Natural and Steroid-Free Alternatives to Steroid Cream for Eczema and Psoriasis
Steroid-free skin care
Part of our Eczema guide · Psoriasis guide
The main alternatives to steroid cream for eczema and psoriasis are daily moisturisers, colloidal oatmeal, Chinese herbal creams, non-steroid prescription creams (such as tacrolimus, vitamin D creams and newer targeted creams), coal tar for psoriasis, and light therapy or systemic medicines for severe disease. Which one fits depends on the condition, body site and severity.
- Moisturisers are the foundation of eczema care and help dry psoriasis too.
- In a meta-analysis of 10 trials (1,058 people), topical Chinese herbal creams achieved skin-lesion scores similar to corticosteroid creams.
- Non-steroid prescription creams calm inflammation without the steroid risk of skin thinning. In a Cochrane review, tacrolimus 0.1% outperformed mild steroid creams.
- Some creams sold as "herbal" have been found to contain hidden steroids, so choose one with a full ingredient list and independent lab testing.
- If you currently use a prescribed steroid, change your plan with your doctor rather than stopping suddenly.
What are the alternatives to steroid cream?
| Option | What it does | Best for | Prescription? |
|---|---|---|---|
| Moisturisers and emollients | Repair the skin barrier and reduce water loss | All eczema; dry psoriasis | No |
| Colloidal oatmeal | Soothes dry, itchy skin | Dry, itchy, eczema-prone skin | No |
| Chinese herbal creams | Calm itch and redness with TCM herbs such as Ku Shen and She Chuang Zi | Itchy eczema-type rashes; steroid-free daily care | No |
| Calcineurin inhibitors (tacrolimus, pimecrolimus) | Reduce inflammation without steroids | Eczema on face and folds; facial or fold psoriasis | Yes |
| PDE-4, JAK and AhR creams | Target specific inflammatory signals | Selected eczema and psoriasis | Yes |
| Vitamin D creams (calcipotriol) | Slow fast skin-cell growth | Plaque psoriasis | Yes |
| Coal tar | Reduces scale and itch | Psoriasis, including scalp | Often no |
| Phototherapy, biologics, oral medicines | Treat widespread disease | Moderate to severe eczema or psoriasis | Yes |
Looking for a steroid-free herbal cream? QICAOGANGMU is built on Ku Shen and She Chuang Zi, with every ingredient declared and steroid-free results from TÜV SÜD PSB. Rated 4.6 to 4.7 out of 5 on Amazon. See the formula
Why do people look for steroid-free options?
Topical corticosteroids remain effective treatments when used at the right strength, site and duration. People often look for steroid-free options for three reasons:
- Thin, sensitive skin. Prolonged use of stronger steroids can thin the skin, especially on the face, eyelids and folds. On the face, steroid creams can also trigger perioral dermatitis.
- Long-term care. Eczema and psoriasis are chronic, and many people want a daily option they can use between flares.
- Concern about topical steroid withdrawal. Recent reviews describe burning, redness and skin sensitivity after stopping steroids, while noting that diagnostic criteria are still evolving (Myles and Ratley, 2026; Choi et al., 2026). Read more about topical steroid withdrawal.
Worry about steroids is very common. A systematic review of 16 studies found that 21% to 84% of eczema patients or parents reported steroid fears, and in one study people with these fears skipped treatment far more often (49.4% vs 14.1%) (Li et al., 2017). A plan you are comfortable using every day tends to work better than one you avoid.
What are the best natural alternatives to steroid cream?
Moisturisers
Regular moisturising is the foundation of eczema care, reducing water loss and repairing the skin barrier. Thicker creams and ointments generally work best for very dry skin.
Colloidal oatmeal
In a clinical study, a colloidal oatmeal lotion significantly improved dryness, scaling, roughness and itch in people with dry, itchy skin (Reynertson et al., 2015).
