Adult Eczema Treatment (Atopic Dermatitis)
Fast MD-only eczema care by secure online video visit, $49 flat-fee, no insurance required.
Adult eczema (atopic dermatitis) is a chronic, itchy inflammatory skin condition that causes dry, red, and sometimes oozing patches on the skin. Our board-certified MDs use guideline-based evaluation to classify severity, identify triggers, screen for infection, and build an evidence-based plan that fits your skin and lifestyle.
- $49 flat-fee adult visit
- MD-only care (no mid-levels)
- No insurance required
- Secure video visits in 25+ states
Online MD-Only Eczema Care
- Adult-only evaluation for atopic dermatitis flares
- Assessment of itch, sleep impact, and skin infection risk
- Topical steroid and non-steroid options when appropriate
- Clear criteria for when in-person dermatology is needed
Adults 18+ only. No controlled substances are prescribed through TeleDirectMD. Systemic steroids are used cautiously and often require in-person follow-up.
What Is Adult Eczema (Atopic Dermatitis)?
Adult eczema, also called atopic dermatitis, is a chronic inflammatory skin disease characterized by dry skin, intense itching, and recurrent red or scaly patches. It often involves the hands, arms, legs, neck, and flexural areas such as the inner elbows or behind the knees. Many adults have a personal or family history of allergies, asthma, or eczema.
The skin barrier in eczema is weakened, allowing more water loss and easier penetration by irritants, allergens, and microbes. Flares can be triggered by dry air, sweating, stress, harsh soaps, fragrances, or infections. Mild to moderate stable eczema can usually be evaluated and treated by telehealth, as long as there are no red-flag features such as extensive infection, eye involvement, or systemic symptoms.
Symptoms and Red Flags in Adult Eczema
Most eczema flares can be managed through a virtual visit. Certain patterns or symptoms, however, suggest infection, severe systemic involvement, or a different diagnosis that requires urgent in-person evaluation.
| Symptom | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Dry, itchy patches on hands, arms, or legs | Mild to moderate atopic dermatitis | Yes, typically well-suited for telehealth | Not a red flag by itself if skin intact |
| Red, rough plaques that worsen with cold, dry weather | Chronic eczema flares due to barrier disruption | Yes, if no signs of infection or systemic illness | Extensive redness with fever or feeling very ill |
| Crusting, oozing, or honey-colored discharge from lesions | Possible secondary bacterial infection (impetiginization) | Often appropriate for telehealth triage and treatment | Rapidly spreading pain, warmth, or streaking redness |
| Clusters of painful blisters on top of eczema patches | Possible eczema herpeticum (herpes superinfection) | No, concerning for serious viral infection | Requires urgent in-person or emergency evaluation |
| Widespread bright-red skin covering most of the body | Possible erythroderma or severe eczema flare | No | Needs urgent in-person evaluation for systemic risk |
| Thickened, leathery areas from chronic scratching | Long-standing lichenified eczema | Often manageable via telehealth with stepwise therapy | Not a red flag alone if stable and skin intact |
| Eye redness, crusting, or vision changes with facial eczema | Possible eyelid dermatitis with ocular involvement | Telehealth may guide initial steps | Eye pain, visual disturbance, or severe swelling |
| Fever, chills, or feeling very ill with skin flare | Possible systemic infection or severe inflammatory reaction | No | Requires urgent in-person or emergency care |
| New rash after starting a medication | Possible drug eruption rather than simple eczema flare | Telehealth can triage and guide next steps | Widespread blistering, skin peeling, or mucosal lesions |
Differential Diagnosis: Eczema vs Other Adult Rashes
Not every itchy rash is classic atopic dermatitis. During your TeleDirectMD visit, the MD will assess the lesion type, distribution, triggers, and time course to distinguish eczema from other conditions that may look similar but require different treatment.
Atopic Dermatitis (Typical Adult Eczema)
- Dry, itchy, red patches, often in skin folds, on hands, neck, or limbs
- Chronic or relapsing course with environmental triggers
- Frequently associated with allergies, asthma, or childhood eczema
- Improves with emollients, topical steroids, and trigger avoidance
Other Conditions That Mimic Eczema
- Contact dermatitis: Rash after contact with an irritant or allergen such as fragrances, nickel, or hair dyes.
