Clinical reference

Atopic Eczema in Adults

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources7 sources

Betamethasone Valerate 0.1%w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 102491) · Eumovate (clobetasone butyrate 0.05%) Cream SmPC sections 4.2 and 4.4 (eMC product 3807) · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · NICE CKS: Eczema - atopic 2025 · NICE Technology Appraisal TA82: Tacrolimus and Pimecrolimus for Atopic Eczema 2004 · No labelled dose - emollient applied liberally and as often as needed, to effect · Protopic 0.1% ointment SmPC sections 4.1 and 4.2 (eMC product 1608)

Verified against5 documents

Betamethasone Valerate 0.1%w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 102491)
Eumovate (clobetasone butyrate 0.05%) Cream SmPC sections 4.2 and 4.4 (eMC product 3807)
Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103)
No labelled dose - emollient applied liberally and as often as needed, to effect
Protopic 0.1% ointment SmPC sections 4.1 and 4.2 (eMC product 1608)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

Itching severe enough to disturb sleep, with a history of the rash's onset and spread [itching · rash]
Personal or family history of atopic conditions such as asthma, hay fever or eczema [allergic rhinitis]
Flares may be triggered by dust mites, animal dander, soaps, fragrances, synthetic fabrics, sweating or certain foods [sweating]

Signs — what you find (5)

Adults typically show thickened, lichenified plaques with exaggerated skin lines, often on the hands [plaques]
In the acute stage, lesions are swollen red papules and plaques that may weep or crust [papules · plaques]
Subacute lesions show redness, scaling and variable crusting [crusting · redness · scaling]
Chronic lesions are thick plaques with lichenification and scale [plaques]
Keratosis pilaris may be an associated finding supporting the diagnosis

Tests (3)

Diagnosis is usually made clinically from the typical presentation, without routine testing
A skin biopsy, if done, typically shows an eczematous pattern
In hard-to-treat pediatric cases, IgE testing by immunoassay or skin prick may look for specific allergens

If not this — what else fits (4)

Allergic contact dermatitis rather than atopic disease
Lichen simplex or lichen planus
Psoriasis, scabies, or a fungal (tinea) infection
Seborrheic dermatitis, a distinct scaly rash

SourceStatPearls "Atopic Dermatitis" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Emollient - use throughout | Topical steroid - face and flexures | Topical steroid - trunk and limbs | Topical steroid - potent, short flare | Steroid-sparing alternative

EMOLLIENT - USE THROUGHOUT

LIQUID PARAFFIN

Emollient - use throughout

1st line

Formtopical

Adult dose and duration

Apply emollient liberally and frequently (at least 2-3 times daily) to all skin, including areas that are currently clear - long-term continuous maintenance

Paediatric dose

Not applicable in this adult entry - see 'Atopic Eczema in Children' for paediatric dosing

Dose source

No labelled dose - emollient applied liberally and as often as needed, to effect

Why

Emollients remain the foundation of adult eczema management and reduce the amount of topical corticosteroid needed

Cautions

Continue emollient use even when skin is clear to maintain barrier function.
Apply emollient 15-30 minutes before or after a topical steroid, not at the same time.
Warn about fire hazard when fabric contacts paraffin-based products.
Use a soap substitute rather than standard soap.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
ADCOCARE CREAM 20 GM! also contains glyceryl monostearate, propylene glycol, urea	ARAB DRUG COMPANY (ADCO)	12.00 EGP
DERMOLAN CREAM 50 GM! also contains allantoin, glycerol, glycolic acid, panthenol, salicylic acid, urea, vitamin c, zinc oxide	HI-CARE > EMICO PHARMA	19.00 EGP
ADCOCARE CREAM 40 GM! also contains glyceryl monostearate, propylene glycol, urea	ARAB DRUG COMPANY (ADCO)	21.75 EGP
CARE MIX PLUS HAIR CREAM 50 GM! also contains cetostearyl alcohol, lanolin, panthenol, wheat protein, white soft paraffin	VITA PHARM > CARE MIX	29.50 EGP
PROPOLIS CREAM 15 ML! also contains cera alba, glycerin, propolis	LUNA FOR PERFUMES AND COSMETICS > TECHNOMED GROUP	30.00 EGP
PROPOLIS CREAM 30 ML! also contains cera alba, glycerin, propolis	LUNA FOR PERFUMES AND COSMETICS > TECHNOMED GROUP	55.00 EGP
HEALTHPOINT NAPPY CREAM 100 GM! also contains benzyl alcohol, cetearyl alcohol, glyceryl stearate, lanolin, peg-100 s, water, zinc oxide	HEALTHPOINT LTD. > PAXTON	70.00 EGP
HERCUL WHITENING CREAM 60 GM! also contains alpha arbutin, diemthicone, glycerin, licorice ext, octyl methoxy, titanium dioxide, vit.c	LEADER FOR COSMETICS > JUNIER PHARMA	74.75 EGP

