Regardless of thestage of the disease, self-care is important to relieve currentsymptomsand prevent future episodes and skin infections.
This article discusses the different types of treatment for eczema.
This includes over-the-counter therapies, prescriptions, specialist-driven procedures, and complementary medicine.
This could include pollen, certain foods, or a change in weather.
Cold weather is often a trigger.
It could also include things you do, like scratching or getting stressed.
The following home remedies that may offer some relief.
Avoidance of Triggers
There are a wide variety oftriggersthat can cause an eczema flare.
Avoiding triggers is often easier said than done.
It involves buy-in from your family and a clear set of rules to avoid accidental exposures.
They are not only harsh but can strip away many of the skin’s natural oils.
Choose an eczema-friendly soap or cleanser designed specifically for dry, sensitive skin.
An ever-expanding range is available on store shelves.
The best of them carry the seal of acceptance from theNational Eczema Association.
Antibacterial gels are preferred for cleaning hands compared to other formulations.
For people with eczema, these concerns are more than cosmetic.
You should soak for no longer than 10 minutes and moisturize immediately after rinsing and toweling off.
A bleach bath should never be used for children without your pediatrician’s approval.
Sun Exposure
Many people with eczema claim thatsunlighthelps improve mild to moderate symptoms of the disease.
It is believed that sun exposure increases the production ofvitamin Din the skin.
This releases anti-inflammatory compounds (calledcathelicidins) that reduce local redness or discoloration and swelling.
When first starting out, five minutes may be enough to see how well you tolerate sunlight.
When it comes to sun exposure, more is not always better.
Too much sun can actually trigger an eczema flare while increasing the risk of sun damage andskin cancer.
When outdoors, always wear sunscreen with anSPF ratingof 15 or higher.
There is some evidence that the zinc oxide used in some mineral sunscreens may bebeneficial for eczema.
If your skin condition is severe, use sunscreen intended for sensitive skin or babies.
Over-the-Counter (OTC) Therapies
The most important over-the-counter (OTC) therapy for eczema is moisturizer.
Daily moisturizing isessentialto eczema treatment, regardless of the severity of your case.
The addition of a medication may be recommended if moisturizing alone doesn’t improve your skin.
Mild to moderate eczema can often be managed with OTC medications.
Moisturizers
Itching and dry skin (xerosis) characterize eczema at every stage of the disease.
At the same time, dry skin can trigger a flare if left untreated.
Not only is dry skin itchier, but it compromises the barrier function of the skin.
This allows bacteria, fungi, and viruses easy access to vulnerable tissues.
Even if these microbes do not establish an active infection, they can incite theinflammationneeded to trigger a flare.
Whatever option you use, avoid moisturizers with fragrances and dyes, which can be irritating.
In addition, while healing, avoid cosmetics or choose products that are fragrance-free and hypoallergenic.
Moisturize before applying makeup and reapply moisturizer when needed.
Avoid rubbing in circles or up-and-down because this can generate heat and irritate inflamed skin.
OTC hydrocortisone is sold at drugstores in strengths of 0.5% and 1%.
After cleansing, a thin layer is applied to the affected skin and gently rubbed in.
A moisturizer can then be applied to lock in moisture.
Both 0.5% and 1% hydrocortisone belong to Class 7, the lowest strength.
Common side effects include stinging, burning, redness or discoloration, and dryness.
It should be used with extreme caution around the eyes.
Antihistamines
Despite what some might tell you,antihistaminesdo not inherently relieve itching in people with eczema.
If eczema is triggered by an allergy, an antihistaminemayavert a flare or reduce its severity.
On the other hand, if an allergy is not involved, an antihistamine may have no effect.
Antihistamines are most often recommended if itching is keeping you up at night.
Prescriptions
In some cases, prescription medications may be appropriate as the first treatment you try.
In others, they are considered only if eczema symptoms worsen or fail to respond to conservative treatment.
These drugs are sometimes used on their own or in combination with other treatments.
Topical Steroids
Topical steroidsare intended for the short-term treatment of acute eczema symptoms.
They are not used to prevent flares or as a substitute for a moisturizer.
A high-potency steroid may be needed for thick skin (such as the feet).
As such, stronger topical steroids are typically only prescribed in the first-line treatment of moderate to severe eczema.
The overuse or prolonged use of topical steroids can have potentially serious consequences.
This includesirreversible skin atrophy,pustular psoriasis, andcorticosteroid withdrawal.
TCIs work by blocking a protein calledcalcineurin.
This protein stimulates the production of inflammatorycytokines, which signal the body’s immune responses.
Unlike topical steroids, Elidel and Protopic are not absorbed into deeper tissues and do not cause skin thinning.
As such, they can be used safely on the face and other delicate skin.
Common side effects include skin discoloration, headache, acne, nausea, folliculitis, and flu-like symptoms.
