE THROUGHOUT 1. LIQUID PARAFFIN [1st line] Adult Apply emollient liberally and frequently (at least 2-3 times daily) to all skin, including areas that are currently clear - long-term continuous maintenance Peds Not applicable in this adult entry - see 'Atopic Eczema in Children' for paediatric dosing Source No labelled dose - emollient applied liberally and as often as needed, to effect Why Emollients remain the foundation of adult eczema management and reduce the amount of topical corticosteroid needed Caution Continue emollient use even when skin is clear to maintain barrier function. Apply emollient 15-30 minutes before or after a topical steroid, not at the same time. Warn about fire hazard when fabric contacts paraffin-based products. Use a soap substitute rather than standard soap. Egypt ADCOCARE CREAM 20 GM ARAB DRUG COM... 12.00 EGP -> ! also contains glyceryl monostearate, propylene glycol, urea DERMOLAN CREAM 50 GM HI-CARE > EMI... 19.00 EGP -> ! also contains allantoin, glycerol, glycolic acid, panthenol, salicylic acid, urea, vitamin c, zinc oxide ADCOCARE CREAM 40 GM ARAB DRUG COM... 21.75 EGP -> ! also contains glyceryl monostearate, propylene glycol, urea CARE MIX PLUS HAIR CREAM 50 GM VITA PHARM > ... 29.50 EGP -> ! also contains cetostearyl alcohol, lanolin, panthenol, wheat protein, white soft paraffin PROPOLIS CREAM 15 ML LUNA FOR PERF... 30.00 EGP -> ! also contains cera alba, glycerin, propolis PROPOLIS CREAM 30 ML LUNA FOR PERF... 55.00 EGP -> ! also contains cera alba, glycerin, propolis HEALTHPOINT NAPPY CREAM 100 GM HEALTHPOINT L... 70.00 EGP -> ! also contains benzyl alcohol, cetearyl alcohol, glyceryl stearate, lanolin, peg-100 s, water, zinc oxide HERCUL WHITENING CREAM 60 GM LEADER FOR CO... 74.75 EGP -> ! also contains alpha arbutin, diemthicone, glycerin, licorice ext, octyl methoxy, titanium dioxide, vit.c TOPICAL STEROID - FACE AND FLEXURES 2. HYDROCORTISONE [1st line] Adult Adults and children: To be applied sparingly to the affected skin two or three times daily after gently cleansing the area. x up to 1-2 weeks, then reassess. The label does not set a number for the face beyond avoiding prolonged use - keep facial courses as short as the flare allows Peds Not applicable in this adult entry - see 'Atopic Eczema in Children' for paediatric dosing Source Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) Why Mild potency is reserved for delicate facial and flexural skin; step up to moderate potency for the trunk and limbs if inadequate response Caution Avoid prolonged use on the face - the label says so without naming a number, so the five-day figure often quoted is custom rather than licence. Shortest course that settles it. Stop once the flare resolves; do not use as long-term continuous maintenance. Watch for secondary bacterial infection (weeping, crusting, pustules) requiring oral flucloxacillin. Limit a course in a child to 7-10 days, and remember the face and scalp absorb far more than limb skin. Hydrocortisone Cream is contra-indicated in patients with bacterial, viral or fungal infections of the skin. Urticaria, rosacea, ulcers and local infection are also contra- indications. Egypt NOVACORTIN 1% CREAM 15 GM PHAROPHARMA 4.75 EGP NOVACORTIN 1% OINT. 15 GM PHAROPHARMA 4.75 EGP MICORT 1% CREAM 20 GM MISR 12.50 EGP HYDROCORTISONE 1% OINT. 20 GM MISR 21.00 EGP TOPICAL STEROID - TRUNK AND LIMBS 3. CLOBETASONE [1st line] Adult Apply 0.05% cream/ointment thinly once or twice daily to inflamed skin on the trunk and limbs - Up to 4 weeks of continuous daily use; a child should not normally exceed 7 days Peds Not applicable in this adult entry - see 'Atopic Eczema in Children' for paediatric dosing Source Eumovate (clobetasone butyrate 0.05%) Cream SmPC sections 4.2 and 4.4 (eMC product 3807) Why Moderate potency for trunk/limb flares not controlled by mild potency steroid, per the CKS potency ladder Caution Do not use on the face or flexures - reserve moderate potency for the trunk and limbs. There is a risk of skin thinning (atrophy) with prolonged or repeated courses. Four weeks of continuous daily use is the adult ceiling. In a child it is normally seven days, and under 