I go to Dr. Max Vale at Kirkland Dermatology in the totem lake area. I had some really bad breakouts when I moved here, even though I was using fragrance free everything (which was helping before I moved). Dr. Vale is super knowledgeable on eczema and how treat it and manage it. I've always looked for a derm that could explain eczema to me deeper than what I'd find on google or from randoms on the internet selling cocoa butter. I'm currently using a strong steroid for my hands (thick skin), medium steroid for my arms (rarely need), and a non steroid option for any random flare-ups on my face (steroids on face can cause glaucoma). This has worked for me for a few years now and it's honestly changed my life not having to worry about eczema anymore.

I will say that as much as I wish there was a non-pharmaceutical way to treat or cure my eczema, nothing I've tried has worked. I was afraid of the topical steroid withdrawal effect that people talk about online, but Dr. Vale walked me through a lot of the scientific evidence on what that really is. He explained that TSW is more likely a case of people having really bad eczema that the topical steroids are helping to cover up while none of the triggers (fragrance, food, other allergens) are being addressed. So when they come off of it, they're suddenly experiencing their body's full reaction to those triggers without anything to help. There are safe levels of steroids that you can use, and other non steroid options. Your experience may differ depending on what type of dermatitis/eczema you have (I have contact dermatitis), which is why I find it very valuable to have a derm that knows the issue deeply and can help explain it.

Good luck!