Few healthcare providers will ever consider using an oral steroid in children with eczema, no matter how severe.
Extreme caution should be exercised in all cases of oral steroid use.
To avoid this, the steroid dose would begradually tapered downover the course of weeks or months.
Prednisone, hydrocortisone, and Celestone (betamethasone) are among the oral steroids healthcare providers may consider.
They work by suppressing the immune system as a whole and are only intended for short-term use.
Stronger oral immunosuppressants like cyclosporine, methotrexate, and Imuran (azathioprine) have also been tried.
However, there is little solid evidence to support their use for this purpose.
Antibiotics
In some cases, eczema can compromise the skin and allow bacteria to establish an infection.
Secondary bacterial skin infections are common among people with eczema (most especiallyStaphylococcus aureusinfections).
They can be treated withtopical or oral antibiotics.
Topical antibiotics are usually enough to treat minor local infections.
Oral antibiotics may be needed for infections involving larger areas of the skin.
Cephalosporins, nafcillin, and vancomycin are among the antibiotics most commonly used.
The duration of therapy can vary depending on the severity of symptoms.
It generally does not exceed 14 days due to the risk ofantibiotic resistance.
Antibiotics can only treat bacterial infections.
Fungal infections likeringwormcan be treated with antifungal drugs (like miconazole cream).
Viral infections likeherpes simplexcan be treated with antivirals (like acyclovir).
JAK inhibitors interfere with an enzyme that usually promotes inflammation.
However, the benefits of such use have yet to be established.
They might be used to treat eczema when symptoms are severe and resistant to any other form of therapy.
They are more commonly used totreat asthmaand severe seasonal or year-round allergies.
These are not used on their own but are typically combined with other therapies.
Phototherapy
Phototherapy, also known as light therapy, functions similarly to sun exposure.
It involves controlled bursts of UVA or UVB radiation delivered either in a dermatologist’s office or specialized clinic.
Phototherapy is typically added to the treatment plan when topical therapies prove less than effective.
Phototherapy can reduce itch and inflammation associated with eczema and usually requires multiple treatments.
Common side effects include skin dryness, redness or discoloration, and mild sunburn.
Coal tar or light-sensitizing drugs like psoralen are sometimes used to enhance the effects of phototherapy.
Wet Wrap Therapy
Wet wrap therapy is sometimes recommended for people with severe, difficult-to-treat eczema.
The aim of wet wrap therapy is to help rehydrate the skin while enhancing the absorption of topical drugs.
A bottom wet layer provides steady hydration, while a top dry layer helps lock in moisture.
Immunotherapy
Immunotherapyis meant to minimize the effects of allergy.
Immunotherapy works by desensitizing you to allergens that trigger attacks.
By exposing you to incrementally increasing doses, your immune system “learns” not to react excessively.
After allergy symptoms are controlled, ongoing treatments may be needed to maintain control.
Allergy shots cannot treat food allergies.
Immunotherapy is sometimes used in the treatment of eczema.
It is an injectable monoclonal antibody.
It blocks a receptor to inhibit inflammation.
Adbry (tralokinumab-ldrm) and Ebglyss (lebrikizumab-lbkz) are other biologic medications approved for eczema.
This means it seals off water molecules so they are retained in the skin.
A number of other plant oils, such as sunflower oil and shea butter, also have moisturizing qualities.
Olive oil, on the other hand, may dry the skin and further diminish its barrier function.
Vitamin D
Vitamin D plays a central role in the effects of sun exposure on eczema.
It makes sense, then, thatvitamin D supplementstaken orally may also help relieve eczema symptoms.
A 2016 review of studies published in the journalNutrientssupported this hypothesis.
It demonstrated that vitamin D deficiency was more common in people with eczema.
Supplementation in those with a deficiency resulted in an improvement in symptoms.
Other studies have shown little benefit to supplementation.
Probiotics
Probioticsare live bacteria sold in supplement form.
They’re found naturally in fermented foods like yogurt, miso, and kefir.
They help support healthy gut flora and aid with digestion.
While other studies have shown little or no effect, probiotics do not appear to cause any harm.
Speak with your healthcare provider before trying any complementary therapy.
you’re able to help manage eczema at home by avoiding triggers like stress and certain foods.
Wash with eczema-friendly soaps, and try taking diluted bleach baths.
Over-the-counter moisturizing creams are important for rehydrating the skin.
Hydrocortisone creams can also help heal skin inflammation.
Prescription medicines and procedures may be recommended for moderate-to-severe cases.
Proper skin care with a consistent moisturizing routine is a big part of the treatment plan.
Many patients find the need to try different treatment options or even change their treatment regimen over time.
Persistence and patience are key to finding the regimen that works best for you.
Frequently Asked Questions
Eczema is likely sparked by a combination of factors.
These may include allergens, genetics, environmental irritants, and stress.
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