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By Joseph Bennington-CastroMedically Reviewed by Ross Radusky, MDReviewed: August 10, 2022Medically ReviewedThe goal of eczema treatment is to reduce symptoms.Getty ImagesThere's no cure for eczema, a chronic skin condition marked by itchy, rash-like symptoms. People with atopic dermatitis (the most common type of eczema) and other forms of the condition often go through symptom-free periods (remissions) followed by flare-ups, when symptoms become severe. Eczema mainly causes dry, itchy skin, which inevitably causes people to scratch or rub the affected area. This can result in inflammation, rashes, blisters, and skin that “weeps” (oozes clear liquid), among other symptoms. Bacterial, viral, and fungal infections can also develop because eczema breaks down the skin barrier. There is no cure for eczema — natural or otherwise. The goal of treatment is to reduce symptoms, heal the skin and prevent further damage, and prevent flare-ups.Medication, moisturizers, and at-home skin-care routines are all part of an effective treatment plan. Easing Eczema During COVID-19
Recorded 3/11/21. Managing eczema can be a struggle, especially in harsh winter temperatures. Factor in pandemic-related stress and that's a recipe for flare-ups. Tune in to hear dermatologist Ross Radusky, MD, and eczema patient advocate Nicola Johnston...see more Corticosteroids for Treating Eczema Symptoms
You may have heard of cures for treating eczema naturally online, but the truth is that topical corticosteroids are the standard, go-to treatment for eczema flare-ups. Applied directly to the affected areas of skin, these ointments, creams, or lotions may:Reduce inflammationTame allergic reactionsEase irritation or sorenessReduce itching and the desire to scratchTopical corticosteroids come in varying degrees of strength — with 1 the most powerful and 7 the weakest — and are most effective when applied within three minutes of showering. For example, Vanos (0.1 percent fluocinonide) cream is a “super potent” class 1 medication, while over-the-counter hydrocortisone creams are a “least potent” class 7, according to the National Eczema Association. Topical corticosteroids should not be used as moisturizers and should only be applied to areas of the skin that are affected by eczema. Over time, these drugs can thin the skin, cause changes in color, or result in stretch marks.Rarely, topical corticosteroids can be absorbed into the skin and enter the blood stream, causing systemic side effects (those that affect the whole body). These more severe side effects may include: Eye problems (glaucoma and cataracts)Avascular necrosis (death of bone tissue due to loss of blood supply)Worsening diabetesCushing syndrome (a condition with wide-ranging symptoms that are caused by too much of the hormone cortisol in the body)High blood pressureBlemishes (acne, bumps, and pus-filled follicles)Adrenal suppressionTopical steroid addiction If topical corticosteroids aren’t working, doctors may prescribe a systemic corticosteroid, taken by mouth or injected.Doctors only recommend systemic corticosteroids for short periods of time, because these drugs can cause a number of serious side effects, including osteoporosis, hair loss, and gastrointestinal issues. Most Recent in Eczema
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Other Topical Medication for Eczema
Topical calcineurin inhibitors (TCIs) are another category of prescription medication for eczema that includes tacrolimus (Protopic) and pimecrolimus (Elidel). TCIs don’t contain steroids. Instead, they control inflammation and reduce eczema flare-ups by suppressing the immune system. Though TCIs don’t cause the same side effects as topical corticosteroids, patients should only use them for short periods of time. A boxed warning alerts patients to the possible cancer risk associated with these drugs. PDE4 inhibitors, another class of topical drugs for eczema, work by blocking an enzyme called phosphodiesterase 4 (PDE4) from producing too much inflammation in the body. There is currently only one PDE4 inhibitor on the market that is approved by the U.S. Food and Drug Administration (FDA) for atopic dermatitis: crisaborole (Eucrisa). The skin cream ruxolitinib (Opzelura), the first topical Janus kinase (JAK) inhibitor for atopic dermatitis, is another approved treatment. The FDA has placed a boxed warning on this medication for potentially increasing the risk of all-cause mortality, as well as increasing the risk of developing dangerous infections, heart attack, stroke, and thrombosis (blood clots) and certain cancers, including lymphoma. Wet-wrap therapy is another option for severe eczema. Sometimes given in a hospital, this treatment involves applying topical medicines (corticosteroids) and moisturizers to affected areas, then sealing them with a wrap of wet gauze. Oral and Injectable Medications
