Can a Vitamin B12 cream help treat eczema?

We recently spotted this on our Instagram feed, from the National Eczema Association (USA):

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Can topical vitamin B12 be used to treat eczema? Studies show some compelling evidence that it is helpful for both adults and children. However, because there is currently no commercial product, it must be compounded at a pharmacy. Dr. Peter Lio of Chicago Integrative Eczema Center, who's also a member of NEA’s board and Scientific Advisory Committee, shares this recipe for a B12 compound, called Pink Magic: 💕 • 0.07 g Cyanocobalamin (vitamin B12) • 46 g Persea Gratissima Oil (avocado oil) • 45.42 g water • 8 g TEGO® Care PS or Methyl Glucose Stearat (an emulsifier) • 0.26 g Potassium Sorbate (a preservative) • 0.25 g Citric Acid 💕 Dr. Lio points out that some people simply use 0.07 grams of B12 in a moisturizer base. • 👉👉👉Listen to the archive of our webinar with Dr. Lio, Complementary and Alternative Treatments for Eczema: Separating Fact from Fiction, to learn about evidence-based alternative therapies for eczema. Tap link in bio > Webinars > Archives > Complementary & Alternative Treatments for Eczema 👈👈👈 • • • #nationaleczema #unhideeczema #eczematips #alternativetherapy #alternativemedicine #naturaltreatment #drpeterlio #vitaminB12

A post shared by National Eczema (@nationaleczema) on Nov 5, 2019 at 12:55pm PST

This post claims that a Vitamin B12 cream can help treat eczema and their website links back to one study to back up their claims.

Firstly, Vitamin B12 is not an accepted treatment for eczema. Many vitamins have been tried over the years, especially Vitamin E and Vitamin D, but none have been found to work. While creams often are used to treat eczema, these creams work as emollients and moisturizers. Essentially they prevent the skin from drying out and making eczema worse. What makes a cream effective is how much water vs. how much oil is contained in the mixture. Whether it contains Vitamin B12, sunflower extract, rose blossoms or anything else is largely irrelevant. It’s the oil vs. water content that matters more than anything else. Products like petroleum jelly have very little water, and are very effective. But as a trade off, the are more greasy and some people therefore find them unpleasant.

Since eczema is a disease that fluctuates over time, short term studies like this are not generally that helpful in deciding if something works.

The study used to back up the claims is a relatively small study of only 21 children that lasted only 4 weeks. Since eczema is a disease that fluctuates over time, short term studies like this are not generally that helpful in deciding if something works. What you really want to know is whether this product will work consistently 6 months or 12 months out. And we don’t know that it does.