TOPICAL STEROID - FACE AND FLEXURES

HYDROCORTISONE

Topical steroid - face and flexures

1st line

Formtopical

Adult dose and duration

Adults and children: To be applied sparingly to the affected skin two or three times daily after gently cleansing the area. x up to 1-2 weeks, then reassess. The label does not set a number for the face beyond avoiding prolonged use - keep facial courses as short as the flare allows

Paediatric dose

Not applicable in this adult entry - see 'Atopic Eczema in Children' for paediatric dosing

Dose source

Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103)

Why

Mild potency is reserved for delicate facial and flexural skin; step up to moderate potency for the trunk and limbs if inadequate response

Cautions

Avoid prolonged use on the face - the label says so without naming a number, so the five-day figure often quoted is custom rather than licence. Shortest course that settles it.
Stop once the flare resolves; do not use as long-term continuous maintenance.
Watch for secondary bacterial infection (weeping, crusting, pustules) requiring oral flucloxacillin.
Limit a course in a child to 7-10 days, and remember the face and scalp absorb far more than limb skin.
Hydrocortisone Cream is contra-indicated in patients with bacterial, viral or fungal infections of the skin. Urticaria, rosacea, ulcers and local infection are also contra-indications.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
NOVACORTIN 1% CREAM 15 GM	PHAROPHARMA	4.75 EGP
NOVACORTIN 1% OINT. 15 GM	PHAROPHARMA	4.75 EGP
MICORT 1% CREAM 20 GM	MISR	12.50 EGP
HYDROCORTISONE 1% OINT. 20 GM	MISR	21.00 EGP

TOPICAL STEROID - TRUNK AND LIMBS

CLOBETASONE

Topical steroid - trunk and limbs

1st line

Formtopical

Adult dose and duration

Apply 0.05% cream/ointment thinly once or twice daily to inflamed skin on the trunk and limbs - Up to 4 weeks of continuous daily use; a child should not normally exceed 7 days

Paediatric dose

Not applicable in this adult entry - see 'Atopic Eczema in Children' for paediatric dosing

Dose source

Eumovate (clobetasone butyrate 0.05%) Cream SmPC sections 4.2 and 4.4 (eMC product 3807)

Why

Moderate potency for trunk/limb flares not controlled by mild potency steroid, per the CKS potency ladder

Cautions

Do not use on the face or flexures - reserve moderate potency for the trunk and limbs.
There is a risk of skin thinning (atrophy) with prolonged or repeated courses.
Four weeks of continuous daily use is the adult ceiling. In a child it is normally seven days, and under 12 it should be a doctor's decision to use it at all.
Keep it off the face where you can - facial skin thins faster than anywhere else.
Under a dressing it absorbs far more and the warm damp underneath breeds bacteria. Clean the skin before each fresh dressing.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
EUMOVATE 0.05% TOP. CREAM 15 GM	GLAXO SMITHKLINE	12.75 EGP
EUMOVATE 0.05% TOP. OINT. 15 GM	SMITHKLINE BEECHAM > GLAXO SMITHKLINE	12.75 EGP

TOPICAL STEROID - POTENT, SHORT FLARE

BETAMETHASONE

Topical steroid - potent, short flare

2nd line

Formtopical

Adult dose and duration

Apply 0.1% cream/ointment thinly twice daily to affected areas for itch and inflammation - Short courses during a flare, usually 1-2 weeks; step back down once the flare settles

Paediatric dose

This entry is for adults. In a child, a potent steroid on the trunk or limbs is a short, deliberate course - see the childhood eczema entry, and never use a potent steroid on a child's face or flexures.

