Eczema symptoms and effective therapies vary. Treatment for severe eczema may include at-home treatments plus prescription medications to ease the awful, stinging itch and discomfort.
Researchers are conducting clinical trials on new medications in the hopes of finding long-term solutions for managing eczema. There have been many advancements, with ideally more to come.
Other than regular cleaning and moisturizing, here are suggested treatments for severe eczema.
Wet dressings are an effective method to treat severe eczema and often reduce symptoms in several hours to days.
While wet dressings may sound simple, a doctor or nurse may need to apply them. They’ll spread a corticosteroid cream on the affected area and cover it with a wet bandage. The wet bandages are then covered with dry bandages.
Sometimes, a doctor can show you how to apply the wet dressings so you can put them on at home.
Calcineurin inhibitors are medications that modify your immune system. Their purpose is to reduce the inflammation associated with eczema. Examples of these medications include:
- tacrolimus (Protopic)
- pimecrolimus (Elidel)
These are prescription-only creams that you can apply to your skin.
When you use these creams, it’s possible to experience some skin irritation, burning, and itching. This will usually go away after a few applications. Other side effects include cold sores or blisters on your skin.
Doctors may prescribe oral medications to people with eczema that isn’t in one specific area. Those who don’t respond to creams may also benefit from taking oral medications. These work by slowing the immune system response, which can help to reduce the severity of eczema symptoms.
Examples of oral medications for severe eczema symptoms include:
- azathioprine (Imuran)
- mycophenolate mofetil
- oral steroids, such as prednisolone or prednisone
While these may help to reduce the incidence of eczema, they can come with some severe side effects, including:
- increased infection risk
- high blood pressure
- kidney or liver damage, depending on the medication
As a result, these medications are typically used for a short time to reduce severe symptoms.
Light therapy is often used to treat severe eczema that doesn’t respond to creams. This involves a machine that exposes your skin to ultraviolet (UV) light.
UVB light is most common. However, some forms of eczema therapy use UVA. According to the National Eczema Association, about 70 percent of people with eczema had improved symptoms after phototherapy.
Phototherapy usually involves a visit to a dermatologist’s office two to three times a week. Your doctor may reduce the frequency of treatment if it’s effective. It can sometimes take one to two months for the treatment to take effect.
In March 2017, the U.S. Food and Drug Administration (FDA) approved dupilumab (Dupixent). This medication is a biologic that can help lower inflammation in the treatment of moderate-to-severe eczema. It can help those with eczema that isn’t well-controlled as well as people who can’t use topical products.
More than 2,000 adults with eczema participated in three clinical trials involving dupilumab. The trials showed that most people experienced clear skin and reduced itching after about 16 weeks. Common side effects associated with this medication include:
- cold sores
- eyelid inflammation
Researchers are currently studying another injectable eczema medication called nemolizumab. It’s also a biologic that helps lower inflammation. It requires a monthly injection.
Those in clinical trials for this medication experienced reduced itching. Nemolizumab must undergo more clinical trials before the FDA can approve it for people with severe eczema.
Severe eczema can impact your quality of life. If the itching, burning, and discomfort has made your eczema unbearable, it’s time to contact your dermatologist. Many medications and therapies are available that can reduce or stop severe symptoms.