A clear guide to eczema creams — so you can settle flares early, reduce itch, and keep your child comfortable.
Moisturising is the foundation of eczema care, but when a flare is active, moisturiser alone often isn’t enough. Eczema medication is used to calm inflammation quickly, stop the itch–scratch cycle, and then return to a maintenance routine.
At The Skin Doctor, our approach is simple: the right medication, on the right area, for the right length of time — with a plan that parents can follow without guesswork.
[Book appointment] (Childhood Eczema Consultation)
Key takeaways for parents
- Eczema is dryness plus inflammation — flares often need anti-inflammatory treatment to settle properly
- The most common problem we see is undertreating a flare (which leads to weeks of itch, thickened skin and broken sleep)
- Sensitive areas (face/eyelids/folds) often suit steroid-sparing options
- If you’re needing creams “constantly”, you don’t need more trial-and-error — you need a clearer plan
Start here:
Jump links
- Why medications are used
- Topical steroids (how to use safely)
- Elidel (pimecrolimus): expanded guide
- Tacrolimus: where it fits
- Crisaborole (STAQUIS™): expanded guide
- Itch relief (antihistamines)
- Infected eczema: when antibiotics/antivirals are needed
- Preventing relapse (proactive therapy)
- FAQs
- Book an appointment
Why medications are used
Eczema isn’t just “dry skin”. During a flare, the immune system in the skin becomes overactive, causing redness, itch and irritation. Scratching then damages the barrier and the flare escalates.
Medication is used to:
1.settle inflammation quickly,
2.stop the itch–scratch cycle, and
3.allow the skin barrier to recover (supported by daily moisturising).
The three main treatment “tools” (quick guide)
Steroids vs Elidel/tacrolimus vs Crisaborole — which is “best”?
Most children don’t need one “forever cream” — they need the right tool for the right job.
- Topical steroids: best for fast control of an active flare, especially on the body and limbs (short courses).
- Elidel (pimecrolimus) / tacrolimus: steroid-sparing options often used for sensitive areas (especially face/eyelids/folds) and for relapse prevention in children who flare repeatedly. (1,2)
- Crisaborole (STAQUIS™): a non-steroid anti-inflammatory for mild to moderate eczema, available in Australia since 2019 (and approved for ages 2+). (3,4)
We tailor the choice to your child’s age, eczema severity, and body site (face vs folds vs limbs).
1) Topical corticosteroids (steroid creams)
Topical steroids reduce inflammation and itch and are the most commonly used prescription treatment for eczema flares.
Are steroid creams safe?
Used correctly, topical steroids are effective and generally safe in children. (2,5)
Problems usually occur when very strong steroids are used for long periods on delicate areas without review.
In real life, many flares drag on because treatment is too weak, used inconsistently, or stopped too early.
Choosing the right strength (site matters)
A key eczema principle: skin thickness varies by body site, so your plan changes depending on where the eczema is.
- Face/eyelids/groin: we usually avoid strong steroids and often prefer steroid-sparing options (see below). (1,2)
- Body/limbs: mild to moderate steroids are commonly used for short courses. (5)
- Thickened, scratched areas: may need a stronger option short-term under guidance.
How to apply steroid cream (simple rules)
- Apply to active eczema patches (red/itchy/rough), not normal skin.
- Use once or twice daily as directed. (5)
- Continue until the skin is calm and smooth, not just “a bit better”.
- Moisturiser still matters: apply steroid to the eczema patch, then moisturiser over the area and the rest of the body Daily Eczema Routine for Children. (5)
A practical point from paediatric guidelines: there is generally no need to use steroids “sparingly” during a flare — the priority is settling the inflammation properly, then stepping down. (5)
2) Elidel (pimecrolimus 1% cream) — expanded
Elidel is a steroid-free anti-inflammatory cream (a topical calcineurin inhibitor). It is commonly used in childhood eczema because it does not thin the skin, making it especially useful for delicate areas. (1,6)
Elidel is indicated in Australia for infants 3 months and older for:
- short-term treatment of signs and symptoms, and
- intermittent longer-term treatment of emerging and resolving eczema where steroid use is not warranted, no longer needed, or is inadvisable. (6,7)
When we commonly choose Elidel
Elidel is often particularly helpful when:
- eczema is on the face, including around the mouth and cheeks
- eczema involves eyelids or skin folds
- your child has frequent relapses and you want a steroid-sparing plan
- you want to treat early — Elidel is commonly used at the first signs of itch/redness to reduce escalation to a larger flare. (8)
What parents notice (and what it means)
A temporary warm or stinging feeling can occur at first, especially if the skin is very inflamed or cracked. This usually settles as the eczema calms. (1,8)
How Elidel is often used
Elidel is commonly applied twice daily to active patches until the eczema settles, then used as part of a longer-term plan in children who relapse in predictable zones. (6,8)
3) Tacrolimus (ointment) — where it fits
Tacrolimus is another steroid-sparing anti-inflammatory (also a topical calcineurin inhibitor). It is often used for more persistent eczema, and is particularly useful on face and eyelids when stronger steroids are not desirable. (1)
In Australia, currently registered tacrolimus ointment products include 0.1% ointment indicated for adults and adolescents 16+. (9,10)
For younger children, tacrolimus may still be used in selected cases under specialist guidance (sometimes via compounding pathways), depending on the clinical situation and availability. (1)
4) Crisaborole (STAQUIS™) — expanded
Crisaborole 2% ointment (STAQUIS™) is a non-steroid anti-inflammatory for mild to moderate atopic dermatitis.