In addition to topical medications that keep the skin hydrated as a means of managing dry skin and itchiness, oral and injectable medications have been approved to help manage symptoms such as itching. These include biologics (which target specific parts of the immune system that contribute to inflammatory diseases such as atopic dermatitis), immunosuppressants (which can help slow down symptoms), and JAK inhibitors (which block certain enzymes that cause inflammation). Dupilumab (Dupixent) is the first FDA-approved biologic drug for the treatment of moderate to severe eczema in people who have not responded well to topical approaches. A self-administered injectable drug, dupilumab works by blocking the activity of certain inflammatory chemicals in the body, and it is sometimes used in conjunction with light therapy. The side effects of dupilumab are generally mild, and they include pink eye, injection site reactions, and cold sores. Tralokinumab-ldrm (Adbry) is the second injectable biologic approved by the FDA. It works by blocking a protein that plays a role in the body’s immune response that leads to inflammation of the skin. In especially severe eczema cases, doctors may prescribe an oral immunosuppressant, such as cyclosporine (Neoral, Sandimmune, or Restasis), methotrexate (Trexall or Rasuvo), or mycophenolate (CellCept). These drugs carry potentially serious side effects, such as an increased risk of developing dangerous infections and cancers. In addition to ruxolitinib cream, the FDA has approved two oral JAK inhibitors, upadacitinib (Rinvoq) and abrocitinib (Cibinqo), to treat moderate to severe atopic dermatitis. Rinvoq and Cibinqo are not recommended for use in combination with other JAK inhibitors, biologics, or other immunosuppressants. The FDA has placed a boxed warning on these medications for potentially increasing the risk of all-cause mortality, serious infections, certain cancers (including lymphoma), heart attack, stroke, and thrombosis (blood clots). Editor s Picks on Eczema
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Additional Treatments
Doctors may also recommend that patients take certain antihistamines for eczema — such as diphenhydramine (Benadryl), hydroxyzine, or doxylamine succinate (Unisom) — to make it easier to sleep through the night. Antihistamines may help prevent nighttime scratching, which can further damage the skin and cause infections. Various protectant repair creams may also help ease eczema symptoms by restoring essential skin components, like ceramides, fatty acids, and cholesterol. If patients develop a skin infection that is affected by eczema, doctors will prescribe antibiotic, antiviral, or antifungal drugs to treat it, depending on the particular cause. Light therapy (phototherapy) using ultraviolet waves is a common treatment for people with moderate to severe atopic dermatitis. Skin improvements don’t occur immediately but instead become evident after one to two months of treatments several times a week, according to the National Eczema Association. Light therapy is effective for up to 70 percent of people with eczema. Burns, increased skin aging, and a higher risk of skin cancer are potential side effects, particularly if the patient receives light therapy for a long period of time. What Triggers Eczema
Numerous factors — from cold weather to dust and laundry detergent — can set off a flare. Be aware of these common culprits.Photolist Bacterial Treatments for Eczema
While scientists still don’t know exactly what causes atopic dermatitis, they have been exploring the role that the microbiome may play in the disease. People with eczema have unusually high amounts of harmful bacteria on their skin and lower than normal levels of “good” bacteria. A potential new approach to treating eczema involves using “good” bacteria to kill pathogenic (disease-causing) bacteria like Staphylococcus aureus, which is commonly found in large quantities on the skin of people with eczema and is known to cause symptom flare-ups. Though such treatments are not yet available to the public, preliminary research is encouraging. An early study published in JCI Insight found that more than half of a small group of adults treated with Roseomonas mucosa (a type of bacteria found on healthy skin) in a spray form experienced improvement in their eczema, with some reporting that they needed less steroid cream to manage their symptoms. And a study published in Nature Medicine looked at using a particular “good” bacteria strain, known as Staphylococcus hominis A9, to kill a “bad” bacteria, Staphylococcus aureus. According to the researchers of the study, roughly half of people with eczema have a significant problem with bacterial infections, particularly from S. aureus. The scientists reasoned that if there was a type of bacteria found on healthy skin that could inhibit the growth of S. aureus, it could prevent infection and bring the microbiome into better balance. In the clinical trial, symptoms improved in two-thirds of the subjects after applying the “good” bacteria. Bacteria Therapy Shows Promise as Cheap Effective Eczema Treatment
