Atopic dermatitis, the eczema that shows up as dry, itchy, inflamed skin, is the most common inflammatory skin disease worldwide. DermNet puts the number of people affected at about 230 million, with a lifetime prevalence above 15% and up to 20% of children affected; around 80% of children who develop it do so before the age of six. Hong Kong adds its own pressures: an annual mean relative humidity of 78%, hours at a time in air-conditioned interiors, hot showers, and roadside pollution. This guide covers what sets sensitive skin off here, what actually helps, and how to use topical steroids at the strength a given area of skin needs.

Key facts

  • Eczema is a skin-barrier problem: the aim is to protect and repair the barrier, not only chase the itch when it flares.
  • The first line is a plain, fragrance-free emollient, used liberally and continued long term, including when the skin looks and feels comfortable.
  • A topical steroid treats active inflammation, with potency matched to the area and severity; clobetasol propionate sits at the very potent end, up to 600 times as potent as hydrocortisone in DermNet’s classification.
  • Potent and very potent steroids are for short, medically supervised courses: the Drug Office says they should not be used for more than seven days without a dermatologist’s oversight, and DermNet notes that thin sites such as the eyelids, genitals and skin creases absorb the most, so potent steroids are best avoided there.
  • Tacrolimus is a steroid-sparing option a doctor may suggest for the face and skin folds, as is pimecrolimus.
  • Hong Kong’s relative humidity averages 78% a year (Observatory normals, 1991 to 2020), from about 70% in December to 83% in April and May; the Hong Kong Asthma Society lists warm, humid weather and sweating as triggers, and roadside pollution and long spells of air conditioning add to the load.
  • Hong Kong’s tap water is soft, averaging 37 milligrams per litre total hardness as calcium carbonate from July 2025 to June 2026 (Water Supplies Department), inside the USGS soft range of 0 to 60 milligrams per litre; the shower problem is heat, since hot water washes away the skin’s natural oil.
  • See a doctor for eczema that is widespread, weeping, infected, not settling, or wrecking your sleep, and to confirm the diagnosis.

Why does Hong Kong flare sensitive skin?

Hong Kong moves your skin between extremes all day. The Observatory’s 1991 to 2020 normals give an annual mean relative humidity of 78%, from 70% in December to 83% in April and May, and much of daily life is spent moving between that outdoor air and air-conditioned offices, malls and trains.

Eczema, or atopic dermatitis, begins with the skin barrier. When the barrier does not hold moisture in and irritants out, the skin dries, itches and inflames, and Hong Kong adds heat, sweat and roadside pollution on top of that. Tap water is not part of the problem: the Water Supplies Department reports average total hardness of 37 milligrams per litre as calcium carbonate for July 2025 to June 2026, and the USGS classes anything from 0 to 60 milligrams per litre as soft. The Hong Kong Asthma Society points at the shower instead, advising against water that is too hot because it washes away the skin’s natural oil.

The barrier can be repaired, and that is what treatment aims at. DermNet’s overview of atopic dermatitis describes generalised dryness, itch and rash, running a course of remission and relapse with acute flares on a background of chronic dermatitis, and attributes it to genetic and environmental factors acting together.

What actually helps eczema and sensitive skin?

Emollient first, applied liberally and kept up long term, then a topical steroid at the strength the site needs. DermNet’s guidance on treating atopic dermatitis makes emollients and moisturisers an essential part of care for all types of dermatitis: applied regularly and liberally, continued long term even when the skin looks and feels comfortable, with high oil, low water preparations generally best for hydration and barrier repair and greasier products better for dry skin. Moisturiser use has been associated with fewer flares and less use of topical corticosteroids.

The Hong Kong Asthma Society advises more emollient in dry winter weather to counter dry, itchy skin, and a comfortable indoor humidity level at other times, since humidity that is too high or too low can worsen atopic dermatitis. The rest of the trigger list is largely a matter of clothing and household products rather than the weather.

Treatment goes with trigger control. The Asthma Society’s eczema page lists loose cotton clothing rather than wool or rough fibres, laundry washed with a gentle soap and rinsed at least twice, no bleach or fabric softener, and new clothes and bedding washed before first use to remove manufacturing chemicals. Alcohol-based products, household cleaning agents, dust mites, pets and smoke appear on the same page. Our skin-care category covers the products used for this, and the atopic triggers in our guide to allergy relief in Hong Kong overlap with much of that list.

When skin is actively inflamed the mainstay is a topical corticosteroid. Strength and the site decide which one. The Drug Office divides them into mild, moderate, potent and very potent: hydrocortisone acetate sits in the mild group, fluocinolone acetonide in the moderate, betamethasone dipropionate in the potent, and clobetasol propionate in the very potent group, reserved for stubborn conditions that have not responded to other treatment and used short term. DermNet’s figures show the spread: clobetasol propionate can be up to 600 times as potent as hydrocortisone. Absorption varies with skin thickness: greatest through the thin skin of the eyelids, genitals and skin creases, where a potent topical steroid is best avoided, and least through the thick skin of the palms and soles, where a mild topical steroid is ineffective. Applied once daily as directed, these medicines are safe and effective, as the Drug Office sets out in its guide to topical corticosteroids. For the face and skin folds, where you would rather not use a steroid, tacrolimus is a steroid-sparing option a doctor may suggest.

Are topical steroids safe to use?

Used at the right strength, on the right area, for a sensible course, they are safe and effective; the risk comes from misuse, not from steroids themselves. The two opposite mistakes are overuse and steroid fear.

Misuse is real: slathering a potent steroid on the face or using strong ones for months can thin the skin and cause problems, which is why the stronger strengths are gated and worth a doctor’s input. The DermNet page on topical steroids explains safe use clearly.

