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How to Tell It’s Time to Switch Treatment for Your Severe Eczema

Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on July 14, 2017Written by Rachel Nall, RN, BSN, CCRN on July 14, 2017
switch treatment

You apply moisturizer around-the-clock and avoid allergens. Yet you haven’t experienced relief from the itching, scaling, and dryness of eczema as you’d hoped. This may be a sign that it's time to re-evaluate your treatments. While it’s true there is no cure for eczema, many treatments are available.

Eczema treatment isn’t a one-size-fits-all approach. It’s important to know when to say the treatment that may have worked well for someone else isn’t working for you.

Here are some signs it’s time to get in touch with your dermatologist or change up your home regimen.

Signs it’s time for a change

You can expect to have some periods of dry, itchy skin when you’ve been a little lax with your treatment regimen. You may be able to relieve some symptoms by staying on your current regimen. For others, you should see your doctor.

See your dermatologist if you experience these symptoms:

  • You’ve got itchiness or symptoms that inhibit your sleep or daily activities most days of the week.
  • You’re experiencing new symptoms associated with your eczema.
  • The duration of time between flare-ups is getting shorter.
  • Your eczema seems to be getting worse.
  • Your eczema seems to be spreading to new locations.

Contact your doctor if you experience signs and symptoms that suggest an infection. Eczema puts you at higher risk for staph infections. Because staph bacteria grow on your skin, they can infect any open areas of skin.

It’s important for you to listen to your intuition about your eczema treatments. If you feel your dermatologist isn't managing your eczema as well as they could, talk to them. You could also look for a new dermatologist who specializes in the treatment of eczema.

Treatment options

Innovations and research on treatments for eczema are ongoing. This means there’s a growing number of treatments available on the market to help you manage your eczema. Sometimes, finding a new treatment can be a matter of trying out different treatments. It can also mean trying combinations of treatments to find the ones that are the most effective.

Emollients (moisturizers)

These are the mainstay of eczema treatment. Most people with eczema apply moisturizers at least twice a day. Depending on their occupation and eczema type, they may apply them more often.

If you’re currently using a lotion as a moisturizer, consider upgrading to a cream or ointment. The thicker consistency is reflective of a higher percentage of moisture-retaining oil. The moisturizer should be free of fragrances and dyes.

Topical steroids

These may be used alone or in combination with light therapy. They reduce inflammatory skin reactions that can lead to eczema symptoms. Frequent use of topical steroids can lead to them becoming less effective over time.

Topical immunomodulators

Pimecrolimus (Elidel) and tacrolimus (Protopic) are two topical immunomodulators. These interfere with inflammatory compounds in the skin. They may be especially helpful in treating eczema on your face, genitals, and areas of folded skin. But they're associated with more side effects than topical corticosteroids, particularly eye irritation.

Wet wraps

Wet wrap bandages are a special wound care approach to severe eczema treatment. They may even require admission to a hospital. They are usually applied by a doctor or nurse.

Antihistamines

Antihistamines can reduce the amount of histamine in your body. Histamines are what causes your skin to itch. Antihistamines are usually more effective in treating eczema in children. But they may also be effective in reducing symptoms in adults.

Phototherapy

This treatment involves exposing skin to ultraviolet light, which can help symptoms. This requires seeing a doctor several days a week for a few months before symptoms begin to subside. After that time, people undergoing phototherapy often make less frequent doctor visits.

Oral medications

There are many oral eczema treatments that the U.S. Food and Drug Administration (FDA) has approved. Oral corticosteroids are one treatment that help with short-term flare-ups. Immunosuppressing medications are usually limited to moderate-to-severe eczema treatments.

Injectable medications

In March 2017, the FDA approved the use of dupilumab (Dupixent), an antibiotic that helps lower inflammation. This drug is for the treatment of moderate-to-severe eczema. Clinical trials are currently ongoing for more injectable medications.

Behavioral counseling

Some people take part in behavioral counseling sessions to change their itching and scratching behaviors. They also use these sessions to help relieve stress, which can worsen eczema symptoms in some people.

Talking to your doctor

If there is a treatment that sounds particularly promising to you, talk to your doctor. Questions you may wish to ask about treatment options include:

  • Reflecting on my current treatment plan, are there areas where I could benefit from a different or extra medication?
  • Are there treatments you would rule out for me due to my eczema type or health?
  • What is a realistic treatment outlook for my particular eczema type?
  • What are some newer topical, oral, or injectable medications that could be helpful to me?

Checking in with your doctor about your eczema can ensure your treatment plan is the most effective. While you may not become eczema-free, a change in treatment could improve your quality of life.

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