There is no cure for eczema. The best way to help reduce symptoms and manage eczema is by taking medications recommended by your physician, along with making behavioral changes. There are several types of medications that help reduce itchiness, bring down inflammation, and prevent future bouts of eczema, including antihistamines and corticosteroid medications. If your infant or young child has eczema, talk to your pediatrician about the safest and best treatment options.
Oral over-the-counter antihistamines may provide some relief from the itchiness of eczema. Histamine is a chemical that is responsible for allergic reactions. Just as their name suggests, antihistamines work by blocking histamine and reducing the potential for the allergic reactions. These drugs also make you sleepy so they are best taken at night. Over-the-counter antihistamines include:
- cetirizine (Zyrtec)
- diphenhydramine (Benadryl)
- fexofendaine (Allegra)
- loratidine (Claritin)
Cortisone (steroid) creams and ointments are a mainstay of eczema treatment. The cream is applied directly to the affect area of skin. Corticosteroids relieve itching and reduce scaling. These medications should not be used long-term because they carry the risk of side effects, including thinning of the skin and skin irritation and discoloration. In severe cases, your dermatologist may prescribe oral corticosteroids. They help bring down inflammation.
Remember, all steroid creams are not created equal. Low-potency steroids like hydrocortisone are available over the counter, but high potency steroids may be helpful to patients that do not respond to low-potency steroids. Make sure you see your doctor to get appropriate relief.
Oral corticosteroids have the potential to cause serious side effects including bone loss. One of the most commonly prescribed corticosteroid medications is prednisone (Meticorten, Sterapred.)
Certain prescription medications that impact the immune system and prevent it from overreacting are used to treat severe atopic dermatitis. For example, the drug cyclosporine (Sandimmune), which comes in liquid or capsule form, suppresses T cells (a type of white blood cell), which in turn keeps the immune system from overreacting and prevents flare-ups of eczema. There are potential serious side effects, including an increased risk of developing cancer, high blood pressure, and kidney disease as well as headache. Immunosuppressants like tacrolimus or pimecrolimus also act to reduce the activity of T cells and improve the lesions and symptoms of eczema.
The itchy skin of eczema results in a lot of scratching, which can break the protective barrier of the skin. This allows bacteria such as staph to enter, causing an infection. If there is an infection, your physician may prescribe a topical or oral antibiotic to treat it. It’s important to take antibiotics exactly as they are prescribed. Skipping doses or not finishing the prescription can allow some bacteria to remain and can lead to antibiotic resistance, making the infection harder to treat.