Eczema Treatments and Medications

Living with and treating dry, itchy skin can be difficult and frustrating to tackle. These symptoms commonly indicate a case of eczema or atopic dermatitis. Understanding what eczema is and how to treat it, both at home and with medications, are great first steps in managing your eczema. Let’s take a look at what eczema is and what can be done to treat it.

What is eczema?

Atopic dermatitis, also known as eczema, is a condition that causes the skin to be red and itchy. It more commonly first appears in early childhood, but eczema can occur at any age and is a chronic condition. Most eczema sufferers will have flare-ups throughout life and require treatments when they occur. Atopic dermatitis is more common in families with a history of the condition and often appears on the arms or behind the knees. There is no cure for eczema at this time, but there are many eczema treatment options available.

How is eczema diagnosed?

Atopic dermatitis is commonly self-diagnosed because it is easy to see and feel when it occurs. However, it can be important and incredibly helpful to receive an official diagnosis from a healthcare professional. Getting an official diagnosis will also open up opportunities for prescription-strength treatments and, more often than not, a quicker recovery.

While there isn’t an exact cause for eczema, there are some indicators of what may cause a flare-up. Eczema is believed to be due to genetics, among other factors, which causes the body’s immune system to overreact in response to certain substances. Many patients experience flare-ups that may be linked to allergens in food or the environment, such as dander and dust.

When these situations occur, the most common symptom is red, itchy skin. Itching can also occur in the area impacted by eczema before the rash even appears, indicating that a flare-up is about to occur. The rash itself will commonly appear on the backs of the knees, face, hands, feet, and wrists. Dyshidrotic eczema (or dyshidrosis) may also result in oozing blisters on the hands or feet.

Due to the ease of identification, eczema can be diagnosed by a variety of doctors and specialists. If you suspect that you or your child may have this skin condition, you will want to make an appointment with your child’s pediatrician or your primary care provider.

During the appointment, the doctor will look at the rash itself as well as assess other eczema symptoms that might be present. It’s also likely you’ll be asked about family history with eczema or other conditions that pertain to immune system overactivity.

Eczema is commonly associated with allergies as well, so it is likely your doctor will perform an allergy test at the appointment or refer you to a dermatologist for further allergy and skin testing. It is possible that your healthcare professional will try other patch tests to rule out other skin diseases or conditions. There is not, however, an official test for eczema that will be performed.

Eczema treatment options

Receiving a diagnosis for eczema is a great first step to getting better and understanding your next steps. There is no cure for eczema that exists at this time, which means treating symptoms or preventing flare-ups are the best ways to combat the condition. Treating the itchiness and inflammation can also be important for preventing skin infections. This can be done in a variety of methods using many different products or practices.

Treatment of eczema will vary depending on the patient's needs, age, and severity of eczema when it occurs. Medications such as steroid cream, topical calcineurin inhibitors, and immunosuppressives are all possible treatment options. Wet wraps, phototherapy with ultraviolet light, and prevention methods like stress relief have all been used to both treat and prevent eczema. Infants experiencing eczema should be treated in a more preventative way as the use of more extreme medications may cause issues for them.

Eczema medications

One of the biggest concerns with eczema is the risk of skin infection caused by itching the rash excessively. Because of this, most of the medications for eczema treatment are focused on relieving the symptoms and eliminating the rash entirely.

Hydrocortisone

A commonly used medication to treat eczema is hydrocortisone topical treatments. Eczema creams, ointments, tape, gels, or lotions containing hydrocortisone are often prescribed or recommended for purchase as over-the-counter options. This is a more mild treatment option and typically isn’t recommended for use over a long period of time.

The use of these topical steroids can reduce or eliminate inflammation, redness, and itching. Some side effects to look out for with hydrocortisone treatments include burning, dry or cracking skin, and discoloration of the skin. A few common brands of hydrocortisone creams include Skinfix, Cortizone-10, and TriCalm which are available over the counter.

Calcineurin inhibitors

Topical calcineurin inhibitors (TCIs) are a treatment applied thinly on the affected area. This treatment works by suppressing the overactivity of the immune system. The suppression is done by acting on T-Cells to dampen the immune system and, as a result, reduce or eliminate inflammation of the skin.

There are two commonly used prescription TCIs which are Protopic (tacrolimus) and Elidel (pimecrolimus). Sometimes a doctor will start patients on a prescription of tacrolimus but will switch to pimecrolimus after six weeks if there is not an improvement. As with many topical treatments for eczema, TCIs can sometimes cause burning, pain, or discoloration to the application site.

Immunosuppressive

In some moderate or severe cases of eczema immune system suppressing drugs will be prescribed as a treatment. Due to their more serious side effects, these medications are typically used after many other treatments have been attempted and failed for severe atopic dermatitis. These immunosuppressants can be in the form of oral medication or injection and are prescribed by your doctor.

Some of the more commonly used medications in this category include mycophenolate mofetil and cyclosporine. These medications work by suppressing the immune system so that it will not cause overactivity, but they do come with some severe side effects. Those side effects include kidney issues and high blood pressure.

Antihistamines

Eczema can cause severe itching that can result in trouble sleeping for some individuals. In some cases, a sedating oral antihistamine like Benadryl (diphenhydramine) or Vistaril (hydroxyzine) may be used short term. However, they are not generally recommended for long-term use and should not replace topical treatments. Topical antihistamines are not recommended due to insufficient evidence for their use and the risk of allergic reactions.

NSAID ointment

More recently a newer ointment has become available for mild to moderate eczema that does not involve the use of steroids. This is a prescription ointment that is applied twice daily when inflammation occurs, the medicated ointment will then provide relief of inflammation. Many users of this medication have reported that it helped their skin return to a more normal appearance as well. Currently, the option for this prescription medication is the brand Eucrisa, which does report a side effect of application site pain for some users.

What is the best medication for eczema?

Finding the best medication or treatment option for atopic dermatitis can be tricky. Patients may need to try a few different methods depending on their condition, severity, and frequency of flare-ups. As with all medications, your best fit will depend on other medications you use, allergies, and how your body reacts to different medication types. Please consult a healthcare professional when selecting a medication for your eczema.

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Best medications for eczema