Lubrication of dry eczematous dermatitis can be done with a wide variety of emollients, the simpler the better.  Frequent use of bland products such as Eucerin, Aquaphor, or Vaseline is preferable to the more expensive fragrance containing and chemically complex products.  Fragranced products, while "elegant", are potential irritants and/or allergens and should be avoided on irritated skin of any kind, but especially in patients with eczema.

The medication leg of the footstool usually involves topical steroids.  The advice here is similar; keep it simple.  Topical steroids are available in a variety of potencies and vehicles.  In general, do not use medium potency or higher products on the face or genitals.  Gels or aerosolized steroid sprays are appropriate for moist and weepy dermatitis.  Creams and ointments are effective on drier more chronic lesions.  While topical steroid "allergies" do occur, the reactions to topical steroid medications more likely represent a sensitivity to a preservative, fragrance, or other ingredient in the vehicle.

Medication of acute or "wet" eczema (e.g. poison ivy or flare of atopic or dyshidrotic eczema of the hands) has additional considerations.  Burow's Solution compresses (see Impetigo) can dry out a wet oozing eczema within a few days.  Decrease the bacterial colonization of the eczema with a few days of antistaphyloccal antibiotic therapy.

Systemic steroids are reserved for cases of substantial morbidity or widespread involvement.  If required, use 1 mg/kg of prednisone in a tapering dose over a 2-3 week period while initiating topical therapy.  Shorter courses or lower doses frequently result in "rebound" of the dermatitis.  Otherwise healthy active duty personnel tolerate brief courses of prednisone very well.  If a patient has reached this point of severity, dermatology consult is highly advised.

The last leg of the footstool is environmental control.  This simply means to decrease the skin's exposure to any identified offending substance, harsh bath soaps, occupationally related chemicals and the like.

Most cases of hand eczema are irritant or endogenous (i.e. a form of atopic dermatitis) rather than allergic.  The proper use of protective gear (e.g. work gloves), minimizing repeated wet/dry exposures of the involved area etc will allow the skin to heal faster.