Tackling “bad” germs with “good” ones may be the answer to fending off eczema flares in children and adults. Here’s how it works.Article Home Remedies for Eczema
In addition to seeking help from a doctor, people with eczema may be able to take a few steps on their own to reduce itching and the need for medication. These measures include:Keeping fingernails short, and avoiding scratching the skinMoisturizing skin frequently with ointments (petroleum jelly), creams, and lotions that are free of alcohol, fragrances, and dyesUsing a humidifier, particularly if the air is dryAvoiding skin irritants, such as wool or man-made fibers (wear soft cotton clothing instead), strong soaps and detergents, and situations or environments that cause sweatingAvoiding airborne allergens, such as pollen, pet dander, and dust mites When bathing, it's important to minimize time in the tub or shower and to use cool or lukewarm water. Use gentle body washes and cleansers, and avoid scrubbing or toweling off for too long.Also be sure to apply a moisturizer immediately after drying off. Natural Remedies and Lifestyle Changes for Eczema Symptom Relief
While you can’t cure eczema naturally, some people have used the following so-called natural or alternative therapies for eczema:Adding oatmeal, baking soda, or fragrant-free bath oils to bathwater Getting a massage with essential oils, such as chamomile, chickweed, licorice, or thymeManaging stress through yoga, meditation, biofeedback, or mindfulness training Most Popular in Eczema
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Dietary Changes and Supplements for Eczema
For some people with atopic dermatitis, certain foods may cause allergic reactions that can lead to flare-ups.An elimination diet, or food challenge — which involves cutting certain foods out of the diet for a while, and then slowly adding them back in and monitoring how the skin responds — may help determine whether any foods may be triggering. But keep in mind that research supporting this approach as an effective treatment for atopic dermatitis is lacking, notes a review published in the journal Pediatric Dermatology. Supplements for Atopic Dermatitis
Some patients report that certain dietary supplements offer some eczema relief, including:ProbioticsFish oilVitamin DVitamin CBromelain (an enzyme derived from pineapple)FlavonoidsBut a review of the scientific literature found no convincing evidence that such supplements are effective. Talk with a doctor or dermatologist for more information about how diet might affect eczema. Editorial Sources and Fact-Checking
Atopic Dermatitis. MedlinePlus. October 24, 2016.Prescription Topical Treatment. National Eczema Association.Kwatra G, Mukhopadhyay S. Topical Corticosteroids: Pharmacology. In: Lahiri K, ed. A Treatise on Topical Corticosteroids in Dermatology. 2018.Topicals, Oral Medicines, and Phototherapy: An Overview of Eczema Treatments. National Eczema Association.Immunosuppressants. National Eczema Association.Phototherapy. National Eczema Association.Biologics. National Eczema Association.Boguniewicz M, Fonacier L, Guttman-Yassky E, et al. Atopic Dermatitis Yardstick: Practical Recommendations for an Evolving Therapeutic Landscape. Annals of Allergy, Asthma & Immunology. January 2018.Eczema (Atopic Dermatitis) Treatment. National Institute of Allergy and Infectious Diseases. May 24, 2017.Eczema and Bathing. National Eczema Association.Complementary and Alternative Treatments. National Eczema Association.Lim NR, Lohman ME, Lio PA. The Role of Elimination Diets in Atopic Dermatitis: A Comprehensive Review. Pediatric Dermatology. September 2017.Bath-Hextall FJ, Jenkinson C, Humphreys R, Williams HC. Dietary Supplements for Established Atopic Eczema. Cochrane Database of Systematic Reviews. February 15, 2012.What Exactly Is Eczema. American Academy of Dermatology.Myles IA, Earland NJ, Anderson ED, et al. First-in-Human Topical Microbiome Transplantation With Roseomonas mucosa for Atopic Dermatitis. JCI Insight. May 3, 2018.Nakatsuji T, Hata TR, Tong Y, et al. Development of a Human Skin Commensal Microbe for Bacteriotherapy of Atopic Dermatitis and Use in a Phase 1 Randomized Clinical Trial. Nature Medicine. April 2021.Show LessNEWSLETTERS Sign up for our Healthy Skin Newsletter
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