Eczema Treatments: From Topicals to Therapies—What Works?

Eczema, or atopic dermatitis, is a chronic skin condition that affects millions of people worldwide. Characterized by red, itchy, and inflamed patches of skin, eczema can be frustrating and challenging to manage. However, with the right treatment approach, relief is possible. In this blog, we’ll explore various eczema treatments—from topicals to therapies—to help you understand what works best for managing this common condition.

Understanding Eczema: The Basics

Eczema is more than just dry skin. It’s a complex condition that often has genetic, environmental, and immune-related causes. The symptoms can range from mild irritation to severe, painful flare-ups that disrupt daily life. Because eczema is such a multifaceted condition, treatment often requires a tailored approach that addresses both symptoms and underlying triggers.

Topical Treatments: The First Line of Defense

For many people with eczema, topical treatments are the first step in managing symptoms. These treatments are applied directly to the skin and can help reduce inflammation, itching, and dryness.

• Moisturizers (Emollients):
  • Purpose: Moisturizers are essential in any eczema treatment plan. They help to restore the skin’s barrier function, lock in moisture, and protect against irritants.
  • Types: Look for thick creams or ointments rather than lotions, as these are more effective at retaining moisture.
• Topical Corticosteroids:
  • Purpose: These anti-inflammatory creams or ointments are used to reduce redness and swelling during flare-ups.
  • Usage: They come in various strengths, and it’s crucial to use them as directed by a healthcare provider to avoid side effects like skin thinning.
• Topical Calcineurin Inhibitors (TCIs):
  • Purpose: TCIs, such as tacrolimus and pimecrolimus, are non-steroidal medications that help reduce inflammation and itchiness.
  • Usage: These are often prescribed for sensitive areas like the face or groin, where corticosteroids might be too harsh.
• Topical PDE4 Inhibitors:
  • Purpose: A newer class of treatment, such as crisaborole, that reduces inflammation by inhibiting the enzyme phosphodiesterase 4.
  • Usage: This is typically used for mild to moderate eczema and is a good option for those who want to avoid steroids.

Systemic Treatments: When Topicals Aren’t Enough

In more severe cases of eczema, topical treatments may not be sufficient. Systemic treatments, which work throughout the body, can be prescribed.

• Oral Corticosteroids:
  • Purpose: These are powerful anti-inflammatory medications that can quickly reduce severe symptoms.
  • Usage: Due to potential side effects, oral steroids are usually prescribed for short-term use during intense flare-ups.
• Immunosuppressants:
  • Purpose: Drugs like cyclosporine, methotrexate, and azathioprine suppress the immune system to reduce inflammation.
  • Usage: These are typically used for chronic, severe eczema that hasn’t responded to other treatments.
• Biologics:
  • Purpose: Biologics, such as dupilumab, target specific pathways in the immune system that contribute to eczema.
  • Usage: Administered via injection, biologics are an exciting advancement for moderate to severe eczema that doesn’t respond to traditional treatments.

Light Therapy (Phototherapy): A Non-Invasive Option

Phototherapy involves exposing the skin to controlled amounts of natural or artificial light. It’s a non-invasive treatment option for moderate to severe eczema.

• UVB Phototherapy:
  • Purpose: Narrowband UVB light is the most commonly used form of phototherapy for eczema. It helps to reduce inflammation and can lead to long-term remission of symptoms.
  • Usage: Treatment typically involves sessions several times a week in a dermatology clinic.
• PUVA Therapy:
  • Purpose: PUVA combines UVA light with a drug called psoralen to increase the skin’s sensitivity to light.
  • Usage: This is usually reserved for more severe cases due to the higher risk of side effects, including skin aging and an increased risk of skin cancer.

Lifestyle Changes: Supporting Your Skin from the Inside Out

Beyond medical treatments, lifestyle changes play a crucial role in managing eczema. These adjustments can help minimize flare-ups and improve your overall skin health.

• Diet and Nutrition:
  Tip: Some people with eczema find that certain foods can trigger flare-ups. Common culprits include dairy, gluten, and eggs. Keeping a food diary and working with a nutritionist can help identify triggers.
• Stress Management:
  Tip: Stress is a known trigger for eczema. Incorporating stress-reducing practices like meditation, yoga, or regular exercise can help manage symptoms.
• Environmental Control:
  Tip: Reduce exposure to irritants like harsh soaps, detergents, and allergens. Use a humidifier to maintain moisture in the air, especially during dry winter months.

Finding the Right Treatment Plan for You

Eczema is a highly individualized condition, meaning what works for one person might not work for another. It’s essential to work closely with your dermatologist to develop a personalized treatment plan that addresses your unique symptoms and triggers. With the right combination of treatments, lifestyle adjustments, and professional guidance, managing eczema and achieving healthier skin is within reach.

Need Help Managing Eczema?

We’re here to support you in finding the best eczema treatment plan. Contact us today to schedule an appointment with one of our board-certified dermatologists and start your journey to clearer, healthier skin.