- Psoriasis: Well-defined, thick, scaly plaques on elbows, knees, scalp, or trunk.
- Seborrheic dermatitis: Red, flaky patches on scalp, eyebrows, and nasolabial folds.
- Scabies: Very itchy rash with burrows, often between fingers or in skin folds, and household contacts affected.
Telehealth can often distinguish these based on detailed history and video images. When the diagnosis is uncertain, severe, or not responding to appropriate therapy, in-person dermatology or allergy evaluation may be recommended.
When Is a Video Visit Appropriate for Adult Eczema?
When a Video Visit Is Appropriate
- Mild to moderate eczema flares without systemic symptoms
- Stable chronic eczema that needs a more structured regimen
- Localized rashes that can be clearly shown on camera
- Partial response or irritation with over-the-counter products
- No rapidly spreading pain, warmth, or streaking redness
- No eye pain, vision changes, or facial swelling
- Adult 18+ who can follow skin-care and medication instructions
Red Flags Requiring In-Person or ER Care
- Clusters of painful blisters or sores on eczema patches
- Fever, chills, or feeling very ill with a skin flare
- Rapidly spreading redness, warmth, or tenderness
- Widespread bright-red skin or skin peeling
- Eye pain, visual changes, or marked swelling around the eyes
- New medication with severe rash or mucosal involvement
- Immunosuppression with rapidly progressing lesions
If any red-flag symptoms are present, seek in-person or emergency care immediately. TeleDirectMD is not an emergency service.
Treatment Options for Adult Eczema
Effective eczema management combines skin-barrier repair, trigger avoidance, and targeted anti-inflammatory treatment. Our MDs follow evidence-based guidelines and focus on balancing symptom relief with long-term skin safety.
Supportive Skin-Care and Lifestyle Measures
- Use fragrance-free, dye-free cleansers and moisturizers daily.
- Apply thick emollients or creams immediately after bathing to lock in moisture.
- Avoid hot showers, harsh soaps, and known irritants such as fragrances or wool.
- Use a humidifier in very dry environments if safe and appropriate.
- Keep nails short and consider cotton gloves at night to reduce scratching damage.
First-Line Prescription Options (When Appropriate)
- Low to mid-potency topical corticosteroids for short courses during flares.
- Topical calcineurin inhibitors as steroid-sparing options for sensitive areas.
- Non-sedating oral antihistamines for daytime itch relief when appropriate.
- Sedating antihistamines at night in selected adults when benefits outweigh risks.
- Topical or oral antibiotics when there is clear evidence of secondary bacterial infection.
TeleDirectMD emphasizes safe use of topical steroids with attention to potency, body site, and duration. Systemic steroids or advanced biologic therapies usually require in-person evaluation and ongoing specialist care.
Common Medications Used for Adult Eczema
The exact regimen is individualized based on eczema severity, body areas involved, prior treatments, and other medical conditions. The table below shows typical examples your MD may consider.
| Medication | Dose | Duration | When it is used |
|---|---|---|---|
| Hydrocortisone 2.5% cream | Apply thin layer to affected areas 2 times daily | Up to 7–14 days during flares | Mild facial or flexural eczema in adults when low-potency steroid is needed |
| Triamcinolone 0.1% cream | Apply thin layer to body plaques 2 times daily | Typically 7–14 days, then taper or pause | Moderate body eczema; avoid routine use on face, groin, or skin folds |
| Mometasone furoate 0.1% ointment | Apply once daily to thicker plaques as directed | Short courses such as 7–14 days | More stubborn, localized plaques on trunk or extremities in adults |
| Tacrolimus 0.1% ointment | Apply thin layer to affected areas 2 times daily | Weeks to months with periodic reassessment | Steroid-sparing therapy for sensitive sites such as face, neck, or skin folds |
| Cetirizine 10 mg tablet | 10 mg by mouth once daily as needed | Short to intermediate term for symptom control | Daytime itch relief in adults without contraindications |
| Mupirocin 2% ointment | Apply thin layer to open or crusted areas 3 times daily | Usually 5–7 days | Suspected localized bacterial superinfection of eczema lesions |
These are example regimens only. Actual medications, strengths, and durations are determined by the MD after reviewing your history, skin findings, other diagnoses, and concurrent medications. TeleDirectMD does not prescribe controlled substances via telehealth and uses systemic steroids cautiously with clear follow-up plans.
