The exact cause of eczema (atopic dermatitis) is unknown, and as such, there is no cure. However, there are treatment options available to help manage symptoms and reduce the occurrence of flare-ups. Eczema medications help reduce the severity of symptoms such as itching and inflammation, while other treatments such as phototherapy can help reduce and even clear up eczema flare-ups.
Several medications can help to calm itchiness, reduce inflammation, and prevent future flare-ups. The right medication for your eczema will depend on a variety of factors. Your doctor will help determine which is right for you.
Over-the-counter antihistamines may provide some relief from the itchiness of eczema. Histamine is a chemical that causes allergic reactions. Just as their name suggests, antihistamines work by blocking histamine and the allergic reactions it causes. Over-the-counter antihistamines include:
- cetirizine (Cytec)
- diphenhydramine (Benadryl)
- fexofenadine (Allegra)
- loratidine (Claritin)
Antihistamines can cause side effects, such as sleepiness and fatigue, so you may want to take these medications at night. Talk to your doctor about the potential side effects of antihistamines to find a treatment option that best suits your needs.
Cortisone (steroid) creams and ointments are a common eczema treatment and are applied directly to the skin. Corticosteroids relieve itching and reduce scaling. However, these are made for short-term use because they carry the risk of side effects.
Side effects from topical steroids include:
- thinning of the skin
- skin irritation
In severe cases, your doctor may prescribe oral corticosteroids. These help reduce inflammation.
Remember, all steroid creams are not the same. Low-potency steroids such as hydrocortisone are available over the counter, but may not be as effective as prescription steroids. These are only available through your doctor.
Oral corticosteroids have the potential to cause serious side effects, including bone loss. One of the most commonly prescribed oral corticosteroid medications is prednisone (Meticorten, Sterapred).
Certain prescription medications that impact the immune system and prevent it from overreacting can 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). This keeps the immune system from overreacting and prevents flare-ups of eczema.
There are potential serious side effects with these drugs. They include:
- increased risk of cancer
- increased risk of high blood pressure
- increased risk of kidney disease
Medications such as tacrolimus or picrolimus also act to reduce the activity of T cells and improve the lesions and symptoms of eczema.
Eczema can cause itchy skin and therefore scratching. This can cause small tears and breaks in the skin, which allow bacteria such as staph to enter and cause an infection. If there is an infection, your physician may prescribe a topical or oral antibiotic to treat it. You must take these exactly as directed. Skipping doses or not finishing the medicine can allow some bacteria to remain. This can lead to drug resistance, making the infection harder to treat.
Light therapy involves the use of ultraviolet light or sunlamps under a doctor’s supervision to help prevent the immune system’s response that triggers eczema symptoms.
Phototherapy requires a series of treatments. It can help reduce and in some cases clear up eczema and prevent bacterial skin infections. According to the American Academy of Dermatology (AAD), more than 80 percent of eczema patients treated with phototherapy showed significant improvement. In some cases, symptoms cleared up completely within three weeks.
Behavioral changes can help make eczema treatment easier. By avoiding things that cause flare-ups, you can reduce the symptoms of this skin disorder.
Stress can trigger symptoms or make them worse. Taking steps to ease anxiety can help reduce stress and flare-ups. You can reduce stress with:
- deep breathing
- relaxing music
Get Adequate Sleep
A lack of sleep induces stress, making you more vulnerable to a flare-up. Make getting a good night’s sleep a priority to help control the symptoms of eczema. The Mayo Clinic recommends adults get at least seven to nine hours of sleep each night.
Soak the Skin
Applying a cold compress to the affected area can cool and soothe symptoms. Also, taking warm or lukewarm baths or showers to soak the skin for 15 to 20 minutes can help ease itchiness.
Treatment for eczema often involves a combination of doctor-directed treatment and self-guided flare-up prevention and treatment. By working closely with your doctor, you can reduce flare-ups and decrease the symptoms of this condition.