Ointments are generally better for eczema because they seal in more moisture, but creams are the smarter choice in certain situations, like when your skin is weeping or inflamed. The real answer depends on where your eczema is, how severe it is, and whether you’ll actually use the product consistently.
Why Ointments Work Better for Dry Eczema
The difference comes down to oil and water content. Ointments are roughly 80% oil and 20% water, while creams split about 50/50. That higher oil concentration means ointments create a thicker barrier on the skin’s surface, which slows water evaporation and keeps moisture locked in longer. For eczema, where the skin barrier is already compromised and losing water too quickly, that occlusive seal is exactly what’s needed.
This is why ointments tend to be the default recommendation for chronic, dry eczema patches. When skin has thickened from repeated scratching (a condition called lichenification), dermatologists typically reach for ointment-based treatments. The thick consistency helps active ingredients penetrate that toughened skin more effectively, and covering treated areas overnight can boost results even further.
When Creams Are the Better Choice
Ointments aren’t always appropriate. If your eczema is actively weeping or oozing fluid, you should avoid ointments entirely. Ointments trap moisture against already-wet skin, which can worsen irritation and slow healing. Creams feel light and cool on the skin, spread easily over sore areas, and absorb without trapping excess fluid underneath.
Inflamed, swollen skin also responds better to creams. The NHS recommends creams and lotions for inflamed areas, reserving ointments for dry patches that aren’t actively swollen. If your eczema is in a flare with redness and puffiness, a cream will feel more comfortable and work with your skin rather than against it.
Body Location Matters
Where your eczema shows up should influence your choice. Your face and neck have thinner, more sensitive skin that absorbs products quickly. A lighter cream works well here and won’t leave you looking greasy. Many people also find ointments uncomfortable on the face, especially during the day.
Thicker skin on your palms and soles can handle (and often needs) the heavier moisture an ointment provides. These areas lose water faster and take more of a beating from daily use, so the extra occlusion pays off. For body folds like the insides of elbows and behind the knees, where eczema commonly flares, either formulation can work, though creams tend to feel less sticky in areas where skin touches skin. Hairy areas are another situation where creams or even lotions spread more easily than thick ointments.
The Preservative Problem With Creams
One underappreciated advantage of ointments is what they don’t contain. Because creams mix oil and water, they need preservatives to prevent bacterial growth. Those preservatives can trigger contact reactions in eczema-prone skin. In one study of adults with eczema, over 83% of those tested reacted to methylisothiazolinone, a preservative widely used in skincare. Other common irritants included parabens, formaldehyde-based preservatives, and lanolin alcohol.
Ointments, with their minimal water content, require fewer (or no) preservatives. If you’ve noticed that certain moisturizers sting or make your eczema worse, preservative sensitivity could be the reason. Switching to a simple ointment, like plain petrolatum, eliminates most of those potential triggers in one step.
Ceramide Creams vs. Petrolatum Ointments
You’ve probably seen moisturizers marketed with ceramides, which are fats naturally found in healthy skin. The idea is that these creams repair the skin barrier from within rather than just sitting on top like petrolatum does. It’s a compelling concept, but the evidence hasn’t caught up to the marketing. A review in the journal Clinics in Dermatology found no convincing proof that prescription ceramide-based moisturizers outperform well-made, traditional petrolatum-based products. Plain petrolatum remains one of the most effective and cheapest options for sealing in moisture.
Does Greasiness Affect How Often You Apply?
A common argument for creams is that people will actually use them because they’re less greasy. If an ointment sits unused in your cabinet, it’s not helping anyone. But a randomized study on hand eczema patients found no significant difference in how consistently people applied cream versus ointment formulations of the same medication. About 42% of cream users and 54% of ointment users met their daily application targets, and the gap wasn’t statistically meaningful.
What did predict consistency was emollient use. Patients who regularly moisturized were nearly twice as likely to stick with their treatment regimen, regardless of whether that treatment came in a cream or ointment. The takeaway: building the habit of moisturizing matters more than which vehicle you choose.
How to Get the Most From Either Formulation
Application technique can close the gap between creams and ointments. The “soak and seal” method involves soaking in a lukewarm bath for about 15 minutes, then patting skin mostly dry while it’s still slightly damp. You then apply your medication first, followed by a generous layer of moisturizer over the top. This traps bath water in the skin before sealing it with your emollient, and it works with both creams and ointments.
For severe flares, wet wrap therapy takes this further. After the soak, medication, and moisturizer steps, damp wraps are applied over the treated skin and left on for about two hours or overnight. This approach keeps products in contact with the skin longer and boosts absorption significantly.
Choosing the Right One for You
A practical approach is to use both. Keep an ointment for nighttime, when greasiness doesn’t matter and your skin has hours to absorb it. Use a cream during the day for comfort and convenience, especially on visible areas like your face and hands. If your eczema is actively weeping or inflamed, stick with creams until it calms down. For chronic, dry, thickened patches, prioritize ointments.
If you suspect your skin reacts to preservatives, try switching to a plain petrolatum ointment for two weeks to see if the irritation improves. Whatever you choose, applying it generously and consistently after bathing will do more for your eczema than picking the “perfect” formulation and using it sporadically.