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Eczema is a common group of skin conditions that result in inflamed, itchy patches on the skin. In severe cases, these patches may cause constant discomfort and open weeping sores. The most common form of the condition is atopic dermatitis. Doctors cannot cure eczema, but treatments can reduce the severity of rashes and inflammation. This article will look at the treatment options for severe eczema in adults and children. How to treat severe eczema Share on PinterestIri-s/Getty ImagesSevere eczema can significantly affect a person’s quality of life. A person with the condition may experience symptoms that:do not respond to standard treatmentscovers a large area of their bodyflare up for extended periodscause unbearable itching or pain Eczema appears pink or red on those with light or fair skin tones, with silvery-white scales. On medium skin tones, it can appear salmon-colored with silvery-white scales. On darker skin tones, eczema could look violet with gray scaling. It can also appear dark brown and difficult to see. Discover how eczema appears in People of Color. A person with severe eczema should speak with their doctor to develop a personalized treatment plan. This may include some or all of the following. Home treatments Treatment commonly involves using over-the-counter creams or emollients on the affected areas. Doctors may also recommend trying coping strategies, such as avoiding:itchingregular contact with watercosmetic products containing irritants Some people may find that their eczema does not respond to initial treatments. In these cases, talking with a doctor is essential. Without proper treatment, the condition can cause the skin to crack, increasing the risk of infection. A doctor might prescribe further treatment if a person’s eczema does not respond to initial treatments. Wet wraps Wet wrap therapy involves applying damp strips of fabric onto the skin where eczema is flaring up. This aims to increase the skin’s moisture content and prevent the skin from becoming dry and cracked. To use this therapy, a person applies medicines or moisturizers onto the skin and then wraps clean, water-soaked gauze or fabric around the area. This helps maximize how long the lotions stay in contact with the skin. It can help to apply a dry layer on top of this treatment to stop the wraps from drying out. The best time to use wet wraps is just after bathing and moisturizing. People can leave the wraps on for a few hours or overnight. Phototherapy Phototherapy can reduce the body’s inflammation response and ease the symptoms of eczema and other similar skin conditions. This treatment involves exposing the skin to UV light in a controlled environment. During phototherapy, a person enters a machine that emits UVB light for a few seconds or minutes. Healthcare professionals can target phototherapy to specific areas. People usually need to continue phototherapy treatments for several months. They can reduce the frequency of their treatments once their symptoms start to improve. A 2021 study concluded that phototherapy is effective in reducing atopic dermatitis symptoms. It may also reduce someone’s need for topical steroids and other treatments. Phototherapy can help:relieve itchinessreduce inflammationincrease vitamin D in the skin Immunosuppressing drugs The body’s immune response plays a key role in the development of eczema symptoms. To treat severe eczema, doctors may prescribe medications to suppress a person’s immune response. These may take the form of oral tablets or topical ointments. Immunosuppressive drugs for eczema include:Janus kinase inhibitorscyclosporinemethotrexateazathioprine mycophenolate mofetil While these medications can help reduce eczema symptoms, more research is necessary to assess their efficacy in treating chronic and severe conditions, according to a 2020 meta-analysis. Other medications If other treatments are ineffective, doctors may prescribe Dupixent (dupilumab) or Adbry (tralokinumab). These medications can treat the symptoms of eczema by decreasing skin inflammation. Doctors may also prescribe the vitamin A derivative called alitretinoin. Treatments for children Eczema is a common condition among children and babies. A challenge for parents and caregivers is that infants are unable to control the urge to scratch their eczema. Scratching is one of the main factors that worsen eczema and can lead to infections. Wet wraps may be particularly helpful for children and babies, as they can prevent the individual from scratching the affected areas. The treatments for infants are similar to adults and focus on moisturizers and anti-inflammatories. The National Eczema Association (NEA) also recommends avoiding key triggers, such as:not addressing dry skinirritantsheat and