Finding relief from eczema
Let’s start with the not-so-good news. There’s no cure for eczema (also known as atopic dermatitis). It’s a chronic condition that causes red, itchy and bumpy skin. And 1 in 10 people in the U.S. have it. That means you’ll likely need to manage it for a long time. But there’s good news. You can choose from a variety of medications to treat it.
People with eczema often have an overactive immune system. When they’re exposed to a trigger, their body responds by producing inflammation.
It shows up on the skin as itchy redness or scaliness. Any number of things could set it off — stress, dry skin, an ingredient in your shampoo or something you’re allergic to, such as pollen.
There’s no single best therapy for eczema, says Raj Chovatiya, MD. He’s a dermatologist at Northwestern Memorial Hospital in Chicago. But there are medications that can help.
Here’s what you need to know about eczema and how it’s treated. Remember: Use your free prescription discount card any time you go to the pharmacy. You don’t want to miss out on potential savings.
First, keep skin hydrated
Before you try medication, make sure you’re doing everything you can to keep your skin clean and well moisturized. That alone can head off symptoms and help your skin heal.
Let’s tackle washing first. Dr. Chovatiya recommends fragrance-free cleansers that aren’t soap-based. And stay away from anything with “exfoliating” on the label, such as facial scrubs, he says. Make sure you thoroughly (but gently) wash every day.
Then moisturize, moisturize, moisturize after you wash your skin. And reapply moisturizer several times a day. You want the most hydrating moisturizer you can find. Typically, “the greasier, the better,” says Rebecca Thiede, MD. She’s a Banner-University Medicine dermatology specialist and an assistant clinical professor of dermatology at the University of Arizona in Tucson.
Thick ointments are better than creams, she says. And creams are better than lotions or gels. Dr. Thiede especially likes moisturizers that say they contain ceramides or lipids.
You want a moisturizer that doesn’t have fragrances or essential oils. In fact, that should be true of everything you put on your skin if you have eczema.
Recommended reading: What are the differences among psoriasis, eczema and rosacea?
Try an eczema medication
Eczema patients have more of the cells that react to triggers and produce inflammation, Dr. Thiede says. Many medications work by targeting those inflammatory cells.
It might take some trial and error to find the medication that works for you. Team up with your dermatologist to make a plan. And don’t give up if the first thing you try doesn’t help. (Find out how your doctor can help you afford eczema care.)
Your doctor will first have you try topical corticosteroids. They come in a range of strengths and forms. There are creams, ointments, lotions, foams, gels and shampoos.
The one your doctor prescribes will depend on a couple of things. First, where on your body will you use it? You would use a less powerful medication on your neck, for instance. But the skin on your hands or feet could probably handle something stronger.
It also depends on how bad your flares are. The more severe, the stronger a corticosteroid your doctor might start you on. Some common topical corticosteroids are:
- Kenalog® (triamcinolone)
- Cutivate® (fluticasone)
- Cyclocort® (amcinonide)
- Betanate® (betamethasone dipropionate)
- Elocon® (mometasone furoate)
These medications do come with potential side effects. You might get acne or have discolored or thinning skin. There’s a chance of developing cataracts or glaucoma with prolonged use. But those side effects are rare when the medication is used properly, Dr. Thiede says.
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Topical calcineurin inhibitors
If topical steroids don’t help, your doctor might suggest another type of medication. It’s called a topical calcineurin inhibitor (TCI). Calcineurin is an enzyme in your body that causes certain immune cells to flare up. Calcineurin inhibitors block them. TCIs include Protopic® (tacrolimus), which is an ointment, and Elidel® (pimecrolimus), a cream.
TCIs are good for places on the body with delicate skin, such as the face or neck, says Danielle Baruch, MD. She’s a dermatologist at Mercy Medical Center in Baltimore. TCIs have few side effects. You might feel a slight stinging or burning sensation when you put them on, according to Dr. Thiede.
Topical PDE4 inhibitor
Eucrisa® (crisaborole) is an ointment that reduces swelling and itching on the skin. It blocks the action of an enzyme called phosphodiesterase 4 (PDE4), which plays a role in inflammation. You may notice slight skin irritation as a side effect of this medication.
For severe eczema, your dermatologist might turn to a group of medications that the FDA approved in 2022. They’re known as JAK inhibitors. They work quickly to ease itching and redness.
Experts think that cytokines (proteins made by your immune system) may cause eczema. Cytokines cause inflammation by using JAK signaling pathways. JAK inhibitors reduce the effects of cytokines by blocking the pathway.
These medications come in a couple of forms. Cibinqo™ (abrocitinib) and Rinvoq® (upadacitinib) can be taken by mouth. Opzelura™ (ruxolitinib) is a cream that you rub on your skin.
Common side effects of JAK inhibitors include acne, nausea, upper respiratory tract infection and headaches, Dr. Thiede says.
Dupixent® (dupilumab) is what’s known as a biologic. It’s a medication made with proteins from living cells. Treatment starts with 2 injections followed by 1 injection every 2 to 4 weeks.
This treatment works by blocking a type of protein called interleukin (IL) from binding to their cell receptors. When triggered by the immune system, interleukins can mistakenly attack the body. This can result in chronic inflammation such as eczema.
The main potential side effect is conjunctivitis (also called pink eye). It usually happens only in children and can be treated, Dr. Thiede says.
Will your eczema always flare up?
Not necessarily. But you should be prepared to deal with it for a long time. Some people have eczema in childhood but then grow out of it as an adult, Dr. Chovatiya says. For others, “eczema waxes and wanes throughout life,” says Dr. Thiede.
Finding the medication that works best can take time. Dr. Baruch recommends choosing a dermatologist who can tailor a plan to your specific needs. The sheer number of medications available might seem overwhelming at first. But it means that you have lots of things to try that can get your eczema under control. The whole goal is to stop your itching and get relief.
Be sure to search for your prescription on the Optum Perks discount app before heading to the pharmacy. You could find medication coupons for up to 80% off.
Eczema facts: National Eczema Association
Managing eczema: American Academy of Dermatology Association
Dupixent information: U.S. Food and Drug Administration