Eczema (Atopic Dermatitis)

Treatment choices depend on symptoms, age, and general health as well as how severe the condition is.

There is no cure for atopic dermatitis. Treatment aims to reduce itching and skin inflammation, keep the skin moist, and prevent infection.

In severe cases, medication might be prescribed, such as:

• Antihistamines. These medicines, taken by mouth, can help reduce itching. Some examples include diphenhydramine and hydroxyzine. They may cause drowsiness, though some newer antihistamines don’t.

• Steroid creams. Applied to the skin, these help ease inflammation, itching, and swelling. Many topical steroids are available in different strengths. But if overused, they can cause skin thinning and discoloration.

• Systemic corticosteroids. These medicines are used for severe cases to ease inflammation, which can relieve itching. They are available as a pill, liquid, or shot. These steroids have serious side effects from long-term use, so they're used only for a short time to stop a flare-up.

• Oral antibiotics. Scratching the affected skin can bring bacteria to the area, which can lead to infection. Antibiotics kill bacteria that cause infections. 

• Phototherapy. Two types are used: ultraviolet (UV) light therapy and PUVA (chemophototherapy). Light therapy uses UV light of certain wavelengths to target the immune system, stopping the responses that lead to inflammation. PUVA therapy combines medicine and phototherapy. Patients should weigh the risks and benefits of light therapy with their healthcare provider. 

• Topical calcineurin inhibitors. These are nonsteroidal medicines applied to the skin. They stop a part of the immune response that causes redness and itching.

• Cyclosporine. This medicine is used to treat atopic dermatitis that doesn’t respond to other treatments. It works by suppressing the immune system, stopping it from overreacting, and it helps prevent flare-ups. But it has many side effects.

• Methotrexate. This is another immunosuppressive medicine that can be used to manage atopic dermatitis long term. But one possible side effect is liver damage.

• Barrier restoration creams. Similar to moisturizers, they help repair the skin and provide moisture. 

• Topical PDE4 inhibitor. This medicine blocks an enzyme that plays a role in causing inflammation. It is put on the skin, often twice a day.

• Biologic medicines. Several injectable and oral medicines are now available. These medicines are expensive and need to be monitored by a healthcare provider, but they can be very effective.