How to manage eczema flare-ups without major side effects?

Question

Hello doctor,

I am a 31-year-old woman with eczema that has been flaring up a lot more lately, mostly on my hands, neck, and around my eyes. I have tried steroid creams, but they thin my skin, and I am also planning to start trying for a baby. I am worried about which treatments are safe during pregnancy or breastfeeding, and I also feel very self-conscious, especially at work. Is there a connection between hormonal changes and eczema worsening? Are there any newer treatments that help women manage this condition long-term without affecting fertility or causing visible side effects?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Eczema (or atopic dermatitis) can definitely be influenced by hormonal shifts, especially in women during reproductive years, pregnancy, or even with cycle fluctuations. The skin around the hands, eyes, and neck is particularly sensitive and often reacts more severely to stress, allergens, and hormonal changes.

You are right to be cautious about treatments, especially as you plan for pregnancy. While topical steroid creams are often effective short term, long-term use—particularly on thin or delicate skin can lead to issues like skin thinning.

Fortunately, there are several safer options for women trying to conceive:

Topical Calcineurin inhibitors (immunosuppressants) (like Tacrolimus or Pimecrolimus) are non-steroidal and do not thin the skin. They are often used safely around the eyes and neck. While not officially approved for use during pregnancy, some dermatologists may consider them when benefits outweigh risks.
Moisture barrier repair creams and ceramide-rich moisturizers used daily can reduce flares and may help minimize the need for stronger medications.
If your eczema is severe or affecting your quality of life, biologic therapies like Dupilumab (monoclonal antibodies) (Dupixent) have shown good long-term results and are considered relatively safe during pregnancy and breastfeeding under close supervision.
Phototherapy (narrowband UVB) is another non-drug option often used safely in women during pregnancy.
Managing triggers like stress, fragrances, or certain foods, along with maintaining good sleep and hydration, also helps significantly.

If your symptoms persist or worsen, I would be happy to work with you to develop a tailored plan that supports your skin health and your reproductive goals. You are not alone in this, and there are safe, effective options available for women just like you.

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

I hope this helps.

Thank you.