Eczema Treatment in Canada: From Everyday Creams to Prescription Options

Most people searching for an eczema treatment are really after one thing: the cream that will finally make it stop. That’s an understandable hope, but it isn’t quite how eczema works. 

Clearing a flare and keeping skin settled usually involves working through several steps, such as moisturisers and drugstore creams for milder eczema, and prescription options when those aren’t enough. Working out which step you actually need (and when) is what brings the condition under control.

Eczema, also known as atopic dermatitis, is a common, long-term skin condition that tends to flare and settle over time rather than disappear for good. The encouraging part is how treatable it usually is. For most people, the itch, redness, and dry patches can be kept well under control, even though eczema is typically managed rather than cured.

This guide walks through eczema treatment from the ground up. We cover what eczema is and what sets it off, and the ladder of treatments, from everyday moisturisers to prescription creams. We also explain when it’s worth seeing a doctor, and how to get eczema treatment in Canada.

An Overview of Eczema Treatment

Eczema treatment (sometimes called atopic dermatitis treatment) isn’t a single product or approach — it involves a range of options, matched to how severe the eczema is and where on the body it appears. Most cases are controlled with creams and ointments applied to the skin, and only a minority ever need something stronger. Because eczema is a long-term condition, the aim of treatment is to calm flares when they happen and keep skin comfortable between them, rather than to deliver a one-time fix.

Eczema treatments are often described as a “ladder”, going from the gentlest options to the strongest:

• Moisturisers and skincare — the daily foundation, used at every level of eczema to protect the skin barrier and reduce flares.
• Over-the-counter creams — low-strength hydrocortisone for mild, short-lived flare-ups.
• Prescription steroid creams — stronger anti-inflammatory creams like Betaderm for flares that don’t settle with the basics.
• Non-steroid prescription creams — options such as Protopic and Elidel, useful on delicate areas like the face and for keeping eczema calm over the longer term.
• Specialist treatments — tablets and injections reserved for severe eczema that creams can’t control.

The idea behind the ladder is to start with the gentlest step likely to work, moving up only if a flare doesn’t respond. Most people find their eczema settles somewhere on the earlier steps, often without needing a prescription. The sections below walk through each step in turn, then cover when it’s worth seeing a doctor and how to get eczema treatment in Canada.

What Eczema Is, and What Triggers It

Eczema is a group of inflammatory skin conditions, of which atopic dermatitis is by far the most common. 

What causes eczema is two things going wrong at once: 1) the skin’s protective barrier stops holding moisture and keeping out irritants as well as it should; and 2) the immune system in the skin becomes prone to overreacting. Those two problems feed into each other. A weakened barrier lets in irritants and allergens, the immune response flares, and the itching that follows leads to scratching that damages the barrier further. This is often called “the itch-scratch cycle.”

Eczema symptoms can look different from one person to the next, but the common signs include:

• Itching (usually the most noticeable symptom)
• Dry, rough, or scaly patches of skin
• Redness, which can look brown, purple, or grey on darker skin
• Swelling, with cracked or weeping skin during a bad flare
• Thickened, leathery skin in areas that are scratched often

Atopic dermatitis is the long-term, allergy-linked type most people mean when they say “eczema.” Other types of eczema include contact dermatitis (a reaction to something the skin touches), dyshidrotic eczema (small blisters on the hands and feet), and nummular eczema (coin-shaped patches). These can resemble one another, so it’s worth having a doctor confirm what you’re dealing with if you’re unsure.

What Causes an Eczema Flare

Everyday eczema flares are set off by triggers, and these vary from person to person. Common eczema causes and triggers include:

• Irritants such as soaps, detergents, and fragrances
• Allergens like dust mites, pet dander, and pollen
• Cold, dry weather or sudden changes in temperature
• Heat and sweat
• Stress
• Skin infections

Learning your own eczema triggers (and how to manage or avoid them) is one of the simplest ways to keep flares to a minimum.

