Skin Eczema Treatments

Eczema, also known as atopic dermatitis, is a chronic skin condition characterized by dry, itchy, and inflamed skin. Although there is no cure for eczema, various treatments are available to help manage symptoms and reduce the risk of flare-ups. In this article, we will discuss the treatments for skin eczema, focusing on topical medications, systemic therapies, and home remedies.

Topical Treatments

Topical treatments are applied directly to the skin to provide localized relief for eczema symptoms. Some of the most common topical treatments include:

Corticosteroid Creams and Ointments

Corticosteroid creams and ointments are anti-inflammatory medications that help reduce inflammation, itching, and redness. They are available over-the-counter (OTC) or by prescription, depending on the strength needed. These medications work by suppressing the immune system and reducing inflammation in the skin.

Calcineurin Inhibitors

Calcineurin inhibitors, such as tacrolimus and pimecrolimus, are topical medications that suppress the immune system, helping to decrease inflammation and prevent flares. They are prescribed for patients aged ≥2 years and are particularly useful for treating eczema in sensitive areas, such as the face and eyelids.

Phototherapy

Phototherapy, or exposure to ultraviolet (UV) waves, is a treatment that may help manage moderate eczema. It can be used in combination with topical corticosteroids or other medications to treat moderate to severe eczema.

Oral Medications

Oral medications, such as systemic corticosteroids or immunosuppressants, may be prescribed for short periods to treat severe eczema symptoms. However, these medications should only be used for a limited time, and patients should be monitored closely for potential side effects.

Biologics

Biologics, such as dupilumab (Dupixent) and tralokinumab-ldrm (Adbry), are targeted therapies that block specific proteins in the immune system that trigger inflammation. They are prescribed for patients with moderate to severe eczema and are approved by the FDA to treat eczema. However, they may cause side effects, which are usually mild and manageable.

Topical JAK Inhibitors and PDE4 Inhibitors

Topical JAK inhibitors (ruxolitinib cream) and PDE4 inhibitors (crisaborole ointment) are also approved by the FDA to help treat eczema.

Systemic Therapies

For moderate to severe eczema, systemic therapies may be necessary to control symptoms. These therapies include:

Oral Immunomodulators

Oral immunomodulators, such as methotrexate, mycophenolate, and azathioprine, can help manage severe eczema. They work by suppressing the immune system and reducing inflammation.

Oral Janus Kinase (JAK) Inhibitors

Oral JAK inhibitors, such as upadacitinib and abrocitinib, are prescribed for patients with moderate to severe eczema who do not respond to topical treatments or phototherapy.

Narrow-band UVB Light Treatment

Phototherapy, specifically narrow-band UVB light treatment, can also be used to treat moderate to severe eczema.

Home Remedies

In addition to medical treatments, there are several home remedies that may help alleviate eczema symptoms:

Emollients

Emollients, such as moisturizers, should be applied on the skin at least twice a day, including unaffected skin. They work by improving skin barrier function and reducing itchiness.

Barrier Repair Moisturizers

Barrier repair moisturizers help to reduce water loss and repair damaged skin. They should be applied within 3 minutes of bathing to lock in moisture.

Wet Dressing

Wet dressing can promote the transepidermal penetration of topical glucocorticoids and help with skin barrier recovery, especially for acute oozing lesions.

Identification and Elimination of Aggravating Factors

Identifying and eliminating aggravating factors, such as irritants and allergens, can help reduce eczema symptoms.

Proper Cutaneous Hydration

Regular intermittent application of low potency steroids or topical calcineurin inhibitors can be helpful in managing eczema.

Education About Proper Cutaneous Hydration Methods

Education about proper cutaneous hydration methods is essential for patients to ensure they are using emollients correctly.

Avoiding Aggravating Factors

Physicians should help patients identify aggravating factors, such as soaps or detergents, chemicals, wool or nylon clothing, abnormal temperature/humidity, or sudden temperature changes, and advise on how to avoid them.

Wet Dressing

Wet dressing can reduce the chances of infection and promote the drying effect due to evaporation for oozing lesions.

Proper Use of Topical Medications

Patients should be educated on the proper use of topical medications, such as corticosteroids, calcineurin inhibitors, and other treatments, to ensure they are using them correctly.

In conclusion, there are various treatments available for skin eczema, ranging from topical medications to systemic therapies and home remedies. Each treatment option is designed to help manage eczema symptoms, reduce the risk of flare-ups, and improve overall skin health. It is essential for individuals with eczema to work closely with their healthcare provider to develop a personalized treatment plan that addresses their specific needs and concerns.