Chinese herbal creams
Chinese herbal creams have the largest body of clinical trials among natural options for eczema. A meta-analysis of 10 randomised trials (1,058 participants) found topical Chinese herbal medicine had a higher overall effectiveness rate than conventional treatments, with skin-lesion scores similar to corticosteroid creams (Gu et al., 2014). A later review of 20 trials found topical Chinese herbs improved eczema symptom scores, particularly in mild and moderate eczema, and identified Ku Shen (Sophora flavescens) and She Chuang Zi (Cnidium monnieri) among the core herbs (Wang et al., 2023). Both reviews noted that trial quality varied.
Oral Chinese herbal medicine also improved eczema severity and sleep in a meta-analysis of eight placebo-controlled trials (Cai et al., 2022). See how TCM explains eczema.
Licorice gel
A 2% licorice gel reduced redness, swelling and itch in eczema in a double-blind trial (Saeedi et al., 2003).
Which prescription creams for eczema are steroid-free?
- Tacrolimus and pimecrolimus (calcineurin inhibitors): useful on the face, eyelids and folds.
- Crisaborole and roflumilast (PDE-4 inhibitors), ruxolitinib (JAK inhibitor) and tapinarof (AhR agonist), depending on age and local approval.
- Biologics and oral targeted medicines for moderate to severe eczema.
These are recommended in dermatology guidelines (American Academy of Dermatology).
Which prescription treatments for psoriasis are steroid-free?
- Vitamin D creams such as calcipotriol slow the rapid skin-cell growth behind psoriasis plaques.
- Tacrolimus or pimecrolimus are often used for facial and skin-fold psoriasis.
- Coal tar reduces scale and itch, including in scalp shampoos.
- Phototherapy, biologics and oral medicines for widespread psoriasis or psoriatic arthritis.
See our guide to herbal remedies for psoriasis.
How well do steroid-free creams work compared with steroid creams?
For mild to moderate eczema, several steroid-free options perform close to mild or moderate steroid creams in trials:
| Option | Key result | Source |
|---|---|---|
| Tacrolimus 0.1% ointment | Better than low-potency steroids and similar to moderate-to-potent steroids; no evidence of skin thinning. Burning on application was more common. | Cochrane review, 20 trials, 5,885 people (Cury Martins 2015) |
| Roflumilast 0.15% cream | Clear or almost clear at 4 weeks in 32.0% and 28.9% of patients, vs 15.2% and 12.0% with the plain cream base | Two phase 3 trials, 1,337 people aged 6 and over (Simpson 2024) |
| Topical Chinese herbal creams | Skin-lesion scores similar to corticosteroid creams, with variable trial quality | Meta-analysis, 10 trials, 1,058 people (Gu 2014) |
For a severe or rapidly spreading flare, a short course of a prescribed steroid is often still the quickest way to regain control. Many people then use steroid-free care to keep skin calm between flares.
How can you tell if a "natural" cream contains hidden steroids?
Not every cream labelled herbal is steroid-free. Doctors have reported a teenager with psoriasis whose Chinese herbal ointment was found to contain steroids and antifungal drugs (Mose and Bygum, 2019), and a psoriasis patient who developed Cushing's syndrome after long-term use of a "herbal cream" that contained the very strong steroid clobetasol (Chen et al., 2025).
Warning signs that a cream may contain an undeclared steroid:
- thick, long-standing plaques clear within a day or two, then flare badly when you stop
- no full ingredient list, or ingredients listed without concentrations
- no independent laboratory test for corticosteroids
- "miracle" or "cure" claims
- thinner skin, stretch marks or easy bruising where you apply it
QICAOGANGMU publishes its TÜV SÜD PSB steroid test reports. Here is a fuller checklist for checking a Chinese eczema cream.
What is a natural alternative to hydrocortisone cream?