The Eczema Treatment Ladder: From Creams to Prescriptions

Because eczema ranges in severity from the occasional dry patch to a widespread, uncomfortable and distressing flare, eczema treatment works best as a ladder. The idea is to begin with the gentlest option likely to work and step up only if a flare doesn’t settle. 

Some people stay on the bottom rung of eczema treatments for years; others move up and down it as their skin changes. The rungs described below run from everyday eczema creams to prescription options.

Over-the-Counter Eczema Creams and Moisturisers

The foundation of any eczema treatment is good everyday skincare. Moisturisers (also called emollients) work by repairing and reinforcing the skin barrier, which is the very thing eczema weakens. Used regularly, a moisturiser can reduce how often flares happen and how much stronger treatment you end up needing. The usual advice is to apply a plain, fragrance-free moisturiser generously and often, especially after bathing.

When an eczema flare-up does appear, low-strength hydrocortisone (0.5% or 1%) is the main over-the-counter eczema cream in Canada. This one calms itching and redness, and it suits mild, short-lived flares on small areas. Hydrocortisone isn’t meant for long-term daily use, and it’s best used on small areas rather than delicate skin, unless a doctor advises otherwise.

For a lot of people, a steady moisturising routine plus the occasional short course of hydrocortisone keeps mild eczema well under control. When flares keep returning, cover larger areas, or don’t settle within a week or two, that’s the sign it’s worth stepping up.

Prescription Steroid Creams for Eczema

When over-the-counter eczema treatment options aren’t enough, the next rung is usually a prescription steroid cream for eczema, a type of topical corticosteroid. These are stronger anti-inflammatory creams that bring a flare down more quickly. They come in a range of strengths, so the steroid cream can be matched to how severe the eczema is and where it sits on the body. A well-known example in Canada is Betaderm (betamethasone), a mid-strength option.

Prescription steroid creams are effective, but they’re meant for getting a flare under control rather than for constant use. Applied for too long, or at too high a strength, they can thin the skin. Using a steroid cream in short bursts, and returning to moisturisers in between, keeps eczema settled while limiting that risk.

Non-Steroid Prescription Eczema Creams

For eczema on sensitive areas, or eczema that needs calming over the long term, doctors often turn to a non-steroid prescription cream. These settle the overactive immune response in the skin. Because non-steroid eczema creams don’t thin the skin the way steroids can, they suit exactly the places a steroid is hardest to use — the face, the eyelids, and skin folds — as well as calming eczema flares over months rather than days.

The two main non-steroid options in Canada are Protopic (tacrolimus) and Elidel (pimecrolimus). Both calm eczema without a steroid. The main practical difference is strength: tacrolimus is the stronger of the two, while pimecrolimus is suited to milder eczema. A newer option, Eucrisa (crisaborole), works in a slightly different way and is also used for mild-to-moderate eczema.

Non-steroid prescription eczema creams are genuinely effective. In studies, the stronger one (tacrolimus 0.1%) worked about as well as a fairly potent steroid cream, while staying gentle enough for long-term use on delicate skin. Because they don’t carry the skin-thinning risk that limits how long a steroid can be used, non-steroid creams can be used for longer stretches to keep stubborn eczema under control.

All of the creams named here are prescription eczema creams, so getting one means seeing a doctor.

Systemic Treatments for Severe Eczema

For most people, the creams above keep eczema under control. When eczema is more severe, or doesn’t respond to creams at all, there are eczema medications that work systemically throughout the body rather than only on the skin. These include biologic injections, such as dupilumab (Dupixent), and newer oral medicines known as JAK inhibitors. 

Systemic treatments can work well for hard-to-control eczema, but they’re usually started by a dermatologist. Seeing a family doctor is the first step, as they can refer you to a specialist when and if required.