Home Care, Expectations, and Return to Work
Eczema is a chronic condition that tends to wax and wane over time. The goal is not a one-time cure but durable control of symptoms, itch, and skin-barrier health.
- Use prescribed medications and moisturizers exactly as directed.
- Expect several days to weeks for flares to calm, even with appropriate therapy.
- Continue gentle, fragrance-free skin care even when the skin looks better.
- Monitor for signs of infection such as increased pain, pus, or spreading redness.
- Schedule follow-up if symptoms are not improving or are interfering with sleep or work.
Most adults with eczema can safely attend work and usual activities. If a work note is needed, TeleDirectMD can generally provide documentation of evaluation and treatment rather than recommending time off unless there are systemic symptoms or job-specific exposures that worsen flares.
TeleDirectMD Telehealth Disclaimer
TeleDirectMD provides MD-only virtual urgent care for adults using secure video visits to evaluate conditions like adult eczema. Visits are $49 flat-fee with no insurance required and are available in 25+ states. Our physicians follow evidence-based guidelines, clarify what can be safely managed via telehealth, and explain when in-person primary care, dermatology, or emergency evaluation is more appropriate. TeleDirectMD is not an emergency service or a replacement for comprehensive in-person care.
Adult Eczema Treatment FAQs
Adult eczema, also called atopic dermatitis, is a chronic inflammatory skin condition that causes dry, itchy, red patches that can flare and improve over time. It is related to a weakened skin barrier and immune overactivity rather than poor hygiene and is often associated with allergies or asthma in the same person or family.
Yes. Many mild to moderate eczema flares can be safely evaluated by an MD via secure video by reviewing the appearance, distribution, and history of the rash and your prior treatments. If we see signs of infection, severe disease, or another diagnosis, we will direct you to in-person care instead of managing it fully online.
Common triggers include dry air, frequent hot showers, harsh soaps, fragrances, rough fabrics such as wool, sweating, stress, and infections. Some people also flare with certain detergents or contact allergens. Part of your telehealth visit is reviewing likely triggers and building a plan to reduce or avoid them when possible.
Many flares start to calm within several days of consistent moisturization and appropriate topical medication, but full improvement can take 1–3 weeks or longer depending on severity. Because eczema is chronic, long-term skin care and trigger management are important even when the skin looks better.
Depending on your case, we may recommend fragrance-free moisturizers, low or mid-potency topical steroids, topical calcineurin inhibitors for sensitive areas, non-sedating antihistamines for itch, and in some cases antibiotics if there is clear evidence of infection. Systemic steroids are used cautiously and often require in-person follow-up or specialty care.
When used correctly, topical steroids are effective and generally safe for short courses during flares. Problems arise when strong steroids are used for too long or on thin skin such as the face or groin. Your MD will select potency, site, and duration carefully and may use steroid-sparing agents to reduce long-term risks.
Warning signs of infection include increased pain, yellow crusts, pus, bad odor, rapidly spreading redness, or fever. During a video visit, we review these features and decide whether topical or oral antibiotics are appropriate or whether you need in-person evaluation for possible cellulitis or other complications.
In-person dermatology is recommended for very severe or widespread disease, suspected eczema herpeticum or other serious infection, frequent flares that do not respond to appropriate therapy, or when advanced treatments such as phototherapy or biologic medications are being considered. Telehealth can help identify when that step is needed.
Eczema is not contagious and cannot be caught from another person. It is not a sign of poor hygiene. It reflects a combination of genetics, skin-barrier problems, and immune responses to irritants or allergens. Gentle skin care is helpful, but scrubbing or using harsh products can make it worse rather than better.
Daily moisturizing with fragrance-free creams or ointments, using gentle cleansers, avoiding known triggers, keeping showers short and warm rather than hot, and managing stress can all reduce flares. Having a clear plan for how to treat early signs of a flare can also prevent smaller problems from becoming more severe.
TeleDirectMD offers MD-only, guideline-based eczema care through secure video visits with a simple $49 flat-fee model and no insurance required in 25+ states. We emphasize skin-barrier repair, safe use of medications, clear triggers and home-care guidance, and explicit instructions on when in-person dermatology or urgent care is safer for you.