Hydrocortisone 0.5% to 1% is the mildest steroid cream and is sold over the counter for itch, insect bites and mild eczema. Although hydrocortisone is chemically the same as the cortisol your body makes, the cream is a medicine, not a natural product. The right natural replacement depends on why you are using it:
| You use hydrocortisone for | Steroid-free alternative | Good to know |
|---|---|---|
| Mild eczema or dry, itchy patches | A thick daily moisturiser plus colloidal oatmeal or a steroid-free herbal cream | Colloidal oatmeal improved dryness and itch in clinical studies (Reynertson et al., 2015) |
| Insect bites and short itchy spells | A cold compress, then a cooling cream with menthol | Menthol calms itch through the skin's cold receptor within minutes (Misery et al., 2019) |
| A rash you are not sure about | A steroid-free soothing cream while you get it checked | Steroids can make fungal rashes such as ringworm spread and harder to recognise |
| Red patches on the face | Stop facial steroids and keep skin care minimal | Facial steroid use is the leading trigger of perioral dermatitis |
If you have been using hydrocortisone daily for weeks, step down gradually rather than stopping overnight. Our guide to switching from steroid cream to a natural cream has a simple tapering plan.
How do you choose the right steroid-free option?
| If your main concern is | Start with | See a doctor if |
|---|---|---|
| Dry, rough skin | Moisturisers, colloidal oatmeal | Skin stays red, cracked or painful |
| Itchy, irritated rashes | A steroid-free herbal cream plus moisturiser | Itch disturbs sleep or the rash spreads |
| Eczema on face or folds | Gentle care; ask about tacrolimus or pimecrolimus | It persists or the diagnosis is unclear |
| Plaque psoriasis | Moisturisers; ask about vitamin D creams or coal tar | Plaques are widespread or joints hurt |
| Severe or widespread disease | Medical assessment | Always |
When choosing an over-the-counter steroid-free cream, look for a full ingredient list with concentrations, research behind the named ingredients and independent steroid testing. For specific situations, see our guides to hand eczema and winter itch and dry skin.
Ready to come off a steroid cream? Follow our step-by-step guide to switching from steroid cream to a natural cream safely, including a tapering plan and when to involve your doctor.
Where QICAOGANGMU fits
QICAOGANGMU Steroid-Free Herbal Cream
4.7/5 (269 ratings) and 4.6/5 (708 ratings) on Amazon. Read reviews
QICAOGANGMU is a steroid-free Chinese herbal cream built on She Chuang Zi 3% and Ku Shen 1.5%, two of the core herbs identified in topical Chinese herbal eczema trials, with cooling borneol 2%, menthol 0.5% and Bai Bu 0.5% in a moisturising glycerin and petrolatum base. Use it as daily care between flares, or alongside the plan your doctor gives you.
- Steroid-free: TÜV SÜD PSB found none of 8 corticosteroids (lab reports)
- Fully declared formula: every active ingredient and its percentage on the label
- 100-day money-back guarantee
- US shipping in 2 to 6 business days, free over US$15
Just trying it? Buy 1 tube for US$9.50. Free US shipping over US$15.
Patch test on a small area first, use a thin layer on intact skin and avoid the eyes, lips and genitals. QICAOGANGMU vs steroid creams · Product details
Free guide: The 7-Day Itch Relief Plan
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- Daily checklists and an itch diary
- Dermatology and TCM tips side by side
- A bedtime routine for night-time itch
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Frequently asked questions
Is there a natural hydrocortisone cream?
No cream labelled hydrocortisone is natural: hydrocortisone is a mild steroid medicine, even though it matches the cortisol made by the body. Steroid-free alternatives for mild itch and dry patches include a thick moisturiser, colloidal oatmeal, cooling menthol and steroid-free herbal creams.
What can I use instead of steroid cream for eczema?
Options include regular moisturisers, colloidal oatmeal, Chinese herbal creams and non-steroid prescription creams such as tacrolimus, pimecrolimus, crisaborole, roflumilast, ruxolitinib or tapinarof. Severe eczema may need biologics or oral medicines.
What is a natural alternative to hydrocortisone cream?