Dose source

Betamethasone Valerate 0.1%w/w Cream SmPC section 4.2 Posology and method of administration (eMC product 102491)

Why

The potent rung the ladder was missing. Hydrocortisone 1% is mild and clobetasone 0.05% moderate; when a trunk or limb flare does not settle on clobetasone the next step is a potent steroid, not a calcineurin inhibitor. Undertreating a flare with a steroid too weak for it is the commoner failure in eczema, not overtreating.

Cautions

Potent steroid. Not on the face, the eyelids or the flexures - use hydrocortisone 1% there. Potent steroid on facial skin thins it and causes perioral dermatitis.
Short courses during a flare, then step back down. Continuous potent steroid causes skin atrophy, striae that do not recover, and telangiectasia.
Fingertip units, not 'a thin smear'. Undertreating a flare is what makes people believe steroids do not work and then use them for longer.
Do not apply to infected or ulcerated skin. Weeping, crusted or rapidly worsening eczema is usually infected and needs that treated first.
Keep the emollient going underneath and between flares. The steroid treats the flare; the emollient is what reduces how often flares come.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
CRONOMESONE 0.1% CREAM 15 GM	PHAROPHARMA	4.00 EGP
CRONOMESONE 0.1% OINT. 15 GM	PHAROPHARMA	4.00 EGP
BETNOVATE 0.1% TOP. OINT. 15 GM	SMITHKLINE BEECHAM > GLAXO SMITHKLINE	6.90 EGP
BETADERM 0.1% CREAM 15 GM	EIPICO	18.00 EGP
BETAVAL 0.1% CREAM 20 GM	ARAB DRUG COMPANY (ADCO)	20.00 EGP
BETADERM 0.1% CREAM 30 GM	EIPICO	23.00 EGP
BETAMETHASONE DIPROPIONATE 0.05% CREAM 20 GM	AMRIYA	11.50 EGP
BETAMETHASONE DIPROPIONATE 0.05% OINT. 20 GM	AMRIYA	11.50 EGP

STEROID-SPARING ALTERNATIVE

TACROLIMUS

Steroid-sparing alternative

2nd line

Formtopical

Adult dose and duration

Apply 0.1% ointment thinly twice daily to affected areas (the 0.1% strength is licensed for adults only; children use 0.03%) - until lesions clear, then maintenance once a day twice weekly; eligibility for maintenance is a response within 6 weeks of twice-daily use

Paediatric dose

Not applicable in this adult entry - see 'Atopic Eczema in Children' for paediatric dosing

Dose source

Protopic 0.1% ointment SmPC sections 4.1 and 4.2 (eMC product 1608)

Why

Second-line, steroid-sparing option for moderate-to-severe eczema not controlled by topical corticosteroids, or where continued steroid use risks skin atrophy, particularly on the face; TA82 recommends initiation only by a clinician with dermatology experience

Cautions

Not first-line and not for mild eczema - reserve for moderate-to-severe disease unresponsive to topical corticosteroids.
Transient burning or stinging on application is common and usually settles within a few days.
Avoid sun exposure and use sun protection on treated skin.
Avoid occlusive dressings over application sites.
Reconsider the diagnosis and the treatment if there is no improvement after two weeks of twice-daily use.
A patient on maintenance needs a physician review at 12 months to decide whether to continue.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
TAROLIMUS 0.1% TOPICAL OINT. 15 GM	ANDALOUS PHARMA	144.00 EGP
TRECZIMUS 0.1% TOPICAL OINT. 30 GM	MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)	219.00 EGP
PROTOPIC 0.1 % OINT. 30 GM	LEO PHARMACEUTICAL PRODUCTS	407.00 EGP
TRECZIMUS 0.03% TOPICAL OINT. 20 GM	MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)	114.00 EGP
TAROLIMUS 0.03% TOPICAL OINT. 15 GM	ANDALOUS PHARMA	129.00 EGP
PROTOPIC 0.03 % OINT. 30 GM	LEO PHARMACEUTICAL PRODUCTS	371.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.