Looking to find the best treatment options for eczema? You have probably tried different therapies already. While there is still no cure, there are some treatments you can use. Eczema is a chronic condition, with periods of flare-ups and remissions. Many people need to use a treatment for months and years to be able to fully control eczema.
This article covers a review of standard treatments, including special considerations for babies. We’ll also cover add-on therapies and new drugs for managing eczema.
Eczema Treatment Overview
Emollients and topical steroids are the first-line therapy in the majority of cases. Some individuals may benefit from paste bandages and wet wraps, as well.
If symptoms are not controlled well, medicated creams like topical calcineurin inhibitors may be useful.
First, try creams and ointments to apply to the affected area of the skin. Creams work best on moist weeping areas of the skin. Ointments are best for dry thick skin. Lotions are a great choice for hairy areas such as the scalp. You can use these creams to control dryness and itchiness and promote skin repair.
To treat more severe eczema, try add-on therapies like oral steroids. You can also use light and newer therapies like immunosuppressant drugs or biologics.
Prescription Drugs to Treat Eczema
There are some prescription drugs you can use to as a treatment for eczema.
You can use Corticosteroid creams in addition to moisturizers (also called emollients). Steroid creams should be used short-term, to avoid side effects like thinning of the skin. As an example, hydrocortisone cream 1% is a mild topical steroid. The greater the potency, the more effective it is on the skin’s inflammation. But it also carries a greater risk to cause side effects.
Creams-based calcineurin inhibitors are useful to treat eczema. This class of drugs includes tacrolimus and pimecrolimus. Like steroid creams, these drugs also affect the immune system and help control inflammation, but through a different mechanism of action.
These creams are only for use for those older than two years. You must apply them after using moisturizer. It is important to avoid strong sunlight when using these types of creams. As requested by the FDA, these drugs carry a black box warning related to the potential risk of cancer.
Oral steroids like prednisone are used as an add-on therapy to reduce inflammation in severe cases of eczema. While oral steroids are highly effective, you cannot use them long-term. They pose side effects with serious adverse reactions.
Antibiotic creams or oral preparations are recommended short term, in cases of eczema complicated with a bacterial infection. Older generation antihistamines are more sedating compared with the newer generation, and are prescribed if eczema is too itchy and interferes with sleep.
You can use other drugs like antibiotic creams and oral preparations in the short term. Only use these to treat eczema with bacterial infections.
Older generation antihistamines are sedating compared to new generation medications. Although, these can help if eczema is too itchy and prevents sleep.
Newer drugs are typically reserved for severe eczema that doesn’t respond to other treatments. The FDA recently approved upilumab, which is an injectable monoclonal antibody. Although the available research shows this drug is effective, it is not commonly prescribed due to its high cost.
Non-Drug Related Remedies as Eczema Treatments
Some people would rather stay away from taking prescription or over-the-counter drugs to treat their eczema. Fortunately, there are some non-drug-related remedies you can use.
These dressings are very effective for severe cases of eczema that affect large areas of the skin. You’ll wrap the skin with topical corticosteroids and wet dressings. Someone with the required training can apply the dressings at home or in a hospital. A nurse can provide detailed instructions about how to use this technique.
Phototherapy involves exposure to natural sunlight for specific, controlled amounts of time or devices that include ultraviolet A and B rays. Doctors recommend this eczema treatment for adults, either alone, or in combination with drugs. While this therapy is effective, you should only use it in the short term. This avoids the risk of premature skin aging and skin cancer.
Stress management is important, as stress is a major trigger for flare-ups. There are many therapies available including mindfulness meditation, behavior modification, biofeedback, and counseling
It’s important to become aware of substances and chemicals that trigger your eczema. When possible, avoid coming in contact with these triggers. The most common triggers include tobacco smoke, pet dander, dust, pollen, house cleaners, and personal care products.
Eczema Treatment for Babies
According to the American Academy of Dermatology Association, the treatment of eczema in babies involves moisturizers, prescription medications, special baths, and the elimination of potential triggers. Parents have to learn the best way to bathe the baby, washing only the dirty or smelly parts of the body and using fragrance-free products. Apply moisturizer after a bath and as often as needed to help relieve the symptoms. A dermatologist may recommend a bleach bath, with diluted bleach, in case of severe eczema.
Doctors may prescribe topical steroids for babies. However, the doses and duration will vary as babies are more sensitive to them.
Identifying and avoiding triggers is important to manage eczema at any age. Parents need to pay special attention to find the baby’s triggers. It is best to use hypoallergenic, fragrance-free products as much as possible. For example, parents should use ointments and petroleum jelly around a baby’s mouth if saliva aggravates eczema. Apply these before the baby eats or takes a nap.
You can do more than just take medications and apply ointments to treat eczema. A simple change in your diet and lifestyle could show major benefits and relieve eczema.