But the opposite mistake is just as common. Steroid fear leads people to under-treat, dabbing on too little for too short a time, so the eczema never settles and they stay miserable. The answer is not avoidance; it is the right strength, on the right area, for a sensible course, then stepping back down to moisturiser. Treated properly, most eczema is very manageable.

When should I see a doctor?

Eczema that is widespread, weeping or infected, that has not settled after a sensible course of treatment, or that is disturbing your sleep needs a doctor, and so does any rash you are not sure about. DermNet notes that atopic dermatitis is usually diagnosed clinically, with no investigations required, and that patch testing is worth considering when dermatitis resists treatment.

That distinction has practical consequences. A fungal infection, contact dermatitis, seborrhoeic dermatitis or psoriasis will not improve with an eczema cream, and the Drug Office restricts most topical corticosteroids to prescription, leaving hydrocortisone cream of 1% or less as the main pharmacy-counter option under a pharmacist’s supervision. Potent and very potent steroids should not be used for more than seven days without a dermatologist’s oversight, and a doctor is also the route to tacrolimus.

How do I find my medicine by active ingredient?

The active ingredient and its strength are on the tube; the brand name changes from country to country and tells you nothing about what is inside. Learn which molecule works for you, whether that is a steroid such as mometasone or a non-steroid such as tacrolimus.

Our active ingredient pages group the brands that share a molecule, and the Drug Office drug database lists which products are registered in Hong Kong. Not every cream sold as steroid-free is steroid-free: DermNet records that herbal and “natural” creams marketed that way online, including Skin Cap and Wha Wa, turned out to contain potent or superpotent steroids. You can also browse by category or by condition.

How do I buy genuine, and keep a steady supply?

Buy from a registered pharmacy showing the “Rx” logo and check the product is properly registered before you trust it, then set up a supply so a flare never catches you without your creams. Eczema relapses, so the practical aim is never to be caught without your moisturiser or your treatment cream.

The Drug Office’s advice on buying medicines sets out the rules. Products not registered with the Pharmacy and Poisons Board have no guarantee of safety, quality or efficacy, and selling unregistered medicines, over the internet included, is a criminal offence carrying a fine of HK$100,000 and up to two years in prison. Medicines carried in accompanied personal baggage are exempt from import licensing only in reasonable quantities for personal use. The UK Foreign Office notes that prescribed medicine in Hong Kong comes through a doctor unless your UK prescription states the medication will be required here. Once you know which active ingredient works, buy locally or order it for delivery.

ZoneMD option: ZoneMD lists products by active ingredient, so brand and generic versions of the same molecule sit in one place, dispensed and delivered by licensed pharmacy partners. The how ordering works page sets out each step.

Do and don’t

Do:

  • Use a plain, fragrance-free emollient liberally and keep it up long term, including when the skin looks comfortable; DermNet advises leaving on products free of sodium lauryl sulphate and fragrance.
  • Match the steroid strength to the area: DermNet notes the eyelids, genitals and skin creases absorb most, so potent steroids are best avoided there, while the palms and soles absorb least and a mild steroid will not do the job.
  • Apply a topical steroid as directed, usually once a day at night, for a course of five days to several weeks, then step back down to emollient.
  • Keep the shower warm rather than hot, swap harsh soaps for gentle cleansers, rinse off sweat, and choose loose cotton over wool or rough fibres.
  • Confirm any product is registered on the Drug Office drug database before you trust it.
  • See a doctor for anything widespread, weeping, infected, stubborn or affecting your sleep.

Don’t:

  • Fear steroids into under-treating, so the eczema never settles.
  • Put a potent steroid such as clobetasol on your face, or use strong strengths for months without a doctor.
  • Trust “miracle” eczema creams bought online, which have been found to hide potent steroids.
  • Assume every itchy rash is eczema; a fungal infection or contact allergy needs a different treatment.
  • Rely on a foreign brand name a local pharmacy may not stock; learn the active ingredient instead.
  • Let your moisturiser or treatment cream run out before a flare starts.

Frequently asked questions

Does Hong Kong’s humidity help or hurt eczema? Both, depending on how humid it is and how well the barrier is holding up. Annual mean relative humidity here is 78%, with December the lowest month at 70% and April and May the highest at 83%. Warm and humid weather may trigger eczema, humidity that is too high or too low can worsen atopic dermatitis, and hot weather and sweating set it off, which is why air conditioning in a child’s room in summer is one of the measures the Hong Kong Asthma Society suggests. Emollient is what steadies the barrier through all of it.

Can I buy eczema treatment over the counter in Hong Kong? Milder products and emollients are widely available, but the stronger topical steroids and tacrolimus are best used with a doctor’s or pharmacist’s guidance, and the most potent strengths are gated. Confirm any product is registered on the Drug Office drug database.

Is tacrolimus a steroid? No. Tacrolimus is a topical calcineurin inhibitor, a different class from corticosteroids. DermNet lists tacrolimus and pimecrolimus as suitable for sensitive sites such as the eyelids, skin folds and genital areas, where a potent steroid is best avoided. It is used on a doctor’s advice.

Where to go next

Most eczema care in Hong Kong is barrier care: emollient applied liberally and continuously, and a topical steroid at the strength the site and the flare need. Keep track of the active ingredient names, keep a supply at home so a flare does not catch you short, and see a doctor about anything widespread or stubborn. Browse by active ingredient, by category or by condition, read how ordering and delivery work, and see the companion guides to allergy relief in Hong Kong, the atopic cousin of eczema, and to buying medicine in Hong Kong.

This article is general information, not medical advice. Topical steroids are best started with a doctor’s or pharmacist’s guidance, and a rash that is widespread, infected or not settling belongs in a clinic rather than in another round of guessing.