Moisturisers, colloidal oatmeal and Chinese herbal creams are the most common natural alternatives. In a meta-analysis of 10 trials, topical Chinese herbal creams achieved skin-lesion scores similar to corticosteroid creams.
What can I use instead of steroid cream on my face?
Gentle moisturising and prescription calcineurin inhibitors such as tacrolimus or pimecrolimus are commonly used on the face. Steroid creams on the face can trigger perioral dermatitis, and persistent facial rashes should be diagnosed, as several conditions look alike.
What is a steroid-free alternative for psoriasis?
Vitamin D creams, coal tar, moisturisers and, for facial or fold psoriasis, tacrolimus or pimecrolimus. Widespread psoriasis may need phototherapy or systemic treatment.
Can I stop my steroid cream straight away?
If you have used a prescribed steroid regularly, ask your doctor how to reduce it, because stopping suddenly can cause a flare. Steroid-free care can be added as part of that plan.
How do I know a herbal cream has no hidden steroids?
Choose a cream with a full ingredient list including concentrations and an independent laboratory test for corticosteroids. Be wary of creams that clear stubborn rashes within days and then cause a bad flare when stopped.
Related articles
References
- Gu S, Yang AW, Li CG, et al. Topical application of Chinese herbal medicine for atopic eczema: a systematic review with a meta-analysis. Dermatology. 2014;228(4):294-302. PMID 24821063
- Wang MC, Chou YT, Kao MC, et al. Topical Chinese herbal medicine in treating atopic dermatitis (eczema): a systematic review and meta-analysis with core herbs exploration. J Ethnopharmacol. 2023;317:116790. PMID 37328084
- Cai X, Sun X, Liu L, et al. Efficacy and safety of Chinese herbal medicine for atopic dermatitis: evidence from eight high-quality randomized placebo-controlled trials. Front Pharmacol. 2022;13:927304. PMID 36238577
- Reynertson KA, Garay M, Nebus J, et al. Anti-inflammatory activities of colloidal oatmeal contribute to the effectiveness of oats in treatment of itch associated with dry, irritated skin. J Drugs Dermatol. 2015;14(1):43-48. PMID 25607907
- Saeedi M, Morteza-Semnani K, Ghoreishi MR. The treatment of atopic dermatitis with licorice gel. J Dermatolog Treat. 2003;14(3):153-157. PMID 14522625
- Myles IA, Ratley G. Topical steroid withdrawal: dissecting the controversy. Front Med (Lausanne). 2026;13:1786331. PMID 41924752
- Choi H, Orbe M, Esam S, Parker J. An updated systematic review of topical corticosteroid withdrawal (TCSW): steroid addiction or adverse drug effect? Cureus. 2026;18(4):e107365. PMID 42170112
- Cury Martins J, Martins C, Aoki V, et al. Topical tacrolimus for atopic dermatitis. Cochrane Database Syst Rev. 2015;(7):CD009864. PMID 26132597
- Simpson EL, Eichenfield LF, Alonso-Llamazares J, et al. Roflumilast cream, 0.15%, for atopic dermatitis in adults and children: INTEGUMENT-1 and INTEGUMENT-2 randomized clinical trials. JAMA Dermatol. 2024;160(11):1161-1170. PMID 39292443
- Li AW, Yin ES, Antaya RJ. Topical corticosteroid phobia in atopic dermatitis: a systematic review. JAMA Dermatol. 2017;153(10):1036-1042. PMID 28724128
- Mose KF, Bygum A. Chinese herbal remedy found to contain steroids and antifungals. Lancet. 2019;393(10170):446. PMID 30712902
- Chen J, Sun J, Wang C, et al. Iatrogenic Cushing's syndrome induced by topical steroid abuse in a patient with psoriasis: a case report. Front Med (Lausanne). 2025;12:1591869. PMID 41090129
- American Academy of Dermatology. Atopic dermatitis and psoriasis clinical guidelines.
Educational information only. Eczema and psoriasis may need prescription treatment, especially when widespread, painful, rapidly worsening, infected or associated with joint symptoms.