sweatingallergens What causes eczema The exact cause of eczema is unclear. It most likely results from a combination of genetic and external factors. People with a family history of eczema have a higher risk of developing the condition. Additionally, those with an overactive immune system may experience more severe inflammatory responses to irritants. Learn more about the genetic basis of eczema. Risk factors While the exact causes of eczema are unclear, certain risk factors may make people more likely to develop the condition. A family history of atopic dermatitis is one of the strongest risk factors for the condition. Other risk factors include:having overly dry skinhaving an overactive immune systemliving in areas of extreme humidity or cold Triggers Environmental irritants can trigger eczema flares. These include:allergens such as pollen and dustirritants such as harsh soaps and perfumeshormonal changestight clothing According to the NEA, anxiety and stress can also be triggers of eczema. This means a “vicious cycle” can develop, with eczema making a person’s anxiety and stress worse and anxiety and stress affecting eczema. Evidence also exists that links eczema to mental health issues. Although there is no cure for the condition, people can manage its physical and mental health effects, and many different treatments are available. Is there a cure for eczema Eczema is a chronic condition, and there is no cure currently. It is more common in children, and symptoms often lessen in adulthood. However, adults can also develop eczema, which is often more severe than childhood forms of the condition. Adult eczema typically involves periods of flare-ups when it is worse and periods of remission when it gets better. Because doctors cannot cure the condition, treatments focus on a person managing symptoms. Doctors can also recommend that someone with eczema make changes to their everyday life to avoid key triggers. Summary Doctors may classify eczema as severe when it covers a large area of a person’s body, is resistant to treatment, or when flares last a long time. People with severe eczema can try intensive treatment methods, including wet wraps, phototherapy, and therapies that reduce immune system function. They can also take steps to look after their mental health. Eczema is more common in children and tends to get better as a person gets older. There is no cure for the condition, but people can manage their symptoms and treat or prevent flares from affecting their quality of life. Last medically reviewed on June 8, 2022Atopic Dermatitis / EczemaPediatrics / Children's HealthComplementary Medicine / Alternative Medicine 16 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Atopic eczema: Overview. (2019).https://www.nhs.uk/conditions/atopic-eczemaBeyond the eczema rash. (2021).https://nationaleczema.org/blog/beyond-the-eczema-rashBlair, H. A., et al. (2016). Alitretinoin: A review in severe chronic hand eczema [Abstract].https://link.springer.com/article/10.1007/s40265-016-0621-0Can you get eczema as an adult? (n.d.).https://www.aad.org/public/diseases/eczema/adult/can-getChoi, J. Y., et al. (2021). Narrowband ultraviolet B phototherapy is associated with a reduction in topical corticosteroid and clinical improvement in atopic dermatitis: A historical inception cohort study.https://onlinelibrary.wiley.com/doi/full/10.1111/ced.14676Contact dermatitis: Overview. (2019).https://www.nhs.uk/conditions/contact-dermatitisDupilumab (Dupixent) for the treatment of eczema: Overview. (2019).https://www.ncbi.nlm.nih.gov/books/NBK492978/Eczema and emotional wellness. (n.d.).https://nationaleczema.org/eczema-emotional-wellness/Eczema causes and triggers. (n.d.).https://nationaleczema.org/eczema/causes-and-triggers-of-eczemaLøset, M., et al. (2019). Genetics of atopic dermatitis: From DNA sequence to clinical relevance.https://www.karger.com/Article/Fulltext/500402Na, C. H., et al. (2019). Quality of life and disease impact of atopic dermatitis and psoriasis on children and their families.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955769Prescription oral immunosuppressants. (n.d.).https://nationaleczema.org/eczema/treatment/immunosuppressantsPrescription phototherapy. (n.d.).https://nationaleczema.org/eczema/treatment/phototherapy/Sawangjit, R., et al. (2020). Systemic treatments for eczema: A network meta‐analysis.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128359Understanding eczema in children. (n.d.).https://nationaleczema.org/eczema/children/Wet wrap therapy. (n.d.).https://nationaleczema.org/eczema/treatment/wet-wrap-therapy/FEEDBACK:Medically reviewed by Amanda Caldwell, MSN, APRN-C — By Tom Rush and Timothy Huzar — Updated on June 8, 2022 Latest newsWhat sets 'SuperAgers' apart? 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