Objective To explore the efficacy and safety of mometasone furoate cream in the treatment of dermatitis and eczema. Methods A total of 80 patients with dermatitis and eczema admitted to Zhenjiang First People's Hospital from January 2022 to December 2023 were selected as the research objects. According to different treatment methods, they were divided into reference group and study group, with 40 patients in each group. The reference group was treated with hydrocortisone butyrate cream, and the study group was treated with mometasone furoate cream. The clinical efficacy, disease recurrence rate, incidence of adverse reactions, target lesion area, lesion area score and skin barrier function index were compared between the two groups. Results The total effective rate of treatment in the study group was 95.00%, which was higher than 75.00% in the reference group (P <0.05). The recurrence rate of the study group was 0, which was lower than 10.00% of the reference group (P <0.05). The incidence of adverse reactions in the study group was 2.50%, which was lower than 15.00% in the reference group (P <0.05). After treatment, the target lesion area of the study group was smaller than that of the reference group, and the lesion area score was lower than that of the reference group (P <0.05). After treatment, the skin grease, skin humidity and stratum corneum water content of the study group were higher than those of the reference group, and the skin water loss was lower than that of the reference group (P <0.05). Conclusion Mometasone furoate cream is effective in the treatment of dermatitis and eczema, which can effectively reduce the area of target skin lesions and improve skin symptoms. Meanwhile, the recurrence rate and the incidence of adverse reactions after treatment are low, which is beneficial to improve the skin barrier function of patients. It is worthy of clinical application.