12 it should be a doctor's decision to use it at all. Keep it off the face where you can - facial skin thins faster than anywhere else. Under a dressing it absorbs far more and the warm damp underneath breeds bacteria. Clean the skin before each fresh dressing. Egypt EUMOVATE 0.05% TOP. CREAM 15 GM GLAXO SMITHKLINE 12.75 EGP EUMOVATE 0.05% TOP. OINT. 15 GM SMITHKLINE BE... 12.75 EGP TOPICAL STEROID - POTENT, SHORT FLARE 4. BETAMETHASONE [2nd line] Adult Apply 0.1% cream/ointment thinly twice daily to affected areas for itch and inflammation - Short courses during a flare, usually 1-2 weeks; step back down once the flare settles Peds This entry is for adults. In a child, a potent steroid on the trunk or limbs is a short, deliberate course - see the childhood eczema entry, and never use a potent steroid on a child's face or flexures. Source Betamethasone Valerate 0.1%w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 102491) Why The potent rung the ladder was missing. Hydrocortisone 1% is mild and clobetasone 0.05% moderate; when a trunk or limb flare does not settle on clobetasone the next step is a potent steroid, not a calcineurin inhibitor. Undertreating a flare with a steroid too weak for it is the commoner failure in eczema, not overtreating. Caution Potent steroid. Not on the face, the eyelids or the flexures - use hydrocortisone 1% there. Potent steroid on facial skin thins it and causes perioral dermatitis. Short courses during a flare, then step back down. Continuous potent steroid causes skin atrophy, striae that do not recover, and telangiectasia. Fingertip units, not 'a thin smear'. Undertreating a flare is what makes people believe steroids do not work and then use them for longer. Do not apply to infected or ulcerated skin. Weeping, crusted or rapidly worsening eczema is usually infected and needs that treated first. Keep the emollient going underneath and between flares. The steroid treats the flare; the emollient is what reduces how often flares come. Egypt CRONOMESONE 0.1% CREAM 15 GM PHAROPHARMA 4.00 EGP CRONOMESONE 0.1% OINT. 15 GM PHAROPHARMA 4.00 EGP BETNOVATE 0.1% TOP. OINT. 15 GM SMITHKLINE BE... 6.90 EGP BETADERM 0.1% CREAM 15 GM EIPICO 18.00 EGP BETAVAL 0.1% CREAM 20 GM ARAB DRUG COM... 20.00 EGP BETADERM 0.1% CREAM 30 GM EIPICO 23.00 EGP BETAMETHASONE DIPROPIONATE 0.05% CREAM 20 GM AMRIYA 11.50 EGP BETAMETHASONE DIPROPIONATE 0.05% OINT. 20 GM AMRIYA 11.50 EGP STEROID-SPARING ALTERNATIVE 5. TACROLIMUS [2nd line] Adult Apply 0.1% ointment thinly twice daily to affected areas (the 0.1% strength is licensed for adults only; children use 0.03%) - until lesions clear, then maintenance once a day twice weekly; eligibility for maintenance is a response within 6 weeks of twice-daily use Peds Not applicable in this adult entry - see 'Atopic Eczema in Children' for paediatric dosing Source Protopic 0.1% ointment SmPC sections 4.1 and 4.2 (eMC product 1608) Why Second-line, steroid-sparing option for moderate-to-severe eczema not controlled by topical corticosteroids, or where continued steroid use risks skin atrophy, particularly on the face; TA82 recommends initiation only by a clinician with dermatology experience Caution Not first-line and not for mild eczema - reserve for moderate-to-severe disease unresponsive to topical corticosteroids. Transient burning or stinging on application is common and usually settles within a few days. Avoid sun exposure and use sun protection on treated skin. Avoid occlusive dressings over application sites. Reconsider the diagnosis and the treatment if there is no improvement after two weeks of twice-daily use. A patient on maintenance needs a physician review at 12 months to decide whether to continue. Egypt TAROLIMUS 0.1% TOPICAL OINT. 15 GM ANDALOUS PHARMA 144.00 EGP TRECZIMUS 0.1% TOPICAL OINT. 30 GM MARCYRL PHARMACEUTICAL INDUSTRIES (MPI) 219.00 EGP PROTOPIC 0.1 % OINT. 30 GM LEO PHARMACEU... 407.00 EGP TRECZIMUS 0.03% TOPICAL OINT. 20 GM MARCYRL PHARMACEUTICAL INDUSTRIES (MPI) 114.00 EGP TAROLIMUS 0.03% TOPICAL OINT. 15 GM ANDALOUS PHARMA 129.00 EGP PROTOPIC 0.03 % OINT. 30 GM LEO PHARMACEU... 371.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)