Eczema medications & treatments
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Eczema, or atopic dermatitis, is an inflammatory skin condition that can cause itchiness, dry skin, and rashes. More than 31 million Americans have some type of eczema. Eczema is not contagious and can occur at any age but is most common in infants and young children. There is no cure but it can be successfully managed with a treatment plan consisting of medications, moisturizers, and a good skin-care routine.
What is eczema?
Eczema is a chronic skin disorder that results from your immune system overreacting to small irritants or allergens. It causes your skin to become dry, red, and itchy. Eczema affects males and females equally and is more common in people who have a personal or family history of asthma, hay fever, or food allergies.
Most eczema sufferers will have flare-ups throughout life that require treatment. Flare-ups are followed by times when the skin will heal and you may not have any signs of eczema (called remission). Remission can last for weeks, months, or even years.
How is eczema diagnosed?
Your doctor or dermatologist will likely diagnose you with eczema by examining your skin and asking about your medical history. They may also perform an allergy test to rule out other skin diseases or conditions.
While examining your skin, your doctor will look for signs and symptoms of eczema such as:
- Itchy skin
- Dry skin
- Small, raised bumps or blisters that may ooze, weep a clear fluid, or bleed when scratched.
- Red or brownish-gray patches, especially on the hands, feet, wrists, neck, in the bend of your elbows and knees, and in infants, the face and scalp
- Thickened, leathery, scaly skin
Because many people with eczema also have allergies, your doctor may order or perform allergy tests to look for skin irritants. They may also order blood tests to rule out other skin diseases or conditions.
What are some eczema treatment options?
There is no cure for eczema so the goals for treatment are to reduce itching, heal the skin, prevent skin infections, and prevent flare-ups.
Treatments usually include a combination of therapies and can include:
- Medications. Your doctor may prescribe or recommend one or more of the following based on the severity of your symptoms:
- Topical steroid creams and ointments such as hydrocortisone help to reduce inflammation and itching. They are usually effective against mild eczema symptoms but aren’t recommended for long-term use.
- Moisturizing creams or lotions that restore the skin barrier.
- Topical calcineurin inhibitors such as Protopic (tacrolimus) and Elidel (pimecrolimus) are applied to the skin to reduce inflammation and reduce the frequency of flare-ups.
- Phosphodiesterase-4 inhibitors, such as Eucrisa (crisaborole) helps relieve inflammation when the symptoms do not respond to other treatments.
- Janus kinase (JAK) inhibitors, including oral and topical preparations, are typically used in patients with severe eczema. These prescription medications require monitoring.
- Biologics, such as Dupixent (dupilumab) are injected under the skin. They block proteins in the immune system to help reduce its activity which helps manage severe atopic dermatitis.
- Immunomodulators, including CellCept (mycophenolate mofetil) and Sandimmune (cyclosporine) suppress the immune system to reduce flare-ups of atopic eczema. They should only be used only a short time to limit the possibility of serious side effects such as increased cancer risk, infection, high blood pressure, and kidney disease.
- This treatment uses ultraviolet light to treat patients with eczema that is all over the body (widespread) that has not improved with topical treatments. It does come with serious side effects if used long-term, including burns, increased skin aging, and an increased risk of skin cancer.
- Use hypoallergenic soaps and detergents that are fragrance and dye-free.
- Moisturize multiple times a day with creams, ointments, and lotions that are hypoallergenic.
- Take a diluted bleach bath 2 to 3 times a week to help reduce inflammation, itching, and infections. Talk with your healthcare professional before starting this therapy.
- Use wet wraps to rehydrate the skin and help topical medications work better.
What is the best medication for eczema?
The best medication for eczema will depend on the individual’s specific medical condition, medical history, medications that the individual is already taking that may potentially interact with eczema medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter eczema medications approved by the Food and Drug Administration (FDA).