Availability in Australia
STAQUIS was registered in Australia in February 2019 and has been available here since 2019. (3,4)
It is indicated for topical treatment of mild to moderate atopic dermatitis in patients 2 years of age and older. (3)
When we might consider crisaborole
Crisaborole can be useful when:
- eczema is mild to moderate, but still needs an anti-inflammatory during flares
- you want to minimise steroid use, but still treat early and properly
- eczema keeps returning and you need a non-steroid option that fits into a longer-term plan
- your child doesn’t tolerate Elidel/tacrolimus (for example, stinging is a barrier)
When we might prefer Elidel (pimecrolimus) instead
For face/eyelids/folds, calcineurin inhibitors are often the first steroid-sparing choice in children, particularly when eczema is recurrent in those delicate sites. (1,6,8)
How it’s used
Typically applied as a thin layer to active eczema patches, commonly twice daily, as part of a written plan. (11)
Common side effect
A brief stinging/burning sensation can occur, especially if the skin is cracked or very inflamed. (11)
5) Itch relief (antihistamines)
Antihistamines don’t treat eczema inflammation directly, but they can sometimes help sleep during severe itch phases. This is usually a short-term support strategy alongside proper flare treatment (not a replacement for it).
6) Infected eczema (antibiotics / antivirals)
Broken skin from scratching increases infection risk. If infection is present, eczema can flare severely and suddenly.
Seek review if you see:
- yellow crusting, weeping or pus
- rapidly spreading redness
- increasing pain or warmth
- fever or your child seems unwell
- clustered blisters or eczema suddenly becoming very painful
Full red flags and what to do: Infected Eczema in Children
Preventing relapse (proactive therapy)
Some children flare in the same areas repeatedly (for example, elbow creases, behind knees, wrists). In those cases, proactive therapy can help reduce the number of flare-ups.
A common approach is using an anti-inflammatory treatment on “repeat zones” two days per week between flares, alongside daily moisturising. (12)
Steroid-sparing creams like pimecrolimus are also commonly used for maintenance strategies in children who relapse frequently. (1)
This is where a written “what to use where” plan makes a big difference.
FAQ
How much cream should I use?
Enough to cover the eczema patch in a thin layer. If you’re unsure, we can show you a simple method (like fingertip units) and put it into a written plan. (5)
Can I use eczema medication on the face?
Often yes — but face and eyelids need a careful approach. We commonly use steroid-sparing options for delicate sites and reserve steroid creams for selected situations and short courses. (1,2)
Why does eczema come back when we stop treatment?
Because the skin barrier remains sensitive even when redness improves. The long-term answer is daily moisturising Daily Eczema Routine for Children, trigger control Eczema Triggers & Flare Control in Children, and a structured flare plan — sometimes with proactive maintenance for repeat zones. (12)
Book an appointment
If you’d like a simple, written plan for your child that clarifies:
- what to use where
- how long to use it
- how to step down and maintain
- what to do when a flare starts
[Book appointment] (Childhood Eczema Consultation)
Clinics: Ivanhoe and Diamond Creek
References
1.Australian Prescriber. Treatments for atopic dermatitis. 22 June 2023.
https://australianprescriber.tg.org.au/articles/treatments-for-atopic-dermatitis.html
2.Royal Children’s Hospital Melbourne. Clinical Practice Guidelines: Eczema.
https://www.rch.org.au/clinicalguide/guideline_index/eczema/
3.Therapeutic Goods Administration (TGA). Australian Public Assessment Report (AusPAR): Crisaborole (Staquis). Includes decision and ARTG entry dates and age indication.
https://www.tga.gov.au/sites/default/files/auspar-crisaborole-190814.pdf
4.TGA. STAQUIS (Pfizer Australia Pty Ltd) registration summary (date registered).
https://www.tga.gov.au/resources/prescription-medicines-registrations/staquis-pfizer-australia-pty-ltd
5.Royal Children’s Hospital Melbourne. Clinical Practice Guidelines: Eczema (topical steroid use and application guidance).
https://www.rch.org.au/clinicalguide/guideline_index/eczema/
6.NPS MedicineWise. Elidel Cream (pimecrolimus) – suitability from 3 months+ and use in eczema.
https://www.nps.org.au/medicine-finder/elidel-cream
7.healthdirect Australia. Elidel (pimecrolimus) ARTG indication summary (3 months+; short-term and intermittent long-term where steroids not suitable).
https://www.healthdirect.gov.au/medicines/brand/amt,4387011000036109/elidel
8.NPS MedicineWise. Elidel Consumer Medicine Information (early use; repeated episodes).
https://www.nps.org.au/assets/medicines/d858672b-462a-4bb9-97cc-a53300ff3184.pdf
9.TGA. Tacrolimus Intas 0.1% ointment ARTG entry.
https://www.tga.gov.au/resources/artg/388171
10.TGA. Tacrolimus Intas / AZematop 0.1% ointment registration summary (indication includes adults and adolescents 16+).
https://www.tga.gov.au/resources/prescription-medicines-registrations/tacrolimus-intas-azematop-accord-healthcare-pty-ltd
11.TGA. Attachment: Product Information: Crisaborole (Staquis) (approved PI in AusPAR package).
https://www.tga.gov.au/sites/default/files/auspar-crisaborole-190814-pi.pdf
12.Lax SJ, et al. Strategies for using topical corticosteroids in children and adults with eczema (includes proactive twice-weekly approach). 2022.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8916090/