Eczema is a term used to describe dry, red, and itchy skin. There are several different conditions that cause this type of skin rash.

The most common type of eczema is atopic dermatitis (AD). Three major factors that contribute to this chronic skin condition are genetics, immune system differences, and environmental triggers.

Sometimes topical treatments aren’t effective for eczema. In cases like these, doctors sometimes suggest injectable medication.

Injections are a way of delivering a type of eczema medication known as a biologic. One example is dupilumab (Dupixent), approved in 2017 by the Food and Drug Administration (FDA) for eczema that’s moderate to severe.

Biologics work by calming the immune system to ease inflammation. Taking this type of medication can increase your chance of infections, such as the common cold or conjunctivitis (pink eye). However, it’s also effective in treating eczema symptoms.

A 2016 study that examined the safety and effectiveness of the biologic dupilumab found evidence that it could help in the long-term treatment of moderate to severe atopic dermatitis.

Your doctor can review your eczema treatment and medical history to decide whether injectable medication is the right choice for you.

If your doctor thinks an injectable medication might help, you’ll have two choices around receiving the medication:

  • in-office injections administered by a health care professional
  • at-home doses that you can self-inject

Eczema injection treatments don’t happen daily. For example, your regimen might consist of an initial dose of two injections followed by one injection every 2 weeks.

Injectable medications typically come in two formats: pre-filled syringes and pre-filled pens. Unlike other types of medications such as insulin for diabetes, eczema medication syringes and pens contain one dose.

Begin by reading all the instruction materials that came with your medication, and watch any instructional videos provided on the company’s website. The Dupixent Injection Support Center provides detailed instructions.

Here is how to prepare your dose:

  • Remove your pen or syringe from the refrigerator so it can warm to room temperature. This can take anywhere from 30–45 minutes, depending on the dose.
  • Leave the needle cap on until you’re ready to inject.
  • Examine the pen or syringe. Check the expiration date, and don’t use the medication if it’s expired. Make sure the liquid is clear and doesn’t contain any visible floaties.
  • While you’re waiting for your medication to warm to room temperature, gather the other items you’ll need: alcohol wipe, cotton ball, sharps container
  • Wash your hands and find somewhere to sit comfortably.
  • Choose your injection site. Make sure it’s not the same place that you previously injected. Using the same location repeatedly can cause scar tissue to form that will trap injected medication and prevent it from working properly.
  • Make sure your injection site has skin that isn’t broken, bruised, or otherwise irritated, and avoid visible blood vessels. Don’t inject through clothes.
  • For self-injections, the thighs or abdomen are the best locations. If you choose your abdomen, avoid the 2-inch (5-cm) area surrounding your belly button. If a caregiver is administering your injection, the upper arm is also an acceptable location.
  • Use the alcohol wipe to clean the injection site. Allow the area to dry before injecting. Don’t blow on your skin to dry it.
  • Remove the needle cap to proceed.

Once your dose is at room temperature and the site is ready, you can inject the medication. Here’s how:


  • Pinch the area around your injection site to form a mound. This is to create a space under the skin for the injection, and to avoid muscle tissue.
  • Take a deep breath and exhale as you insert the needle at around a 45-degree angle while continuing to pinch.
  • Once the needle is inserted, release the pinch with your other hand.
  • Push down the syringe plunger, slowly and steadily. Continue as far as it will go to ensure you inject the entire dose.
  • Slowly remove the syringe from the injection site, and gently press down on the site with a cotton ball if you see blood.
  • Place the used syringe and needle into the sharps container for disposal.


  • Place the needle end of the pen on the cleaned portion of your skin, so that you can see the injector window.
  • Press the pen down firmly until you hear a click. Hold it in place and watch the injector window which will start to turn yellow until you can no longer see any medication, and until you hear a second click.
  • Continue holding the pen in place as you count to five to ensure you get the full dose. The injector window will turn completely yellow as you count.
  • Lift the pen straight up off your skin, then dispose of it in your sharps container.

Although injectable treatments for eczema are safe and effective, for many people the fear of needles is a barrier.

A 2018 meta-review of 119 studies found that as many as 30 percent of young adults experience needle fear, and for some, it’s enough for them to skip helpful preventive measures like the flu vaccine.

So, if you’re worried about injections, you’re not alone. It may help to:

  • ice the area before the injection to help numb the skin
  • look away when the medication is injected
  • tense your muscles to reduce the chance of feeling faint
  • remember that any discomfort will be brief while the positive effects of the medication will last much longer

Needle fear stress isn’t just something that makes injections more difficult. Research shows that stress, in general, is also a trigger for AD, a link supported by a population-based study involving Korean adults.

But you can take steps to reduce stress and anxiety. This will help to ease eczema flares and can also make injections more manageable.

You can reduce anxiety by managing your autonomic nervous system, which consists of three parts:

  • sympathetic nervous system (fight, flight, or freeze response)
  • parasympathetic nervous system (rest and digest)
  • enteric nervous system

When you’re anxious or stressed, your sympathetic nervous system (SNS) takes over. In an urgent situation, like running from danger, your SNS provides the adrenaline you need.

However, if your stress lingers, prolonged activation of your SNS can create the type of chronic inflammation that can make eczema worse.

Anxiety management techniques can help calm your SNS and return to the rest and digest state of the parasympathetic nervous system.

  • Meditation. Even short meditation sessions are beneficial. Once you become skilled at this mindfulness practice, you can use it at any point during your day if you feel on edge.
  • Breathing exercises. Focusing on your breathing can be a part of your daily mindfulness routine, as well as a tool for calming yourself in an anxious moment.
  • Support groups. Connecting with others in a safe setting helps you feel less isolated with anxiety.
  • Group counseling. Try the American Psychological Association’s psychologist locator tool to find a group counseling session in your area.
  • Lifestyle changes. Improved nutrition and regular exercise can help you sleep better, which eases stress and anxiety.
  • Stress-relieving hobbies. An activity you enjoy can distract you from stressful thoughts, so you have a chance to relax.

Eczema has several treatment options, one of which is injections. The injectable medication helps to settle your immune system to reduce AD flare-ups.

You can regularly visit your doctor for your injections, or you can do them yourself in the convenience of your own home.

The idea of self-injecting may seem like something you’d prefer not to do. However, once you learn how, it gets easier. Not only can anxiety trigger eczema flares, but it can also make self-injecting more intimidating.

Fortunately, stress and anxiety are manageable with a few simple strategies.