Eczema is a common skin condition that causes the skin to become red, inflamed, and itchy. There are different types of eczema, but the most common one is atopic dermatitis. While eczema is not curable, doctors can help manage the symptoms and prevent flare-ups with various treatments. Understanding how doctors treat eczema can help individuals take better care of their skin and prevent the condition from affecting their daily lives.
Diagnosis of Eczema
Before deciding on the best treatment plan, a doctor needs to diagnose eczema. During the examination, the doctor will carefully look at the skin’s appearance, including any redness, bumps, or crusting. The doctor may ask about medical history, such as family members who have eczema or other skin conditions. In some cases, the doctor might perform skin tests to rule out other skin conditions or allergies that could cause similar symptoms. Once diagnosed, the doctor will explain the type of eczema and the recommended treatment options.
Treatment Goals for Eczema
The main goals of eczema treatment are to reduce inflammation, relieve itching, and prevent flare-ups. Eczema treatments focus on managing symptoms and improving the skin’s appearance. Doctors may recommend different approaches based on the severity of the eczema, whether the person is experiencing a flare-up or is in remission, and how the condition is affecting their quality of life.
Topical Treatments for Eczema
One of the most common treatments for eczema is the use of topical medications. These are applied directly to the skin and can help manage inflammation and itching. There are several types of topical treatments that doctors commonly prescribe.
Topical Steroids
Topical steroids are the most commonly prescribed treatment for eczema. They come in different strengths, from mild to strong. Doctors typically recommend starting with the lowest-strength steroid to minimize potential side effects. Topical steroids help reduce inflammation and relieve itching. They can be used on the affected areas of the skin. However, doctors will advise on how long to use these creams or ointments to avoid side effects like thinning of the skin.
Topical Calcineurin Inhibitors
Topical calcineurin inhibitors are non-steroidal medications that can help reduce inflammation. They are often prescribed when steroid creams are not effective or when there is concern about long-term steroid use. These medications work by inhibiting the activity of certain immune system cells that cause inflammation. Doctors may prescribe these for sensitive areas of the skin, such as the face or around the eyes.
Topical Phosphodiesterase-4 Inhibitors
A newer class of medications, topical phosphodiesterase-4 (PDE-4) inhibitors, help reduce inflammation by controlling the activity of certain enzymes. They are applied directly to the skin and can be effective in managing mild to moderate eczema. A commonly used PDE-4 inhibitor for eczema is crisaborole. Doctors may recommend this treatment for people with mild eczema or those who have not responded to other treatments.
Moisturizers and Emollients
Moisturizers and emollients are essential in eczema treatment. These products help hydrate the skin, prevent dryness, and form a barrier to protect the skin from irritants. Doctors recommend using moisturizers regularly, especially after bathing, to lock in moisture and keep the skin hydrated. Emollients can also soothe the skin and reduce the risk of flare-ups. It’s important to choose fragrance-free products, as fragrances can sometimes irritate sensitive skin.
Systemic Treatments for Eczema
If eczema is severe or does not respond to topical treatments, doctors may recommend systemic treatments. These medications work throughout the body to help control inflammation and immune system responses. Systemic treatments are typically used when eczema affects large areas of the body or when the condition significantly impacts a person’s quality of life.
Oral Steroids
Oral steroids are stronger than topical steroids and are used for short periods during severe eczema flare-ups. They help reduce inflammation throughout the body and can provide quick relief. However, oral steroids can have side effects when used long-term, such as weight gain, increased blood sugar, and bone thinning. Doctors only prescribe oral steroids for a short duration to avoid these side effects.
Antihistamines
Antihistamines are commonly used to treat the itching associated with eczema. They work by blocking histamines, which are chemicals released during an allergic reaction and can cause itching. Some antihistamines can make people drowsy, which may be helpful if itching is disrupting sleep. While antihistamines can provide temporary relief, they are not a long-term solution for eczema treatment.
Immunosuppressive Medications
Immunosuppressive medications are prescribed for people with severe eczema who have not responded to other treatments. These medications work by suppressing the immune system’s activity, which can help control the inflammation caused by eczema. Doctors may prescribe oral medications like methotrexate, cyclosporine, or azathioprine, or may suggest biologic therapies that target specific immune system components.
Biologic Therapies for Eczema
Biologic therapies are a newer class of treatments for eczema. These treatments are often used for people with moderate to severe eczema that has not responded to other treatments. Biologics are administered through injections or infusions and work by targeting specific molecules in the immune system that cause inflammation in eczema. Dupilumab is one of the most commonly prescribed biologics for eczema. It is often used when other treatments have not been effective.
Doctors may recommend biologic therapies for people with chronic eczema or those who experience frequent flare-ups. While biologics are generally well-tolerated, they may have side effects, such as headaches, sore throat, or increased risk of infections. It is important for patients to discuss these risks with their doctor before starting biologic treatment.
Light Therapy for Eczema
Light therapy, also known as phototherapy, is a treatment that uses ultraviolet (UV) light to reduce inflammation and control eczema symptoms. It can be an effective option for people with moderate to severe eczema who do not respond well to topical or oral treatments. Phototherapy is typically administered in a doctor’s office or clinic, where the patient is exposed to controlled doses of UV light.
There are two types of light therapy commonly used for eczema treatment:
Narrowband UVB Phototherapy
Narrowband UVB therapy involves using UV light with a specific wavelength that targets the immune system and reduces inflammation in the skin. This type of therapy is typically done in several sessions over weeks or months, depending on the severity of the eczema. It is usually recommended when other treatments have not been successful.
PUVA Therapy
PUVA therapy combines ultraviolet A (UVA) light with a medication called psoralen, which makes the skin more sensitive to light. The patient takes psoralen orally or applies it to the skin before being exposed to UVA light. PUVA therapy can be effective for severe eczema, but it requires careful monitoring due to potential side effects, including an increased risk of skin cancer with long-term use.
Lifestyle Changes and Eczema Management
In addition to medical treatments, doctors may suggest certain lifestyle changes to help manage eczema. These changes focus on preventing flare-ups and improving overall skin health.
Avoiding Triggers
Certain environmental factors can trigger eczema flare-ups. These triggers may include allergens like pollen, dust mites, pet dander, or certain foods. Irritants such as harsh soaps, fragrances, or extreme temperatures can also worsen eczema symptoms. Doctors will work with patients to identify their specific triggers and suggest ways to avoid them. This may include using gentle, fragrance-free products, wearing soft fabrics, and keeping the home environment clean and allergen-free.
Bathing and Skin Care Routine
Proper skin care is an essential part of managing eczema. Doctors often recommend short, lukewarm baths instead of hot showers, as hot water can dry out the skin. After bathing, it is important to gently pat the skin dry with a towel and immediately apply a moisturizer to lock in moisture. Doctors will also recommend using mild, non-irritating soaps and cleansers that are free of fragrances and harsh chemicals.
Stress Management
Stress can be a significant trigger for eczema flare-ups. Managing stress through relaxation techniques like deep breathing, yoga, or meditation can help reduce the frequency and severity of flare-ups. Doctors may recommend stress-reducing practices to help people with eczema maintain better control over their condition.
Conclusion
Eczema is a challenging condition that requires ongoing management. While there is no cure, doctors have a range of treatment options to help control symptoms, reduce flare-ups, and improve the quality of life for those living with eczema. Treatments may include topical medications, systemic therapies, biologics, light therapy, and lifestyle changes. Working closely with a doctor to develop a personalized treatment plan is crucial for managing eczema and preventing its impact on daily life.
Related topics
