Eczema symptoms and effective therapies vary. Severe eczema often needs many treatments to ease the awful, stinging itch and discomfort. Treatment for severe eczema may include at-home treatments plus prescription medications.
Researchers are conducting clinical trials on new medicines in the hopes of finding long-term solutions for managing eczema. There have been many advancements in the field of eczema research, with ideally more to come.
Other than regular cleaning and moisturizing, here are the 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, they often need the expertise of a doctor or nurse to apply them. Your doctor will spread a corticosteroid cream on the area affected with eczema and cover it with a wet bandage. The wet bandages are then covered with dry bandages.
In some instances, 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 the immune system. Their purpose is to reduce the inflammation associated with eczema. Examples of these medications include tacrolimus (Protopic) and pimecrolimus (Elidel). These are creams that you can apply to your skin. They’re only available by prescription.
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 on their body. Those who don’t respond to creams may also benefit from taking oral medications. These work by slowing the immune system’s response, which can help to reduce the severity of eczema symptoms.
Examples of oral medications a doctor may prescribe to reduce 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 an infection risk, nausea, and high blood pressure. There can also be kidney or liver damage, depending on the drug. As a result, these medicines 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 light.
Ultraviolet B light is most common. However, some forms of eczema therapy use ultraviolet A light. According to the National Eczema Association, about 70 percent of people with eczema had improved symptoms after phototherapy.
Those who choose phototherapy will usually go to a dermatologist’s office two to three times a week. Your doctor may reduce the frequency of treatment if phototherapy is effective. But 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 actually an antibiotic that can help lower inflammation, and it’s used for 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 a reduced itching after about 16 weeks. Common side effects associated with this medication include conjunctivitis, cold sores, and eyelid inflammation.
Researchers are currently studying another injectable eczema medication called nemolizumab. It’s also an antibiotic that helps lower inflammation, and it requires a monthly injection. Those who have participated 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 your most severe symptoms.