photo of woman applying cream to hand

There are lots of treatments to ease atopic dermatitis, better known as eczema. These include topical creams, gels, ointments, shots, pills, light treatment, and behavioral therapy.

But treatments only work well if you take them regularly and correctly. Because eczema is chronic, meaning you can have flare-ups over the course of your lifetime, it’s important to form good habits to help you stick to your treatment in the long-term. Poor adherence, or not sticking to your treatment plan, is a major barrier in treating eczema, and it’s a big reason it can be difficult to control.

Why Do People Have Trouble Sticking to Treatment?

There are lots of reasons it can be a challenge to stay with your eczema treatment, including:

  • Feeling like your medication isn’t working
  • Inconvenience
  • Fear of side effects
  • Forgetfulness
  • Cost of treatment
  • Lack of trust in your doctor
  • Dislike of your medication
  • Lack of understanding of your eczema or the treatment
  • If your child has eczema, difficulty giving treatment if they are uncooperative

Simply knowing and acknowledging what the challenge is for you can be a big first step.

If You Feel Like Your Medication Isn’t Working

Your lifestyle can have a big effect on whether your treatment is working. If you smoke, for example, that might be triggering flare-ups and counteracting the effects of your medication.

Other tips to ease your symptoms and help your treatment do its job include:

  • Using a humidifier
  • Using warm water to bathe instead of hot
  • Using mild soap, if any, and moisturizing often
  • Wearing cotton and avoiding wool, silk, and synthetic fabrics 
  • Being conscious of stressors in your life, which can make you more prone to flare-ups

Remember that if you’re not sticking to your treatment exactly how it’s prescribed, it won’t work as well as it’s supposed to. It’s better to get into good habits with gentle treatments than to escalate to the more powerful ones that can have more side effects and be more expensive.

If you feel like you’re taking your medication as often as you’re supposed to but it still isn’t working as well as you’d like, you can talk with your doctor to see about making a change.

Tips for Remembering Your Treatment

If you’re having trouble remembering to apply your treatment or take your medication, there are several tips that can help. These include:

  • Keeping a log or diary to track when you take your treatment, perhaps on your phone, on a wall calendar, or in a notebook in a place you look at regularly
  • If you’re taking oral medication, using a pill organizer and keeping it somewhere visible
  • Putting a reminder sticky note somewhere you can’t miss it, like on your doorknob, bathroom mirror, or computer screen

If your medication is taken or applied every day or twice a day, the key is to make it part of your daily routine, like brushing your teeth. You might even put your moisturizer and topical cream right next to your toothpaste. The fewer extra steps you have to remember, the better.

For some people, it can be very helpful to set alarms on your phone. You can ask a friend or loved one to help you do this if you’re not sure how. This might involve multiple alarms, depending on your eczema:

  • Daily or twice-daily alarms to take medications or apply creams, ointments, or moisturizers 
  • Weekly or twice-weekly alarms to take dilute bleach baths to prevent infections
  • Biweekly alarms for taking biologics or other injectable medications 
  • Alarms or calendar alerts for ordering more medicine before you run out

Fear of Needles

If you need injectable treatments, you might have trouble sticking to your medication due to fear or discomfort with needles. This is very common. Ask a friend or family member if they can give you your medicine, or you can schedule in-office visits to have a nurse do it.

If you choose to do your injections at home, there are some tips to help ease your discomfort:

  • Once your injectable pen or syringe is in the right spot, look away from the needle
  • Take a big breath in before pushing down, then slowly breathe out
  • Distract yourself by wiggling your toes, listening to music, or talking with someone during the injection
  • Practice deep, measured breathing
  • Ask your doctor for numbing cream to use when you do your injections

If Your Child Has Eczema

If you have a child with eczema, it can be a different kind of challenge to help them remember to take their medications and to make the process stress-free.

Use a reward system like stickers or treats when your child takes their medicine, and give them lots of positive reinforcement. If they are uncomfortable putting on topical medications, or if they have severe eczema and need injections, distraction is key. Some ideas for distraction include:

  • For infants, mirrors, rattles, music, pacifiers, or other comfort objects
  • For toddlers or preschoolers, pinwheels, bubbles, kaleidoscopes, singing, playing peek-a-boo, or using puppets
  • For older children, play dough, stickers, electronic devices, counting, or being silly
  • For adolescents, video or computer games, music, pets, or board games

For oral medications, you can make things interesting for small children by putting food coloring drops in their medicine, adding something tasty to it, like chocolate syrup, or mixing it into their food. Just make sure they get all of it.

Ask for Help

Your doctor can play a big role in holding you accountable. Schedule regular follow-up visits to keep them updated on how things are going. Ask if these appointments can be done over the phone or via video chat, which can be cheaper and easier than having to come into the office frequently. Research shows that people stick better to treatment when they know they are seeing their doctor soon. These visits also help you establish trust with your doctor.

Some people with eczema find their topical medication unpleasant, for example because it’s too messy or feels greasy. Ask your doctor if there’s a different kind of cream or gel available that will be more comfortable for you to use.

If you’re not confident that you’re applying your medication correctly, ask your doctor to refer you to a workshop or to talk with a nurse who can show you exactly how it’s done. Make sure you don’t leave your doctor’s office until you know exactly how often to apply treatments.

You can also ask them to print out a patient-friendly list of guidelines for you, or you can find one online. These give you information on what kinds of habits to use depending on how your skin is doing, whether it’s clear, severely itchy, or anywhere in between.

Be a Self-Advocate

If you’re having trouble sticking to your treatment for other reasons, speak up. If you aren’t connecting with your doctor, you can call the office and ask to start seeing a different one. If you aren’t sure that you trust what your doctor is telling you, it’s OK to seek a second opinion.

If cost is an issue, talk with your doctor or pharmacist about options for reducing the financial burden. If you’re taking brand-name medication, ask to switch to the generic version. You can also call the manufacturer of the drug to see if they have an assistance program. These can sometimes significantly reduce the cost of your medication.

Besides forming good habits and using technology to help you stay on track, taking control of your care and asking for help when you need it can go a long way in motivating you to stay on top of your eczema.

Show Sources

Photo Credit: Prostock-Studio / Getty Images

SOURCES:

Advances in Experimental Medicine and Biology: “Adherence in Atopic Dermatitis.”

American Journal of Clinical Dermatology: “Increasing Adherence with Topical Agents for Atopic Dermatitis.”

Cleveland Clinic: “Eczema,” “Trypanophobia (Fear of Needles).”

Cutis: “A Review of Patient Adherence to Topical Therapies for Treatment of Atopic Dermatitis.”

Dermatology and Therapy: “Tolerability of and Adherence to Topical Treatments in Atopic Dermatitis: A Narrative Review.”

Mayo Clinic: “Atopic Dermatitis (Eczema).”

Nursing: “Using Distraction Techniques with Children.”