Best medications for eczema
|Drug name||Drug class||Administration route||Standard dosage||Common side effects|
|Eucrisa (crisaborole)||PDE-4 inhibitor||Topical||Apply a thin layer to the affected area(s) twice daily.||Burning, stinging, or pain at the application site, swelling, redness|
|Elidel (pimecrolimus)||Calcineurin inhibitor||Topical||Apply a thin layer to the affected area every 12 hours.||Burning sensation, headache, fever, cough, common cold|
|Protopic (tacrolimus)||Calcineurin inhibitor||Topical||Apply a thin layer to the affected area every 12 hours. Discontinue when symptoms have cleared.||Burning sensation, itching, redness, flu-like symptoms, headache|
|Cibinqo (abrocitinib)||JAK1 inhibitor||Oral||100mg to 200mg daily.||Nausea, common cold, headache, acne, herpes simplex, vomiting|
|Rinvoq (upadacitinib)||JAK1 inhibitor||Oral||15mg to 30mg daily.||Upper respiratory tract infections, acne, headache, herpes simplex, cough, nausea|
|Opzelura (ruxolitinib)||JAK1 inhibitor||Topical||Apply a thin layer to the affected area(s) twice daily of up to 20% body surface area; Max of 60gm/week||Common cold, bronchitis, ear infection, diarrhea|
|Dupixent (dupilumab)||Interleukin inhibitor||Injection||600mg under the skin once, and then 300mg every other week.||Injection site reactions, pink eye, dry eye, oral herpes, allergic reactions|
|Adbry (tralokinumab-ldrm)||Interleukin inhibitor||Injection||600mg under the skin once, and then 300mg every other week.||Upper respiratory tract infections, pink eye, injection site reactions|
|Sandimmune (cyclosporine)||Calcineurin inhibitor||Oral||The initial dose recommended by the American Academy of Dermatology is 2.5mg/kg daily in 2 divided doses.||Tremor, hypertension, headache, nausea, excessive hair growth|
|CellCept (mycophenolate mofetil)||Immunosuppressant||Oral||250mg twice daily on an empty stomach.||Infection, nausea, diarrhea, high blood sugar, back pain|
|Benadryl (diphenhydramine)||Antihistamine||Oral||25mg to 50mg every 6 to 8 hours as needed.||Drowsiness, fatigue, dry mouth, headache|
|Hydrocortisone||Corticosteroid||Topical||Apply a thin film to the affected area(s) twice daily.||Burning, itching, thinning of the skin|
Your healthcare provider will determine the right dosage for you based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.
What are the most common side effects of eczema medications?
As with all medicines, those used for eczema will have some side effects, depending on the class you are taking. The most common side effects of medications used in the management of atopic dermatitis include:
- Burning, stinging, and pain at the application site
- Increased risk of infections
- Injection site reactions
- Skin discoloration
What are some home remedies for eczema?
In addition to medications and therapies prescribed by your doctor, you can try the following self-care measures:
- Use a humidifier to add moisture to the air in your home.
- Avoid airborne allergens, such as pollen, pet dander, and dust mites.
- Avoid skin irritants to reduce the risk of contact dermatitis.
- Minimize stress.
- Wear light clothes and avoid irritating materials like wool.
- Take short lukewarm showers or baths.
- Try plant-based topicals such as aloe vera gel, coconut oil, and sunflower oil.
- Drink plenty of water.
- Avoid getting overheated.
- Avoid scratching the affected areas.
Frequently asked questions about eczema
How common is eczema?
It is a very common skin condition that affects over 31 million Americans. One in 10 individuals will develop eczema during their lifetime, with prevalence highest in young children.
Can foods cause eczema?
Some people with food allergies or sensitivities find that eliminating these foods can reduce symptoms. Some common foods to avoid include dairy, eggs, nuts, and shellfish.
Can eczema be cured?
There is no cure for eczema. It is a chronic condition with periods of remission between the flare-ups.
Is my eczema infected?
It is possible during a flare-up for your eczema to become infected. Some signs that it is infected include:
- Severe or increased redness and itching
- Clear or yellow fluid drainage
- Yellow pus spots
- Fever and chills
Related resources for eczema
- What is eczema? National Eczema Association.
- Eczema overview. MayoClinic
- Eczema: Symptoms and Causes. Cleveland Clinic
- What is eczema? WebMD
- Eczema types: atopic dermatitis overview. American Academy of Dermatology Association
- Eczema treatment. Everyday Health