Eczema, also known as atopic dermatitis, is a common inflammatory skin condition characterized by dry, itchy, and red patches. Many individuals with eczema experience a burning sensation when applying creams. This reaction, while often distressing, is a frequent concern and can be attributed to several underlying factors related to the skin’s compromised state.
Common Reasons for the Sensation
The burning sensation often occurs because eczema significantly impairs the skin’s natural protective barrier. This barrier, composed of lipids and skin cells, normally acts as a shield against irritants and prevents excessive water loss. When this barrier is compromised, the skin becomes more permeable, allowing ingredients in creams to penetrate deeper and potentially irritate nerve endings.
Inflamed skin, a hallmark of an active eczema flare-up, is inherently more sensitive to external stimuli. Red, cracked, or raw patches of skin, often from scratching or inflammation, react more intensely to any applied substance, even soothing ones. The heightened sensitivity of nerve endings in these inflamed areas contributes directly to the burning or stinging feeling.
Certain ingredients found in eczema creams can also contribute to this sensation. Active ingredients like urea or lactic acid, often included for their moisturizing and exfoliating properties, can cause a temporary stinging on broken or highly sensitive skin. Similarly, some corticosteroids, particularly stronger formulations, might produce a transient burning feeling upon initial application, especially if the skin is acutely inflamed.
Beyond active compounds, inactive ingredients and preservatives within creams can also trigger discomfort. Fragrances, alcohol, and certain preservatives such as parabens or formaldehyde-releasing agents are known irritants for sensitive skin. These components can provoke burning or exacerbate existing irritation, particularly in individuals prone to contact sensitivities. In some instances, burning can signal allergic or irritant contact dermatitis, a distinct reaction to a specific cream ingredient.
When to Be Concerned
A brief, mild stinging sensation, especially when applying cream to very dry or cracked eczema patches, can be an expected initial reaction as the product hydrates the compromised skin barrier. This temporary feeling often subsides quickly as the cream is absorbed. However, it is important to distinguish this from more concerning reactions.
Symptoms indicating the burning is more than temporary may point towards irritation, an allergic reaction, or infection. These concerning signs include the burning intensifying or persisting for an extended period, not resolving after a few minutes. If the skin develops worsening redness, increased swelling, or the rash spreads or becomes more inflamed after cream application, it suggests an adverse reaction.
Other red flags include increased itching, blistering, oozing, or signs of infection (e.g., pus, increased warmth, fever). If the skin feels worse or shows new symptoms after applying the cream, rather than improving, it indicates the product may be unsuitable. Consulting a dermatologist is advisable if symptoms persist, worsen, or new uncomfortable symptoms emerge.
Steps to Take and Future Prevention
If a cream causes intense or prolonged burning, gently washing off the product with lukewarm water and a mild, fragrance-free cleanser is the first step. After patting the skin dry, applying a simpler, highly emollient moisturizer that is known to be well-tolerated can help soothe the skin if tolerated. Observing the skin’s reaction over the next few hours is important to determine if the irritation subsides.
When selecting future products, patch testing new creams on a small, less sensitive area of skin, such as the inner forearm, before widespread application is a valuable preventative measure. This allows for observation of any adverse reactions over 24 to 48 hours. Prioritizing “fragrance-free,” “dye-free,” and “alcohol-free” products can significantly reduce irritation risk, as these common additives are frequent culprits for sensitive eczema-prone skin.
Applying creams to slightly damp skin, such as after a lukewarm bath or shower, can enhance absorption and help lock in moisture, potentially reducing stinging. The skin is more receptive to emollients then, improving treatment efficacy. For highly inflamed areas, gently cooling the skin with a cool compress before applying cream might provide relief and reduce immediate discomfort.
Discussing persistent burning or other adverse reactions with a dermatologist is recommended. They can help identify specific triggers through patch testing, adjust treatment plans, or recommend alternative therapeutic creams. These might include different corticosteroids, calcineurin inhibitors, or specialized barrier repair creams designed to minimize irritation while promoting skin healing.