When to See a Doctor About Eczema

Consider seeing a doctor about your eczema if:

• It isn’t improving after a week or two of moisturising and over-the-counter creams
• Flares are widespread, severe, or keep coming back
• The skin looks infected, with weeping, yellow crusting, or spreading warmth and pain
• Eczema is affecting the face or eyelids, where stronger creams need extra care
• The itch is disrupting sleep or day-to-day life
• You keep needing repeated courses of steroid cream

One warning: if you notice a rapidly spreading rash of small, painful blisters, sometimes with a fever, this could be a sign of a viral infection called eczema herpeticum and needs urgent medical attention. 

How to Get Eczema Treatment in Canada

Some eczema treatments are available over the counter in Canada, while others need a prescription. Moisturisers and low-strength hydrocortisone can be bought from any pharmacy. The prescription-strength steroid creams, and all of the non-steroid options (like Protopic and Elidel) require seeing a doctor.

Getting a prescription for eczema treatment is usually straightforward. Because eczema is diagnosed from your history and a look at your skin, a doctor can often assess it and recommend a treatment in a single visit. 

For eczema treatment in Canada, you can see your family doctor, visit a walk-in clinic, or speak to an online doctor (via video call) without leaving home.

Frequently Asked Questions About Eczema Treatment

Can you get eczema cream on prescription?

The stronger eczema treatments are prescription-only. Moisturisers and low-strength hydrocortisone are sold over the counter, but prescription-strength creams (e.g. Protopic, Elidel, Eucrisa) all need a doctor’s prescription. A doctor can assess your eczema and prescribe the cream that fits.

What’s the best treatment for eczema?

For most people, the best eczema treatment is a steady moisturising routine plus the right-strength cream for how bad the flare is. Mild eczema often settles with over-the-counter options, while more stubborn cases might need a prescription. There’s no single best cream for eczema that suits everyone, though. The right choice depends on how severe your eczema is, where it sits, and how your skin responds.

Is there an eczema cream that isn’t a steroid?

There are several ways to treat eczema without steroids. Protopic (tacrolimus), Elidel (pimecrolimus), and Eucrisa (crisaborole) are non-steroid prescription creams that calm eczema without the skin-thinning risk that comes with long-term steroid use. They’re often chosen for delicate areas and for keeping eczema settled over the longer term. All three are prescription-only.

Can eczema be cured?

There’s no way to cure eczema permanently, but it can be controlled well. Treatment aims to calm flares when they happen and reduce how often they return. Treating eczema as a long-term condition to manage, rather than something to fix once, tends to lead to better results. It’s also worth noting that eczema in children often improves with age.

Is eczema contagious?

Eczema isn’t contagious, so you can’t catch it from someone else or pass it on. It does leave the skin more prone to infection, though. So if a flare starts weeping, crusting, or spreading, that’s worth getting checked by a doctor.

How do I know if it’s eczema or something else?

Several skin conditions can look like eczema, so it isn’t always obvious from appearance alone. Eczema tends to be very itchy and often appears in the same places, such as the creases of the elbows or knees. If you’re not sure what’s behind a rash, or it isn’t responding to eczema treatment, a doctor can confirm the diagnosis and point you to the right treatment.

Choosing the Right Eczema Treatment

Choosing the right eczema treatment comes down to matching the step to the situation. Most eczema is managed with moisturisers and the occasional over-the-counter cream, stepping up to a prescription only when gentler options aren’t enough. Knowing roughly where you sit on the treatment ladder, and when it’s worth moving up, is what keeps flares under control.

If your eczema keeps flaring up, covers a large area, or is affecting somewhere sensitive like your face, that’s usually the sign to see a doctor. A doctor can confirm what you’re dealing with and match an eczema treatment to your skin, whether that turns out to be a prescription cream or simply a better general skincare routine.

If you’re in British Columbia, you can speak to an online doctor from Walk In about eczema from home, free with MSP. Just click the Book Now button to get started.

Speak to a Doctor Online About Eczema